Combined vaginal pelvic floor electrical stimulation (PFS) and local vaginal estrogen for treatment of overactive bladder (OAB) in perimenopausal females. Randomized controlled trial (RCT)

OBJECTIVE: To evaluate the efficacy of combined vaginal PFS & local vaginal estrogen in treatment of female OAB.

MATERIALS AND METHODS: This is an (RCT) carried out on 315 perimenopausal females with OAB who were randomly allocated into 3 equal groups. Group A underwent PFS using vaginal probes twice weekly for 12 sessions. Group B received local vaginal estrogen, while group C received both PFS and local estrogen. All patients were evaluated by a voiding diary, quality of life questionnaire (QOL), vaginal examination, urine analysis, blood sugar, ultrasonography, and urodynamic study before and after therapy. Patients were followed up 1 week, 3, and 6 months post-therapy. The analyzed variables included day and night time frequency, incontinence episodes, urgency, (QOL), detrusor overactivity (DOA), and functional bladder capacity (FBC). Outcome measure was urge incontinence.

RESULTS: Within each group there was a statistically significant improvement in all variables after treatment. Improvement of urgency was better in group C than groups A and B (P 0.000, 0.009). Improvement of incontinence was better in groups A and C than group B (P 0.005, 0.004). Follow up showed worsening of symptoms with in 6 months in all groups except incontinence in group C.

CONCLUSIONS: Vaginal PFS and estrogen found to be effective in treating OAB symptoms in perimenopausal females. Estrogen seems to augment the effect of PFS especially in treatment of urgency incontinence, and can delay its recurrence.

Urology. 2015 Jun 29. pii: S0090-4295(15)00593-2. doi: 10.1016/j.urology.2015.06.007. [Epub ahead of print]

Abdelbary A1, El-Dessoukey AA2, Massoud AM2, Moussa AS2, Zayed AS3, Elsheikh MG4, Ghoneima W4, Abdella R5, Yousef M5.

1 Department of Urology, Bani Swaif University, Bani Swaif, Egypt.
2 Department of Urology, Bani Swaif University, Bani Swaif, Egypt.
3 Department of Urology, Theodor Bilharz Research Institute, Cairo, Egypt.
4 Department of Urology, Cairo University.
5 Department Obstetric and gynecology, Cairo University.