To assess the short-term efficacy of electrical pudendal nerve stimulation (EPNS) versus pelvic floor muscle training (PFMT) plus transanal electrical stimulation (TES) for the early treatment of post-radical prostatectomy urinary incontinence (PRPUI) and explore its mechanism of action.
A parallel designed randomized controlled trial was conducted at a research institute and a university hospital. Ninety-six PRPUI patients were allocated to EPNS group (64 cases) and PFMT+TES group (32 cases) and treated by EPNS and biofeedback-assisted PFMT plus TES, 3 times a week for 8 weeks, respectively. Outcome measurements were improvement rate, scores of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and the number of used diapers.
After 24 treatments, the efficacy rate of 68.7% in EPNS group was significantly higher than that of 34.4% in PFMT+TES group (P=0.005). The ICIQ-UI SF score, and urine leakage amount score, diaper score, symptom and quality of life improved significantly in both groups and showed Therapy x Treatment interaction, and the above scores in EPNS group were significantly lower than these in PFMT+TES group. Perineal ultrasonographic recordings showed that PFM movement amplitude during EPNS (≥1- <3 mm) was similar to that during PFMT, however, PFM movement EMG amplitude was significantly higher during EPNS than during PFMT (P<0.001).
EPNS is more effective than PFMT+TES in short-term (8 weeks) treatments of early urinary incontinence after radical prostatectomy. Its mechanism of action is that EPNS can excite the pudendal nerve and simulate PFMT.
Urology. 2021 Jul 17 [Epub ahead of print]
Xiaoming Feng, Jianwei Lv, Meixian Li, Tingting Lv, Siyou Wang
Clinical Research Section, Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China.; Shanghai University of Traditional Chinese MedicineYueyang Hospital of Traditional Chineseand Western Medicine, Shanghai, China., Department of Urology, Shanghai Jiaotong University School of Medicine Renji Hospital, Shanghai, China., Shanghai University of Traditional Chinese MedicineYueyang Hospital of Traditional Chineseand Western Medicine, Shanghai, China., Clinical Research Section, Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China.; Shanghai University of Traditional Chinese MedicineYueyang Hospital of Traditional Chineseand Western Medicine, Shanghai, China. Electronic address: .