Study design, materials and methods
This study consists of 100 women, complaining of increased bladder sensation and urgency (no overactive bladder) with or without incontinence as principal symptomatology between three and twelve months of evolution and who had not received previous pharmacological treatment, to which detailed history and complete urodynamic study was performed. All patients with urodynamic diagnosis of involuntary detrusor contractions were discarded from this study. Patients from Group-A (without previous treatment) was used as a control group (n = 50). Group-B patients received 18 sessions of medium frequency electrotherapy during 9 weeks, 2 weekly sessions. The study protocols were explained to patients and they were allowed to choose between complete the full treatment (2 weekly sessions during 9 weeks) or wait until the study will finish if they can complete the protocol and these patients remain to be the control group until complete it.
The following analysis pertains to intervention group patients. Mean age was 52,37 years +- 16, 56 year (range 19-82). 80 patients (80%) complained of urgency, 78 (78%) of urge and mixed urinary incontinence, 68 cases of increased daytime frequency (68%) and 63 of nocturia (63%), 32 of patients complained of pain (53.1%) and 63 patients (63%) of voiding dysfunction (VD). On urodynamics testing, Urodynamic Stress Incontinence (USI) was diagnosed in 28 (28%) and it was found that none of the suffered involuntary detrusor contractions. The distribution of both groups is homogeneous and meet the normality criteria.
Treatment with medium frequency electrotherapy, interferential currents between 5500Hz and 8500Hz, was performed using transvaginal application. The frequency was increased progressively over the first six sessions (twice a week), starting with a frequency of 5500Hz until reaching a frequency of 8500Hz, which remained until the end of treatment. At the end of the treatment performed in group B, the complete clinical history was made again to all patients.
All patients signed an informed consent before inclusion in the study, as established by the Declaration of Helsinki. Statistical analysis of data was performed using SPSS 22.0 for Windows. The statistical methods used were descriptive statistics for quantitative variables (DESCRIPTIVE) and descriptive statistics for qualitative variables (FREQUENCIES), contingency tables for the relationship between qualitative variables (CROSSTABS, chi-square test and T-student). A p<0.005 was considered significant.
Interpretation of results
No studies have found using medium frequency electrotherapy for the treatment of increased bladder sensation, urgency and LUTS. The studies founded were performed with low frequency electrotherapy. In our case, the results have shown great efficacy, using medium frequency electrotherapy in patients with increased bladder sensation, urgency and LUTS. Our experience supports that the choice of stimulation parameters should be individualized for each patient depending on the type of incontinence and muscle involvement. The parameters do not be the same in case of treatment of striated muscles (pelvic floor muscles) or smooth muscle (detrusor muscle of the bladder). Physiotherapy approach using sedative type electrotherapy performs well without side effects. The results of therapy we are using are encouraging not only for the effectiveness itself, which is comparable to that of the best-known conservative treatments, but by the absence of side effects resulting from this type of therapy.