Maximal functional electrical stimulation as a single treatment: is it cost-effective?

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Fehrling, MarianneGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences (author)

Maximal functional electrical stimulation as a single treatment: is it cost-effective?

Article/chapterEnglish2007

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2009-07-09
Informa UK Limited,2007

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LIBRIS-ID:oai:gup.ub.gu.se/43847
https://gup.ub.gu.se/publication/43847URI
https://doi.org/10.1080/00365590600917651DOI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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Objective. The ideal electrical parameters for maximal functional electrical stimulation (MFES) in the treatment of an overactive bladder have not yet been well established. It has been speculated that unsatisfactory results may be due to a low stimulation intensity and that the number of sessions may also be an outcome-determining factor. Herein, we present the results obtained in a group of consecutively treated patients who were given 10 sessions of MFES at the highest tolerable amplitude. Material and methods. A total of 60 patients (29 females, 31 males) with an overactive bladder were treated. All subjects underwent a urodynamic assessment and completed a 48-h micturition chart prior to treatment, immediately after the last session and 3 months after termination of treatment. The patients were thoroughly informed that the result of the treatment depended on the amplitude that they could endure; there was a gradual increase in amplitude to the maximum level that did not cause painful discomfort. Results. Immediately after termination of the stimulation, almost half of the subjects reported an improvement in their condition. However, few subjects experienced sustained symptom amelioration 3 months post-stimulation. Decreases in micturition frequency and the number of leakage episodes were noted immediately after cessation of treatment but these decreases were no longer significant 3 months post-treatment. Conclusions. In this series, although MFES was effective in the short term, the long-term treatment outcome was unsatisfactory. A critical review suggests that outcome success is proportional to the patient's ability and willingness to accept quite a high stimulation intensity or, alternatively, follow-up home treatment. Hence, the implementation of strict primary as well as secondary selection criteria can hopefully identify patients most suitable for MFES. Another lesson to be learnt is that the identification of crucial prerequisites of successful treatment is mandatory before embarking on controlled studies.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Urologi och njurmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Urology and Nephrology hsv//eng
Overactive bladder; electrical stimulation; urinary incontinence

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Fall, Magnus,1941Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xfalma (author)
Peeker, Ralph,1958Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xpeera (author)
Göteborgs universitetInstitutionen för kliniska vetenskaper (creator_code:org_t)

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In:Scand J Urol Nephrol: Informa UK Limited41:2, s. 132-137
In:Scandinavian Journal of Urology and Nephrology: Informa UK Limited41:2, s. 132-1370036-55991651-2065

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