Conservative treatment of female stress urinary incontinence with functional electrical stimulation

Background: Treatment of stress urinary incontinence with functional electr ical stimulation (FES) is a recent and efficient method of conservative tre atment. Study design: Before treatment, examinations determining the type o f urinary incontinence should be made: patient history, pelvic and urologic examination, laboratory tests of urine, multi-channel urodynamic tests. Th e degree of urinary incontinence is assessed by pad tests. Only the patient s with moderate stress urinary incontinence without or with a mild utero-va ginal prolapse, are treated by FES. The parameters of stimulation: the impu lse is rectangular and biphasic, duration of impulse is 1 ms, frequency of impulse is 20 Hz, and intensity of current 35 mA. The chronic treatment wit h FES should be applied 1.5-2 h daily for 3 months. This long-term treatmen t requires appropriate motivation of the patient. Results: Three months aft er terminated treatment 56 of the total 111 patients (50.5%) were cured, in 26 (23.4%) the condition improved, whereas in 29 patients (26.1%) the trea tment failed. Conclusions: The efficiency of treatment depends on the patie nt selection, parameters of electrical stimulation, stimulator of the pelvi c floor muscles, mode of stimulation-chronic stimulation, and on motivation of the patient. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved .