Authors:
Fabiana Bianchi Perez
1
;
José Natal de Souza
2
;
Nathalia Cristina Rosa
2
;
Cristiano Jacques Miosso
3
and
Adson Ferreira da Rocha
3
Affiliations:
1
University of Brasilia, Brazil
;
2
University Alfredo Nasser, Brazil
;
3
University of Brasília at Gama, Brazil
Keyword(s):
Electrical Stimulation, Neurogenic Bladder Incontinence, Posterior Tibial Nerve, Parasympathetic System Inhibitor, Anticholinergic Syndrome.
Related
Ontology
Subjects/Areas/Topics:
Biomedical Engineering
;
Biomedical Equipment
;
Biomedical Instruments and Devices
;
Rehabilitation Technology
Abstract:
In a previous paper, we proposed a technique for the therapeutic use of Transcutaneous Electrical Nerve Stimulation (TENS) of the posterior tibial nerve. The goal was to treat patients with signs of urinary incontinence (UI) due to detrusor overactivity (DO). We now conduct a comparison between our proposed TENS technique and the most commonly used treatment against DO, namely the pharmacological therapy based on solifenacin succinate and oxybutynin hydrochloride. Our goal is to show that the TENS of the posterior tibial nerve treats UI associated with DO, as well or better than the pharmacological treatment, but without the adverse side effects of the drugs (the so-called cholinergic syndrome). Method: we applied the proposed posterior tibial nerve
TENS in 21 patients, including the TENS Burst anaesthetic current. We treated each patient in 10 sessions, 2 times per week, for 20 minutes each session. Each patient could control the current intensity, in order to keep it at comfortable
levels, and in order to still be able to move the halux, thus simulating the Babinski reflex. Results: we observed that with the proposed TENS approach and with the removal of the pharmacological treatment, the cholinergic syndrome symptoms disappeared after 3 days without drugs, whereas we attained the modulation of the non-inhibited detrusor contractions. Conclusion: this research provides evidence of the proposed TENS technique’s efficiency in eliminating the effects of the hyperactive bladder, while avoiding the symptoms of cholinergic syndrome associated to the more common pharmacological treatment. The statistical tests showed that the reductions of DO symptoms and of the cholinergic syndrome were significantly improved over the pharmacological treatment (p < 0.01). This improves patients’ life quality by reducing or eliminating the social discomfort and hygiene problems associated to UI while avoiding the cholinergic syndrome.
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