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Efficacy of physical therapeutic modalities in women with proven bladder overactivity
Bary Berghmans1, Ernst van Waalwijk van Doorn, Fred Nieman
1Department of Urology, University Hospital Maastricht, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands. bary.berghmans@epid.unimaas.nl
Objective:
To assess the efficacy of physiotherapeutic treatment modalities in women with proven bladder overactivity.
Methods:
One hundred and twelve women received ambulatory urodynamics. Based on both urodynamic variables of ambulatory cystometry (ACM) and the micturition diary, the Detrusor Activity Index (DAI) for each patient was calculated. After randomization, 68 women with a DAI> or =0.50 were defined as having proven bladder overactivity. In a single blinded RCT patients were randomized over four treatment groups, i.e. lower urinary tract exercises (LUTE); office- and home-based functional electrostimulation (FES); office-based FES and LUTE; no treatment. Patients treated received nine treatment sessions, once weekly. The primary outcome variable was the DAI, measured before randomization and, as soon as possible within a maximum of 14 days after the end of the study period.
Results:
Intention to treat analysis in the group of 68 patients showed a statistically significant decrease of DAI-scores in the FES group (p=0.032) in comparison with no treatment, while this decrease was not statistically significant in the LUTE group (p=0.105) and the LUTE+FES group (p=0.672).
Conclusions:
Our conclusion is that, based on the DAI, in the homogeneous set of 68 patients, only FES seemed to be effective.