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Published on: January 10, 2013
Maximal functional electrical stimulation as a single treatment: is it cost-effective?
Marianne Fehrling1, Magnus Fall, Ralph Peeker
1Department of Urology, Sahlgrenska University Hospital, Göteborg, Sweden.
Scandinavian Journal of Urology and Nephrology
|April 25, 2007
Summary
Maximal functional electrical stimulation (MFES) for overactive bladder showed short-term improvement but unsatisfactory long-term results. Patient tolerance for high stimulation intensity is key for success, suggesting strict patient selection is necessary.
Area of Science:
- Urology
- Neuromodulation
- Pelvic Floor Disorders
Background:
- Maximal functional electrical stimulation (MFES) is used for overactive bladder (OAB).
- Optimal electrical parameters and treatment duration for MFES in OAB are not well-established.
- Previous studies suggest low stimulation intensity may lead to unsatisfactory outcomes.
Purpose of the Study:
- To evaluate the effectiveness of MFES using the highest tolerable amplitude for OAB treatment.
- To determine the long-term outcomes of MFES in patients with OAB.
Main Methods:
- Sixty OAB patients (29 female, 31 male) received 10 MFES sessions.
- Urodynamic assessment and 48-hour micturition charts were completed pre-treatment, immediately post-treatment, and 3 months later.
- Stimulation amplitude was gradually increased to the maximum tolerable level without causing painful discomfort.
Main Results:
- Nearly 50% of patients reported immediate improvement after MFES.
- Symptom improvement, including reduced micturition frequency and leakage episodes, was not sustained at 3 months post-treatment.
- Long-term outcomes were generally unsatisfactory, with no significant decreases in symptoms at the 3-month follow-up.
Conclusions:
- MFES can provide short-term symptom relief for OAB.
- Long-term efficacy of MFES for OAB appears limited.
- Patient's tolerance for high stimulation intensity and potential home treatment options may influence success. Strict patient selection criteria are recommended for future studies.
