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Electrical stimulation with non-implanted electrodes for overactive bladder in adults.

Fiona Stewart1, Luis F Gameiro2, Regina El Dib3

  • 1Academic Urology Unit, University of Aberdeen, Foresterhill, Aberdeen, Scotland, UK, AB25 2ZD.

The Cochrane Database of Systematic Reviews
|December 10, 2016
PubMed
Summary

Electrical stimulation (ES) shows promise for overactive bladder (OAB) management, outperforming placebo, drug treatments, and pelvic floor muscle training (PFMT). However, low-quality evidence necessitates further research to confirm benefits and safety.

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Area of Science:

  • Urology
  • Neurology
  • Rehabilitation Medicine

Background:

  • Overactive bladder (OAB) is a condition with several management options, including electrical stimulation (ES) with non-implanted devices.
  • ES aims to inhibit detrusor muscle contractions, potentially reducing urinary frequency and urgency associated with OAB.

Purpose of the Study:

  • To evaluate the efficacy of non-implanted electrical stimulation (ES) for overactive bladder (OAB).
  • To compare ES against placebo, other active treatments, and ES combined with other interventions.

Main Methods:

  • Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
  • Inclusion of adult participants diagnosed with OAB, with or without urgency urinary incontinence (UUI).
  • Exclusion of trials focusing solely on stress urinary incontinence (SUI).

Main Results:

  • Moderate-quality evidence suggests ES improves OAB symptoms compared to pelvic floor muscle training (PFMT), drug treatment, and placebo/sham.
  • Low-quality evidence indicates ES may be more effective than no active treatment and beneficial when added to PFMT for UUI.
  • ES demonstrated a lower risk of adverse effects compared to tolterodine and oxybutynin.

Conclusions:

  • Electrical stimulation (ES) presents a promising treatment option for overactive bladder (OAB), showing potential benefits over existing therapies.
  • While ES appears effective and safe, the overall low quality of evidence necessitates high-quality, adequately powered trials for definitive conclusions.
  • Further research should focus on subjective outcomes, adverse effects, and long-term efficacy of ES in OAB management.