Sacral and Bladder Stimulation Synergistically Treat Post-Stroke Urgency Incontinence

To evaluate the clinical efficacy and safety of combined sacral magnetic stimulation (SMS) and bladder electrical stimulation (ES) in treating post-stroke urgency urinary incontinence (UUI).

We retrospectively enrolled 90 patients with post-stroke UUI, divided into ES, SMS, and SMS + ES groups (n = 30 each). Urodynamic parameters, voiding diaries, quality of life scales (ICIQ-SF, ICIQ-QoL, SAS), Patient Global Impression of Improvement (PGI-I), urinary tract infection (UTI) incidence, and overall response rates were compared before and 1 month after treatment.

The SMS + ES group demonstrated comprehensive therapeutic advantages. Urodynamically, this group showed significantly greater maximum bladder capacity (408.5 ± 70.1 mL), lower postvoid residual urine volume (75.2 ± 53.4 mL), and lower detrusor pressure at maximum flow (28.4 ± 6.5 cmH₂O) compared to single-therapy groups (all P < 0.01). Clinically, the combined group showed the most significant improvements in 24-h incontinence episodes, ICIQ-SF, ICIQ-QoL, and SAS scores (all P < 0.01), along with the best PGI-I scores. The UTI incidence was 3.3% in the SMS + ES group, significantly lower than the 13.3% in the ES group (P < 0.05). The overall response rate was 93.3% in the SMS + ES group, significantly higher than in the ES (66.7%) and SMS (73.3%) groups (P < 0.05).

Combined SMS and ES therapy synergistically improves storage and voiding function, alleviates anxiety, reduces UTI risk, and significantly enhances quality of life in post-stroke UUI patients, demonstrating superior efficacy over either therapy alone.