Electromagnetic stimulation of pelvic floor muscles in the treatment of urinary incontinence after radical prostatectomy: results of a prospective randomized controlled clinical study

Pavlov I.S., Bochkarev D.A., Akimova E.I., Kotov S.V.

1) Pirogov Russian National Research Medical University, Department of Urology and Andrology, Moscow, Russia; 2) Moscow Multidisciplinary Clinical Center «Kommunarka», Moscow, Russia

Objective. To evaluate the effectiveness and safety of extracorporeal electromagnetic stimulation (EMS) of pelvic floor muscles in patients with urinary incontinence after radical prostatectomy (RP). Materials and methods. A prospective randomized controlled clinical study was conducted involving 101 patients with urinary incontinence 3 months after RP. Patients were divided into experimental (n=51) and control (n=50) groups. In the experimental group, patients received a course of EMS at the Moscow Multidisciplinary Clinical Center «Kommunarka» using the Neuro-MSX device (8 sessions with frequency of 2–4 times per week, amplitude 30%, pulse frequency 50 Hz) in addition to Kegel exercises. The control group performed only Kegel exercises. Evaluation of the outcomes was conducted at 6 and 9 months after surgery using pad test, International Conference on Incontinence Short Form (ICIQ-SF), The Overactive Bladder Questionnaire (OAB-q), Quality of Life (QoL) from International Prostate Symptom Score (IPSS) questionnaires, and prostate specific antigen (PSA) level measurement. Results. Both groups were comparable in baseline clinical and demographic characteristics 3 months after surgery. Both groups showed significant improvements in all evaluated parameters. Statistically significant differences in treatment outcomes between groups were demonstrated at 6 months for the number of pads used per day (1 pad/day (1–1) vs. 1.5 pads/day (1–2), p<0.001) and for the amount of urine lost (14 g/day (4–50) vs. 32.5 g/day (15.25–55), p=0.034) with better results in the experimental group. By 9 months, these differences were leveled. Nocturia indicators (sum of scores for questions 4 and 5 of OAB-q) were significantly better in the experimental group both at 6 months (4 (3–4) vs. 4 (4–5), p=0.014) and at 9 months after surgery (3 (3–4) vs. 4 (2.25–5), p=0.016). No significant differences in PSA level and biochemical recurrence rate were found between groups, confirming the oncological safety of the method. Conclusion. Extracorporeal electromagnetic stimulation of pelvic floor muscles accelerates the recovery of urinary continence after radical prostatectomy, demonstrates sustained efficacy in reducing nocturia, and is oncologically safe. It is recommended to include EMS course in rehabilitation program of patients after RP for faster continence recovery and quality of life improvement.

Keywords

About the Authors

Corresponding author: I.S. Pavlov – Assistant of the Department of Urology and Andrology, Russian National Research Medical University named after N.I. Pirogov, Ministry of Health of Russia, Moscow, Russia; e-mail: dr.pavlov.urology@gmail.com

Similar Articles