電刺激法用於治療根除性攝護腺手術病人術後尿失禁療效-系統回顧及統合分析

許玄昀、吳敏瑞、陳進利、楊明昕、曹智惟

國防醫學院三軍總醫院外科部泌尿外科

Electrical Stimulation for Urinary Incontinence After Radical Prostatectomy: a systemic review and meta-analysis

Hsuan-Yun Hsu, Min-Jui, Wu, Chin-Li Chen, Ming‐ Hsin Yang, Chih‐Wei Tsao

Division of Urology, Department of Surgery

Tri-Service General Hospital, National Defense Medical Center

Purpose: Electro-stimulation (ES) and pelvic floor exercise training are prevention and treatment of urinary incontinence with low cost and risk. The aim of this study was to evaluate the effect of ES and PFMT.

Materials and Methods: We performed a meta-analysis of studies published in the MEDLINE, EMBASE, and Cochrane databases until December 2023. Studies comparing ES or ES+PFMT in patients’ urinary incontinence (UI) after RP. We use international Consultation on Incontinence Questionnaire-Short Form score (ICIQ-SF) score and subjective tools like pad test to evaluation the effect.

Results: The ICIQ-SF score were reported in three studies, the results showed that the combined effect size MD=-3.02, 95%CI (-4.31, -1.74), P<0.001. The reduction of ICIQ-SF score by receiving electrical stimulation and pelvic floor muscle training in the first month. A total of two studies reported the results of the 24-hour pad test after 1 month of treatment. The results showed that the combined effect size was SMD=-0.01, 95%CI (-1.38, 1.36), Z=0.02, P>0.05. The amount of leakage after 1 month of treatment was not significantly reduced by ES+PFMT, compared PFMT only.

Conclusions: In our study shown that ES+PFMT showed limited improvement about the urinary incontinence after prostatectomy. However, there is subjective improvement in patient incontinence. With different evaluation tool of incontinence in including studies, further studies are recommended for the effect of ES.