کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6175088 | 1252947 | 2016 | 10 صفحه PDF | دانلود رایگان |
ContextTranscutaneous electrical nerve stimulation (TENS) is a promising therapy for non-neurogenic lower urinary tract dysfunction and might also be a valuable option in patients with an underlying neurological disorder.ObjectiveWe systematically reviewed all available evidence on the efficacy and safety of TENS for treating neurogenic lower urinary tract dysfunction.Evidence acquisitionThe review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.Evidence synthesisAfter screening 1943 articles, 22 studies (two randomised controlled trials, 14 prospective cohort studies, five retrospective case series, and one case report) enrolling 450 patients were included. Eleven studies reported on acute TENS and 11 on chronic TENS. In acute TENS and chronic TENS, the mean increase of maximum cystometric capacity ranged from 69Â ml to 163Â ml and from 4Â ml to 156Â ml, the mean change of bladder volume at first detrusor overactivity from a decrease of 13Â ml to an increase of 175Â ml and from an increase of 10Â ml to 120Â ml, a mean decrease of maximum detrusor pressure at first detrusor overactivity from 18 cmH20 to 72 cmH20 and 8 cmH20, and a mean decrease of maximum storage detrusor pressure from 20 cmH20 to 58 cmH2O and from 3 cmH20 to 8 cmH2O, respectively. In chronic TENS, a mean decrease in the number of voids and leakages per 24Â h ranged from 1 to 3 and from 0 to 4, a mean increase of maximum flow rate from 2Â ml/s to 7Â ml/s, and a mean change of postvoid residual from an increase of 26Â ml to a decrease of 85Â ml. No TENS-related serious adverse events have been reported. Risk of bias and confounding was high in most studies.ConclusionsAlthough preliminary data suggest TENS might be effective and safe for treating neurogenic lower urinary tract dysfunction, the evidence base is poor and more reliable data from well-designed randomised controlled trials are needed to make definitive conclusions.Patient summaryEarly data suggest that transcutaneous electrical nerve stimulation might be effective and safe for treating neurogenic lower urinary tract dysfunction, but more reliable evidence is required.
Journal: European Urology - Volume 69, Issue 6, June 2016, Pages 1102-1111