Re: [AF] Aparato de electroestimulación

m.carmen Gonzalez mcgonru10 en
Mie Nov 23 13:35:12 CET 2005

Hola a todos,

La electroestimulación se está usando para el
tratamiento de la incontinencia urinaria y fecal.
Adjunto algún artículo que habla de ello.
A Gil Bolaños.  AI Torres Costoso.
Síndrome de urgencia miccional
Fisioterapia. 2004;26:281-94.

Acta Chir Iugosl. 2004;51(2):49-51. Related
Sacral nerve stimulation.
Matzel KE, Stadelmaier U, Besendorfer M.

Chirurgische Klinik der Universitat Erlangen,
Erlangen, Germany.
The current concept of recruiting residual
function of an inadequate pelvic organ by electrostimulation
involves stimulation of the sacral spinal nerves
at the level of the sacral canal. The rationale for
applying SNS to fecal incontinence was based on
clinical observations of its effect on bowel
habits and anorectal continence function in urologic
patients (increased anorectal angulation and anal canal
closure pressure) and on anatomic considerations:
dissection demonstrated a dual peripheral nerve supply of the
striated pelvic floor muscles that govern these
functions. Because the sacral spinal nerve site is
the most distal common location of this dual nerve
supply, stimulating here can elicit both functions. Since
the first application of SNS in fecal incontinence in
1994, this technique has been improved, the patient selection process modified, and the spectrum of
indications expanded. At present SNS has been applied
in more than 1300 patients with fecal incontinence limited.


Urologe A. 2005 Jan;44(1):33-40.  
[Electrostimulation in therapy of postoperative
urinary incontinence. Therapeutic value for
quality of life]

[Article in German]
Hoffmann W, Liedke S, Dombo O, Otto U.
Klinik Quellental, Hartenstein GmbH, Bad Wildungen. en
Worldwide use of electrical stimulation for
therapy of postoperative incontinence is based on a few
prospective randomized controlled studies. We present
a three-arm prospective randomized study evaluating
physiotherapeutic pelvic floor training alone and
in combination with transanal or perineal electrical
stimulation. The study compared specific continence
training (CT) and a combination of CT with transanal
or perineal electrostimulation. The groups included 60
patients each and were analyzed with regard to
self-assessment, objective characteristics of
incontinence, standard quality of life questionnaire
(QLQ-C 30), and recorded data of the stimulation
device. The patients participated in a specific
inpatient rehabilitation program and were assessed
at the time of admittance, upon discharge, and again
after 3 months. Significant improvement could be
achieved in every group concerning urinary
incontinence and quality of life. Additional use
of electrical stimulation was significantly superior
to physiotherapeutic training alone. However, these
results could only be detected in a highly compliant
subgroup. Analysis of device data indicated a high
score of errors and lack of patient compliance.
Perineal electrical stimulation was better
accepted than transanal and showed less side effects and
better outcome in the characteristics of
incontinence.Improvement in the quality of life
was mostly achieved during the weeks of inpatient
rehabilitation. Electrical stimulation could not
improve quality of life items. Electrical
stimulation is an efficient instrument for treatment of
postoperative high-grade incontinence, however,
only with sufficient patient compliance. 

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