Effectiveness of electrostimulation in treating stress urinary incontinence: a metanalysis
DOI:
https://doi.org/10.33233/fb.v23i1.4725Keywords:
electric stimulation; loss of urine; Physical therapyAbstract
Introduction: Electrical stimulation is recognized as one of the fundamental therapies in sphincter and perineal reeducation, by promoting muscle contraction and allowing the patient to become aware of himself. It induces the contraction of the MAPs until the voluntary contractile command is restored and gain of muscle strength, ensuring a smooth functioning of the striated fibers of the external urethral sphincter, providing urinary continence. Objective: To identify the most frequently used frequency in electrostimulation for the recovery of stress urinary incontinence (SUI) in women and men; to verify the effectiveness of electrostimulation in the treatment of stress urinary incontinence. Methods: A search was made in the databases National Library of Medicine (Medline), Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cochrane Library, Lilacs, Web of Science, Scopus, Cinahl and Sport Discus, with the descriptors urinary incontinence, electrostimulation and electrical stimulation, by randomized controlled trials (RCTs), which included studies with male and female patients of all ages with SUI who were submitted to electrostimulation, selected by the Jadad scale and evaluated the risk of by the Cochrane Collaboration tool. From the studies were extracted the age and sex of patients, n of the groups, frequency used in electrostimulation, duration of the session, number of sessions, duration of treatment, evaluation of SUI and result of SUI. The GRADE system was used to evaluate the level of evidence of the meta-analysis. Eight studies were analyzed using RevMan 5.3. Results: The frequency most frequently used in electrostimulation was 50 Hz in women and in men. A total of 172 RCTs were identified and 26 RCTs were reviewed and 8 RCTs were metanalyzed. Six RCTs were with women and presented heterogeneity (I2 = 48%), a reduction in SUI of -12.08 g, 95% CI -14.08 - 10.08 g, P < 0.00001. For men, 2 RCTs showed heterogeneity (I2 = 0%), reduction of SUI of -151.28 g, IC of -236.64 - 65.92 g, P < 0.0005. Conclusion: The most frequently used frequency in electrostimulation to recover the urinary continence of women with SUI and men with post-prostatectomy UI was 50Hz and was effective in the recovery of continence. However, attention is drawn to the results obtained with men, due to the very low level of evidence found.
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