Urinary Incontinence Clinical Trial
Official title:
The Effect of Pelvic Floor Muscle Training and Neuromuscular Electrical Stimulation on Urinary Incontinence and Quality of Life in Women With Spinal Cord Injury
The purpose of this study is to determine whether pelvic floor muscle training (PFMT) and intravaginal neuromuscular electrical stimulation (NMES) are effective in reducing urinary incontinence and improving quality of life in women with spinal cord injury (SCI).
SCI patients often experience neurogenic bladder dysfunction with neurogenic detrusor
overactivity or areflexic bladder. Due to this, 40-50 % of the SCI population suffers from
urinary incontinence, which often reduces the patient's quality of life.
In order to manage the neurogenic bladder dysfunction, SCI patients use specialized bladder
emptying methods, most frequently clean intermittent catheterization. To reduce the symptoms
of neurogenic detrusor overactivity and urinary incontinence in patients with a SCI, medical
anticholinergic therapy can be assessed, but the effect is sparse and many adverse effects
have been reported. Injection of Botulinum-A toxin in the bladder has shown great potential
in minimizing the symptoms of neurogenic detrusor overactivity and urinary incontinence,
though it is an expensive and invasive method that needs to be repeated due to its temporary
effect.
PFMT and NMES of the pelvic muscles are non-invasive and cheap treatments without side
effects and several studies have demonstrated the positive effect of intravaginal NMES and/or
PFMT on urinary incontinence in able-bodied women as well as women with neurological
disorders like multiple sclerosis.
Despite the fact that NMES of weak or paralyzed striated muscles has been used for decades in
patients suffering from SCI, to our knowledge, no study has previously investigated the
effect of PFMT and intravaginal NMES in women with SCI.
The aim of this study is to evaluate the effect of PFMT and intravaginal NMES on Urinary
Incontinence and Quality of Life in women with SCI. In particular, we will investigate the
potential additional effect of intravaginal NMES, when NMES is conducted in combination with
PFMT.
This study is designed as a randomized clinical trial, investigating the effect of PFMT alone
and in combination with intravaginal NMES. We will include 40 female patients with an
incomplete SCI and urinary incontinence. After physiotherapeutic guidance, the patients
perform PFMT or PFMT + NMES daily at home for 12 weeks with follow-up evaluations every
fourth week.
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