Estudo comparativo randomizado do tratamento da bexiga hiperativa com eletroestimulação vaginal e eletroestimulação transcutânea do nervo tibial posterior(PTNS)
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2012-02-15
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Universidade Federal de Goiás
Resumo
INTRODUCTION: The overactive bladder syndrome (OAB) is a lower urinary tract
pathology that negatively affects the quality of life (QOL) of women whose main
symptom is your definition for urinary urgency, with or without incontinence usually
accompanied by urinary frequency and nocturia in the absence of metabolic,
infectious or local. The diagnosis of BH is defined from the clinical symptoms, but the
voiding diary and urodynamic studies are good tools for objective evaluation of this
pathology. There are several forms of treatment for OAB, are the main
pharmacological and physical therapy, physical therapy has been being considered
an important option in a clinical setting. OBJECTIVES: to do a systematic review
article about physical therapy in the treatment of female miccional urgency, to
evaluate and compare the effects, discomfort and improvement in quality of life
(QOL) of vaginal electrostimulation and percutaneous tibial nerve stimulation (PTNS)
in women with overactive bladder. METHODS: We conducted a comparative,
prospective, randomized trial of physiotherapy in the sector of the Hospital Materno
Infantil (HMI) in Goiânia-GO, from march 2010 to august 2011. We randomized 40
women with urodynamic diagnosis of detrusor overactivity, mixed incontinence with
predominant symptoms of overactive bladder or urinary urgency only in two groups:
vaginal electrical stimulation (n=20) and PTNS (n=20), being held 10 sessions in
each group. We used urodynamic studies, voiding diary and QoL questionnaire of
King's Health Questionnaire (KHQ) before and after the two procedures, and then
visual analog scale. Statistical analysis used: Fisher exact tests, chi quadratic, U
Mann Whitney and Wilcoxon tests with a significance level of 0.05. RESULTS: In
voiding diary was a reduction in urinary frequency, urge incontinence, nocturia and
urgency in both groups. The urgency was present in all women and disappeared in
90% in the PTNS group (p<0.001) and 80% in vaginal electrical stimulation
(p<0.001). According to urodynamic evaluation, the group of vaginal
electrostimulation showed disappearance of detrusor overactivity in 60% (p=0.005)
and PTNS in 75% (p= 0.002). The urodynamics showed significant differences in
some parameters analyzed within each specific group and to compare the two
groups was not observed differences. The scale and the KHQ domains of the two
procedures had similar results as physical therapy to improve QOL, but no significant
difference between them. In relation to the discomfort of procedures, PTNS in 80% of
women reported no discomfort and 80% reported vaginal electrostimulation mild to
moderate discomfort (p<0.001). CONCLUSION: There was no significant difference
in the effects and QOL between the vaginal electrical stimulation and PTNS. The
PTNS promoted less discomfort for women.
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Citação
BERQUÓ, Marcela Souza. Randomized comparative study of the treatment of overactive
bladder with vaginal electrical stimulation and percutaneous tibial nerve stimulation (PTNS). 2012. 99 f. Tese (Doutorado em Ciencias da Saude) - Universidade Federal de Goiás, Goiânia, 2012.