55: Intravesical electrical stimulation (IVES) treatment for overactive bladder syndrome (OAB): A pilot study

Abstract

Objectives: To assess the efficacy of Intravesical Electrical Stimulation (IVES) with a novel technique in a pilot study on women with urinary urgency and/or urgency urinary incontinence. Methods: After the study was approved by the Loma Linda University Medical Center Institutional Review Board, IVES was performed in women with OAB-wet (episodes of urinary urgency incontinence ≥3 in 3-day voiding diary) or OAB-dry (frequency ≥ 8/day or nocturia ≥ 2/night) who failed prior medical treatment. Patients with neurogenic bladder, stress predominant urinary incontinence, or other recent OAB treatments were excluded. An 8 Fr detruset™ IVES catheter (EMED, El Dorado Hills, CA) was used to deliver electrical stimulation into the bladder. Each therapy session lasts 20 minutes and all subjects received biweekly treatment for 4 weeks. The primary outcome was PGI-I (Patient Global Impression of Improvement, 1-7 with 1 being the best) at 3 months after treatment. The secondary outcomes included visual analog scale (VAS,0-10 with 10 being the worst) of symptom severity, validated standard questionnaires (OAB-q SF, PFDI, and PFIQ), reduction in urinary frequency and urgency incontinence episodes (average per day) in 3-day voiding diary, and adverse effects. Comparative statistics were performed using paired t-test or non parametric Wilcoxon test with a p value of <0.05 considered statistically significant. Results: A total of 16 patients were included for analysis. The mean age was 60.8 years (range 29-74). All subjects completed the 4-week treatment and were followed up for 3 month after treatment for evaluation. Fourteen (88%) subjects reported improvement on PGI-I (11 with “a little better”, 2 with “much better”, and 1 with “very much better”). The OAB-q SF scores in both symptom severity and quality of life showed statistically significant improvement (Table1). Patients also demonstrated a significant improvement in the pelvic floor distress inventory in the domain of pelvic organ prolapse as well as urinary distress. There was an improvement in quality of life pertaining to bladder symptoms. The 3-day voiding diary results showed decrease of urinary frequency from 10.7±4.2 at baseline to 8.6±2.6 (P=0.01) at 3 months after treatment. No pain was reported during the treatment session. There was one episode of UTI throughout the study and no other adverse events were reported. Conclusions: Intravesical electrical stimulation is a safe and effective novel treatment for overactive bladder syndrome. Larger and comparative studies are needed to investigate its potential for long-term treatment. (Table Presented).