Intravesical Electrical Stimulation Treatment For Overactive Bladder: An Observational Study

Purpose: Intravesical electrical stimulation (IVES) treatment has been successfully used to treat neurogenic bladder. We report the results of an observational study regarding the use of IVES for women with overactive bladder (OAB) syndrome and/or urgency urinary incontinence (UUI).Materials and Methods: IVES was performed in women with OAB (defined by frequency >= 8/day, nocturia >= 2/night, or >= 3 episodes of UUI on 3-day voiding diary) who failed prior medical therapy. Subjects underwent 4 weeks of treatment with an 8-Fr Detruset (TM) IVES catheter. Primary outcome was patient global impression of improvement scale (PGI-I) at 3 months. Secondary outcomes included visual analogue scale (VAS), Overactive Bladder Questionnaire Short Form (OAB-q SF), Pelvic Floor Distress Inventory (PFDI), Pelvic Floor Impact Questionnaire (PFIQ), reduction in frequency and UUI on voiding diary, and adverse effects. Analysis was done with paired t-tests and Wilcoxon signed rank tests.Results: Seventeen subjects completed the study. At 4 weeks post-treatment, 15 improved on PGI-I (11 subjects: 'a little better', 2: 'much better', 2: 'very much better'). There were significant improvements in symptom bother and health-related quality of life as measured by OAB-q SF and pelvic organ prolapse and urinary distress as measured by PFDI. Frequency decreased from 10.3 +/- 4.3 at baseline to 8.9 +/- 2.3 (p=0.04) at 3 months. No pain was reported during treatment. There was one urinary tract infection during the study period. No other adverse events were reported.Conclusions: IVES appears to be a safe and effective novel treatment for OAB. Larger comparative studies are needed to investigate its potential for long-term treatment.