Maximum perineal stimulation. A controlled study

Abstract

Previous workers have debated the value of maximal perineal stimulation (MPS) in the treatment of urinary incontinence in women. In order to assess the efficacy of this simple technique a prospective study was undertaken on 107 consecutive incontinent women. They included those with stress, urge and mixed patterns of leakage. Patients were placed at random into treatment and control groups. All underwent clinical assessment, urodynamic study and a single session of pelvic floor re-education with measurement of pelvic contraction and cystoscopy. Those in the treatment group were given MPS using monophasic square wave pulses while under anaesthesia. Independent follow-up assessment was performed 6 and 12 weeks after treatment. Of the 107 patients 94 completed the trial. Forty-five were treated and 49 acted as controls. Analysis of age, parity, duration and severity of incontinence showed that randomisation had produced comparable results between the treated and the control groups. Sixty per cent of the treatment group and 66% of the control group had significant symptomatic improvement. Pelvic floor function was re-assessed, using a perineometer, and found to be more efficient, having increased equally in both groups. Both groups of women improved irrespective of the pattern of incontinence. This suggests that MPS does not contribute to the management and that a single physiotherapy session with skillful counselling can produce beneficial results in women with all types of urinary incontinence.