A predictive score index for the outcome of associated biofeedback and vaginal electrical stimulation in the treatment of female incontinence

Abstract

A group of 64 women with stress incontinence alone (20), urgency incontinence (7) and mixed incontinence (37) were treated during 12 sessions, each 20 minutes long, during 6 weeks with combined alternating biofeedback and intravaginal electrical stimulation. Of the patients 21 had a complete recovery, 20 recovered sufficiently to avoid other forms of treatment and 23 failed to respond to the treatment. Thus, the overall success rate for this treatment was 64%. Various physiological parameters were collected from each patient before the start of the treatment sessions. Patient age, estrogen status, detrusor hyperreflexia, intravaginal pressure, percent transmission of the abdominal pressure to the urethra, degree of intrinsic sphincter deficiency and compliance with therapy were significant factors affecting the success of treatment. A statistical analysis was performed on these measurements to generate a score index model capable of predicting the outcome of a treatment consisting of associated biofeedback and electrical stimulation. We present a reliable method for distinguishing between patients who will and will not respond to this form of treatment. The most significant variables predictive of a good reduction outcome are patient age, presence of estrogen, absence of detrusor instability and intrinsic sphincter deficiency, low urethral hypermobility and, most of all, compliance with treatment.