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ORIGINAL RESEARCH article

Front. Neurosci.
Sec. Autonomic Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnins.2024.1432616

Effect of intra-vaginal electric stimulation on bladder compliance of stress urinary incontinence patients: the involvement of autonomic tone

Provisionally accepted
Hui-Hsuan Lau Hui-Hsuan Lau 1Cheng-Yuan Lai Cheng-Yuan Lai 1Ming-Chun Hsieh Ming-Chun Hsieh 1Hsien-Yu Peng Hsien-Yu Peng 1Dylan Chou Dylan Chou 1Tsung-Hsien Su Tsung-Hsien Su 1Jie- Jen Lee Jie- Jen Lee 1Tzer-Bin Lin Tzer-Bin Lin 2*
  • 1 Mackay Medical College, New Taipei, Taiwan
  • 2 Graduate Institute of Biomedical Electronics and Bioinformatics,, National Taiwan University, Taipei, Taiwan

The final, formatted version of the article will be published soon.

    Objective: In addition to the well-established advantage that strengthened pelvic musculature increases urethral resistance of stress urinary incontinence (SUI) patients, intra-vaginal stimulation (iVES) is also shown to improve bladder capacity via the pudendal-hypogastric mechanism in pre-clinical studies. This study investigated, in the clinical scenario, whether iVES also benefits bladder storage of SUI patients by focusing on compliance, a viscoelastic parameter critically defining the bladder's storage function. Moreover, the potential involvement of stimulation-induced neuromodulation in the iVES-modified compliance was investigated by comparing therapeutic outcomes of SUI patients in response to iVES from trans-obturator tape (TOT) surgery, in which a midurethral sling was implanted without electric stimulation. Patients and methods: Urodynamic and viscoelastic data of 21 SUI patients treated with a regiment of a combination of iVES and biofeedback-assisted pelvic floor muscle training (iVES-bPFMT; 20-minute iVES and 20-minute bPFMT sessions, b.i.w., for 3 months. This regiment complied with the Ethics) and 21 SUI patients received a TOT implantation were retrospectively analyzed. Mean compliance (Cm), infused volume (Vinf), and threshold pressure (Pthr) of the pressure-flow/volume investigations were assayed.Results: Compared with the pre-treatment control, iVES-bPFMT consistently and significantly increased Cm (18/21;85%, p=0.017, N=21) and Vinf (16/21;76%, p=0.046; N=21) but decreased Pthr (16/21;76%, p=0.026, N=21). In contrast, TOT did not result in consistent or significant changes in Cm, Vinf, or Pthr (p=0.744, p=0.295, p=0.651, respectively; all N=21).Our results provide viscoelastic and thermodynamic evidence supporting an additional benefit of iVES-bPFMT to bladder storage of SUI patients via modifying bladder compliance that is possibly coming from the potentiated hypogastric tone, which did not occur in TOT-treated SUI patients.

    Keywords: viscoelasticity, Thermodynamic, Pudendal Nerve, Hypogastric nerve, intra-vaginal stimulation viscoelasticity, intra-vaginal stimulation Trial Registration: ClinicalTrials.gov (NCT02185235 and NCT05977231)

    Received: 14 May 2024; Accepted: 10 Jul 2024.

    Copyright: © 2024 Lau, Lai, Hsieh, Peng, Chou, Su, Lee and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tzer-Bin Lin, Graduate Institute of Biomedical Electronics and Bioinformatics,, National Taiwan University, Taipei, 10617, Taiwan

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