MD Urological Department ASST Santi Paolo e Carlo Milan, Italy
Introduction: The international guidelines include conservative and surgical treatments for stress urinary incontinence on women. Extracorporeal magnetic stimulation (EMS) is a conservative option for pelvic floor disorders. MS is a non-invasive therapeutic device that interacts with the neuromuscular tissue through an electromagnetic field, thus inducing intense contractions that stimulate pelvic floor muscles. Recently, the TOP Flat Magnetic Stimulation (TOP FMS) has been developed as new generation of traditional magnetic chairs. This new technology generates electromagnetic fields with a homogenous profile optimized for the stimulation of the pelvic area, allowing greater recruitment of muscle fibres without creating areas of uneven stimulation intensity. We sought to assess the short-term outcomes, both subjective and objective, in women suffering from SUI. Methods: In this non-randomized trial, a clinical interview was performed to investigate the presence of isolated or predominant stress urinary incontinence (SUI), subsequently confirmed by a stress test. Urogenital examination was used to exclude significant prolapse (POP-Q stage >2 or higher). Patients could choose to receive the new treatment (eight sessions of 25 minutes of TOP FMS in one month) or home-based, unsupervised, non-personalized pelvic floor muscles training (PFMT) according to the International Urogynecological Association leaflets for one month. At baseline (T0) and at the end of the treatments (T1) the International Consultation on Incontinence Questionnaire-Short Form questionnaire (ICIQ-SF) and the Incontinence Impact Questionnaire (IIQ-7- SF) were administered. The stress test was performed again after treatment and the Patient Global Impression of Improvement (PGI-I) questionnaire was administered. Results: 50 patients were enrolled (1:1 allocation ratio). Improved PGI-I scores were reported by 72% intervention patients vs 20% controls (p < 0.001) after 1 month. According to the stress test at T1 (1 month), the objective cure rate resulted 40% for TOP FMS and 0% for PFMT (p < 0.001). Significant improvements were observed in the TOP FMS, IIQ-7 and ICIQ-SF scores (p < 0.05) but not in the FSFI-19 scores. No adverse events were reported either with TOP FMS or PFMT. Conclusions: The TOP FMS appears promising in patients with isolated or predominant SUI, compared to than unsupervised, non-individualized PFMT, in treating SUI in women. SOURCE OF Funding: None
.jpg "Serena Maruccia, MD (she/her/hers) photo")