Does maximum short-term electric stimulation cause contraction of the pelvic floor muscles?
Martan, A.; Halaska, M.; Masata, M.; Voigt, R.; Vering, A.
Ceska Gynekologie 62(2): 64-67
1997
ISSN/ISBN: 1210-7832 PMID: 9296794 Document Number: 480676
Electric stimulation is successfully used in the treatment of the stress and urgent type of incontinence. Electric stimulation of the muscles of the pelvic floor causes reflex contraction of the striated peri- and paraurethral muscles and is associated with concurrent reflex inhibition of the detrusor muscle. The therapeutic results depends greatly on the total or at least partially preserved innervation of the muscles of the pelvic floor by the pudendal nerve. One of the possible stimuli of the pelvic floor muscles is maximal electric stimulation (MES) and the objective of our study was to evaluate the effect of MES on the muscles of the pelvic floor or to detect possible changes by US and urodynamic examination. The study comprised women with the stress type of incontinence (GSI). The group was formed by 40 women with GSI, 20 were subjected to US examination and urodynamic examination (n = 20). The group of subjects subjected to urodynamic examination was extended to 40 (n = 40). For electrostimulation a Conmax apparatus was used. The applied frequency was 20 Hz, the amplitude from 0 to 90 mA (grades 0.6), pulse duration 0.75 ms. During the cystometric examination the authors recorded a significant increase of the maximal urethral closure pressure (MUCP), prolongation of the functional (FUL) and anatomical length (AUL) of the urethra during MES. During US examination the authors recorded a significant diminution of the gamma angle, a reduction of the mobility of the UV junction and prolongation of the anatomical length of the urethra during MES. From the investigation ensues that the pelvic floor muscles are contracted during MES and those changes contribute to an increase of the muscular tonus and contracting capacity of the muscles of the pelvic floor and thus cause among other things elevation of the neck of the urinary bladder. The elevation contributes to the normalization of the intraabdominal transmission of pressure to the proximal urethra and thus to treatment of the stress type of urinary incontinence.