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INVENTION
Russian Federation Patent RU2286183
METHOD overactive bladder
Name of the inventor: Ailamazyan Edward Karpovich (RU); Niauri Dariko A. (RU); Valery Lebedev (RU); Ziyatdinova Gülnar Myhmankulyevna (RU); Alexander Ivanov (RU)
The name of the patentee: "Center of transcranial electrostimulation" (RU); Institute of Physiology. IP Pavlova, Russian Academy of Sciences (RU); Saint Petersburg State University (RU)
Address for correspondence: 199034, St. Petersburg, nab. Makarova, 6 "Center of transcranial electrostimulation"
Starting date of the patent: 2005.05.24
The invention relates to medicine, namely to physiotherapy and can be used in the treatment of urinary incontinence. The method involves performing transcranial electrostimulation. Electrodes are placed on the forehead and behind the ears. The impact of a rectangular pulsed current with a frequency of 77 Hz, pulse width of 3.5 ms. Moreover, the current strength gradually increase for 1-2 minutes to 1.5-2.0 mA. The duration of treatment 40 minutes. The course consists of 10-15 sessions. The method increases the efficiency of the treatment due to an increase in bladder capacity cystometric.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, to uroginekologii, namely to methods for treating overactive bladder.
There are known methods of electrical stimulation using surface electrodes. Depending on the location of the electrodes can be noted transcutaneous sacral (at S 3) [2, 4], transcutaneous posterior tibial nerve [1, 3] transcutaneous anogenital [5].
Over the next prototype accepted method for the treatment of overactive bladder, including electrical stimulation pulses of rectangular form [4].
However, the prototype method is complicated to implement and traumatic because It requires an electrode implanted at the level of S 3.
The purpose of the invention - atraumatic effective treatment of bladder overactivity.
The essence of the proposed method for treating overactive bladder, comprising rectangular pulses of electrical stimulation, is that transcranial electrostimulation is carried out, the electrodes are placed on the forehead and behind the ears, affect rectangular pulse current with a frequency of 77 Hz, pulse width of 3.5 ms, Session 40 min, and gradually increase the current strength of 1-2 minutes to 1.5-2.0 mA, the course of 10-15 sessions conducted daily or every other day.
The process is as follows. The electrodes with hydrophilic spacers (16 layers of flannel soaked in water) is placed on the forehead and brow area to the area of both mastoid and tightly fixed. These electrodes are fed rectangular pulsed current with a frequency of 77 Hz, pulse width of 3.5 ms. DC Power gradually increase for 1-2 minutes to 1.5-2.0 mA. The duration of a session 40 minutes. Spend sessions every day or every other day, a course of 10-15 sessions.
example 1
Patient B., 35 years old, complained of frequent urination up to 12-14 times a day, increased urination at night up to 3 times, uncontrollable urge to urinate up to 5 times per day, episodes of non-withholding of urine when the urge to 1-2 times week wears pads. Emotionally, mobile, evaluate his condition as unsatisfactory, "prophylactic" drinking limits in order to reduce the number of urination, disturbed sleep. The disease duration of 1.5 years. Double-held anti-inflammatory therapy - a short-term remission of symptoms. As a result of a comprehensive survey have a urinary tract infection were excluded. Neurological examination revealed no organic pathology. When urodynamic study (filling cystometry) was found overactivity of the bladder without detrusor overactivity. Appointed M-anticholinergic Driptan 2.5 mg 2 times a day in conjunction with the method of bladder training and exercises to strengthen the pelvic floor muscles. After 1 month of the drug noted a decrease in the frequency of urination to 9-10 times a day, and no episodes of non-withholding of urine, but remained frequent irrepressible urge to urinate, frequent urination at night. The patient refused further admission Driptana in connection with its adverse manifestations in the form of severe dry mouth.
The patient had a course of transcranial electrostimulation (TES) at: session of 40 minutes, the frequency of the rectangular pulse current of 77 Hz, pulse duration of 3.5 ms, the current strength gradually increase for 1.5 minutes to 2.0 mA. The course of treatment was 15 sessions, held daily.
TPP Adverse effects were observed.
Analysis after voiding diary TES teralen shown to reduce the frequency of urination to 7-8 times a day, at night - no more than 1 times, increased ability to restrain the urge to urinate up to 2.5-3 hours, the number of urgency frequency dropped to 1-2 once a day. It noted improved sleep and overall health.
Control treatment was carried out for 6 months - the effect is stable. Repeat courses are not required.
example 2
Patient M., 47 years old, complained of frequent urination to 15 times a day, urgent desire to urinate 6-7 times a day, at night urinates no more than 1 times, holds the urine. Emotional lability, avoiding long journeys, prophylactically limits drink. History burdened polyvalent drug allergy. The disease duration of 5 years, the deterioration in the course of the year. Antibiotic therapy had no effect.
With comprehensive examination of the urinary tract infection has been ruled out. Neurological examination revealed no organic pathology. When filling cystometry showed a reduction in the volume of the filling of the bladder when the first, natural and uncontrollable urge to urinate and a reduction in the maximum cystometric bladder capacity. failed to register the involuntary contractions of the detrusor. The diagnosis: overactive bladder without detrusor overactivity.
In connection with a polyvalent drug allergy pharmacotherapy it has been decided to refrain.
Spend TES course in time: 40 minutes of the session, the frequency of the rectangular pulse current of 77 Hz, pulse duration of 3.5 ms, the current is gradually build up within 2 minutes and 2.0 mA. The course of treatment was 15 sessions in a day. TPP Adverse effects were observed.
Analysis after voiding diary TES therapy has shown that the frequency of urination decreased to 9 times per day, increased ability to restrain the urge to urinate up to 2-2.5 hours, the number of urgency frequency dropped to 2-3 times a day. The improvement of general well-being. When monitoring filling cystometry was recorded maximum cystometric increase bladder capacity 2-fold (350 ml compared to 180 mL before treatment).
Treatment efficacy was maintained for 2.5 months. Then, the repetition rate of TPP needed.
Clinical study of the efficiency of thermal power plants was performed in 18 women with a diagnosis of overactive bladder without detrusor overactivity. The indications for purpose of TPP was no effect of drug therapy, or contraindications to pharmacotherapy. The average age of patients was 39,5 ± 4,7 years. Clinically, the disease manifested pollakiuria - at 100%, nocturia and urgency - at 50%, urge urinary incontinence - 10%. These symptoms occurred within an average of 2,65 ± 1,55 years. All patients were characterized by changes in the psycho-emotional status in the form of emotional lability, sleep disturbances, state of psychological maladjustment. Every fourth woman urgent development of symptoms was correlated with previous stressful situation.
After treatment significantly decreased the number of urination from 13 ± 9 to 0.84 ± 0.71 times. Decreased expression of urgency (on a five-point rating scale) to 4 ± 0.55 points to 1 ± 0.45 points (p <0.05). According cystometry was statistically and clinically significant increase in the maximum cystometric capacity of the bladder (288 ± 5,6 ml compared to 165 ± 5,6) ml before the treatment, p <0.05).
Thus, TPS is effective against symptoms of overactive bladder, pharmacotherapy is an adequate alternative.
INFORMATION SOURCES
1. Krivoborodov GG Mazo EB Schwartz PG Afferent stimulation of the tibial nerve in patients with overactive bladder. Urology. 2002, №5. 36-39.
2. Mazo EB, Krivoborodov GG Temporary sacral neuromodulation in patients with urge urinary incontinence. Urology, 2000. №4. 42-46.
3. Balken MR, Vandonichik V., Gisolf KW Posterior tibial nerve stimulation as neuro-modulative treatment of lower urinary tract dysfunction. J. Urol, 2001, 163 (3). 914-918.
4. Hassan ST, Robson WA, Pridie AK, Neal DE Transcutaneous electrical nerve stimulation and temporary S3 neuromodulation in idiopathic detrusor instability. J. Urol, 1996.; 155: 2005-2011 - a prototype.
5. Bristow SE, Hasan ST, Neal DE TENS: a treatment option for bladder dysfunction. Int. Urogynecol. J., 1996, 7: 185-190.
CLAIM
A method of treating overactive bladder comprising rectangular pulses of electrical stimulation, wherein the transcranial electrostimulation is carried electrodes placed on the forehead and behind the ears, a rectangular pulse current having a frequency of 77 Hz, pulse width of 3.5 ms, 40 min sessions, the force gradually increase the current 1-2 minutes to 1.5-2.0 mA, the course of 10-15 sessions, daily or every other day.
print version
Publication date 06.01.2007gg
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