Učinkovitost funkcionalne magnetne stimulacije na simptome urinske inkontinence pri moških po odstranitvi prostate - randomizirana, s placebom kontrolirana študija : diplomsko delo

Tepuš, Urška (author), Šćepanović, Darija (mentor), Verdenik, Ivan (co-mentor), Vauhnik, Renata (reviewer)

Uvod: Rak prostate je en izmed najpogostejših rakov v Sloveniji. Za zdravljenje raka prostate se uporabljajo aktivni nadzor, hormonsko zdravljenje, kemoterapija, obsevanje ali operativna odstranitev prostate oziroma radikalna prostatektomija. Po prostatektomiji je pogost neželen učinek dolgotrajna urinska inkontinenca. Novejši način zdravljenja le-te je funkcionalna magnetna stimulacija. Je neboleča in ne invazivna metoda, velika prednost pa je, da je prostovoljec med terapijo lahko oblečen. Pri funkcionalni magnetni stimulaciji magnetni tok povzroči depolarizacijo sakralnih živčnih korenin, ki oživčujejo mišice medeničnega dna, kar privede do kontrakcije teh mišic. Namen: Želeli smo ugotoviti učinkovitost funkcionalne magnetne stimulacije pri zmanjšanju pojavnosti inkontinentnih epizod in pri z urinsko inkontinenco povezano zmanjšano kakovostjo življenja pri moških po odstranitvi prostate. Metode dela: V randomiziran, s placebom kontroliran preizkus so bili vključeni moški z urinsko inkontinenco po prestani prostatektomiji. Naključno so bili razdeljeni v eksperimentalno skupino s funkcionalno magnetno stimulacijo ali v kontrolno skupino s placebom. Deležni so bili desetkratne terapije po 20 minut. Pričakovana je bila subjektivna sprememba stanja glede na 7-stopenjsko lestvico subjektivne ocene spremembe stanja in sprememba parametrov vprašalnika Mednarodnega posveta za inkontinenco – oblika za moške s simptomi urinske inkontinence. Rezultati: V raziskavi je sodelovalo 22 prostovoljcev. Analiza 7-stopenjske Lestvice subjektivne ocene izboljšanja je pokazala, da je 6 (46,2 %) od 13 prostovoljcev v eksperimentalni skupini in 2 (22,2 %) od 9 prostovoljcev v kontrolni skupini navedlo zmerno izboljšanje stanja. Razlika med skupinama ni bila statistično značilna (p = 0,121). Analiza vprašalnika Mednarodnega posveta za inkontinenco je pokazala premik povprečne vrednosti rezultatov eksperimentalne skupine iz območja z zmerno urinsko inkontinenco v območje z blago urinsko inkontinenco. Razlika med skupinama prav tako ni bila statistično značilna (p = 0,614). Razprava in zaključek: Ugotovili smo, da so prostovoljci sicer navajali subjektivno izboljšanje stanja, ki pa ni bilo statistično značilno drugačno v eksperimentalni kot v kontrolni skupini. Glede na trenutne rezultate raziskave zaključujemo, da funkcionalna magnetna stimulacija ne nudi večjega izboljšanja urinske inkontinence kot placebo. Uporaba le-te pri takih pacientih je vseeno smiselna, saj nismo zabeležili stranskih učinkov, hkrati pa noben od prostovoljcev ni navajal poslabšanja stanja. V nadaljnje bi bilo potrebno izvesti raziskavo na večjem vzorcu prostovoljcev.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, funkcionalna magnetna stimulacija, rak prostate, radikalna prostatektomija, urinska inkontinenca
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [U. Tepuš]
• Year: 2022
• Number of pages: 33 str., [7] str. pril.
• PID: 20.500.12556/RUL-143237
• UDC: 615.8
• COBISS.SI-ID: 133062147
• Publication date in RUL: 09.12.2022

Secondary language

• Language: English
• Title: The effectiveness of functional magnetic stimulation on the symptoms of urinary incontinence in men after prostatectomy - randomized, placebo controlled trial : diploma work

Abstract

Introduction: Prostate cancer is one of the most common cancers in Slovenia. Surgical removal of the prostate gland is one of the possible treatments for prostate cancer. After surgical removal prolonged urinary incontinence is a common adverse effect. Functional magnetic stimulation is one of the possible treatments of urinary incontinence. It is non-invasive and painless. The patient can be fully dressed during stimulation. In functional magnetic stimulation the magnetic current causes depolarisation of the sacral nerve roots, which innervate pelvic floor muscles. This leads to their contraction. Purpose: The purpose of the thesis was to evaluate the effectiveness of functional magnetic stimulation in reducing the number of the incontinent episodes and to assess the effectiveness on quality of life which is often reduced in men after prostatectomy. Methods: Men with urinary incontinence after prostatectomy were included in this study. The participants were randomly assigned to experimental or control group. The participants sat down at the middle of the magnetic chair. Protocol lasted 4 weeks, 10 times for 20 minutes. International Consultation on Incontinence Questionnaire Male Lower Urinary Tract Symptoms Module and anamnesis was completed before the protocol. After the protocol they completed International Consultation on Incontinence Questionnaire and The Patient Global Impression of Improvement. Results: 22 men participated in this study. Six (46,2 %) out of 13 participants in experimental group and two (22,2 %) out of 9 in control group reported that their urinary symptoms have improved much. Nobody reported worsening of their condition after the protocol. There was no statistically significant difference between the groups in the analysis of International Consultation on Incontinence Questionnaire (p = 0,614) and The Patient Global Impression of Improvement (p = 0,121). Discussion and conclusion: We found that the participants reported subjective improvement, but based on current research results we conclude that functional magnetic stimulation does not offer a greater improvement in urinary incontinence than placebo. The use of functional magnetic stimulation in this population is still recommended since we did not find any adverse effects of the stimulation. In the future, bigger sample of men should be involved in the study.

• Keywords: diploma theses, physiotherapy, functional magnetic stimulation, prostate cancer, radical prostatectomy, urinary incontinence