Eletroestimulação associada ao treinamento dos músculos do assoalho pélvico no tratamento da incontinência urinária mista em mulheres brasileiras

Abstract

Objective: To investigate and compare the effects of transcutaneous tibial nerve stimulation (TTNS), transcutaneous parasacral electrical stimulation (TPES), and intravaginal electrical stimulation (IVES), combined with pelvic floor muscle training (PFMT), in women with mixed urinary incontinence (MUI). Methods: This was a longitudinal experimental study with pre- and post-intervention assessments, conducted with 60 adult women with MUI. Participants were allocated into three groups (n=20 each): TTNS+PFMT, TPES+PFMT, and IVES+PFMT. Twelve treatment sessions were performed over six weeks. The outcomes assessed included pelvic floor muscle function using the PERFECT scheme, symptom severity using the Pelvic Floor Distress Inventory-20 (PFDI-20), and quality of life using the King’s Health Questionnaire (KHQ). Statistical analysis was performed using repeated-measures ANOVA, with a significance level of 5%. Results: All groups showed significant improvement after treatment (p<0.05). PERFECT scores increased, whereas PFDI-20 and KHQ scores decreased, indicating improved pelvic floor muscle function, reduced urinary symptoms, and improved quality of life. No significant differences were observed among the different routes of electrical stimulation application. Conclusion: Electrical stimulation combined with PFMT was effective in improving pelvic floor muscle function, urinary symptoms, and quality of life in women with MUI, regardless of the route of application used. All modalities provided similar benefits, highlighting IVES with neuromodulation parameters as a promising conservative approach.