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NEUROMODULACIóN PERIFéRICA EN EL TRATAMIENTO DE LA INCONTINENCIA DE ORINA: EFECTO DE LA ESTIMULACIóN TRANSCUTáNEA DEL NERVIO TIBIAL POSTERIOR SOBRE LA VEJIGA HIPERACTIVA

DOI: 10.4067/S0717-75262008000300011

Keywords: urinary incontinence, overactive detrusor, overactive bladder, urge incontinence, urodynamic.

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Abstract:

objective: to demonstrate objectively the efficiency of the neuromodulation with the transcuteneous posterior tibial nerve stimulation in overactive bladder, in a patient with urge incontinence, refractory to traditional treatments. patient: a case of urinary mixed incontinence is presented. the tvt-secur was used for the stress urinary incontinence. the urge-incontinence due to overactive bladder was treated by transcutaneous tibial nerve neuromodulation when refractory appearing to the treatment with medicines and physiotherapy by thirty days. the action of the neuromodulation is demonstrated objectively by cystometry. monochannel urodynamic equipment was used. the biomed 2000 equipment was used for the transcutaneous neuromodulation, with stimuli in continuos way to 20 hertz and 200 milliseconds. results: the transcutaneous tibial nerve neuromodulation is able to inhibit the contraction of the detrusor, in a patient with urge-incontinence refractory to medical treatment. this is demonstrated objectively by the disappearance of the contraction noninhibited of the detrusor in the uridinamic cistometry. the maximum cystometric capacity increases and the urge-incontinence sensation diminish. conclusión: the tibial nerve transcutaneous stimulation is an effective treatment in the overactive bladder, and the objective acute effect can be observed on the urodynamic cystometry. this therapy corresponds to a noninvasive treatment.

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