Table 3.
Recent randomized clinical trials of nerve electrical stimulation therapy and extracorporeal shock wave therapy for detrusor underactivity.
| Author (Year) | Treatment | Size (n) | Age (y) | Treatment Method | Safety | Efficacy (Intervention vs. Placebo) |
|---|---|---|---|---|---|---|
| Liao et al. (2023) [134] |
IVES | IVES: 38 Placebo: 38 |
44.6 47.0 |
Pulse width of 0.2 ms, frequency of 20 Hz, intensity max tolerated; once a day for 30 min, 5 days a week for a total of 4 weeks | 4 UTI in IVES and 2 UTI in placebo, p = 0.67; No severe AEs were reported |
PVR changes for IVES: 2 wk: −64.1 (87.1) mL vs. −9.6 (90.9) mL, p < 0.01 4 wk: −97.1 (107.5) mL vs. −10.5 (86.7) mL, p < 0.01 No significant differences in the number of 24-h CIC procedures, PPBC-S, or AUA-SI-QoL score between the groups. |
| Kajbafzadeh et al. (2016) [136] |
IFES | IFES: 18 Control:18 |
8.4 (2.4) 9.2 (2.5) |
20 min twice a week, 15 courses; 4 kHz carrier frequency and a beat frequency sweep at 5–55 Hz | No side-effects reported during and after IFES | At the end of treatment courses: NOV (SD): 6.3 (1.4) vs. 4.7 (1.3) times/day, p < 0.002 BC (SD): 238 (58) vs. 366 (67) mL, p < 0.001; Maximum urine flow: 22.1 (6.8) vs. 11.8 (5.7) mL/s, p = 0.001; PVR: 14.1 (5.8) vs. 49 (23.3), p = 0.03. 1-year follow-up: BC (SD): 227 (86) vs. 344 (127) mL, p = 0.016; Maximum urine flow: 21 (8.3) vs. 12.8 (4.8) mL/s, p = 0.001; PVR: 22.5 (10.3) vs. 44.1 (39), p = 0.03. |
| Shen et al. (2023) [82] |
ESWT | ESWT: 6 Placebo: 5 |
62.4 61.2 |
4 pulses/s, 2500 shocks, max energy flow density of 0.25 mJ/mm2, once a week for 6 wk | No hematuria, pain, or infection in the two groups reported. | Improvement in PVR (95%CI): 4 wk: 157.8 mL (−380.1,64.4) vs. −6.6 mL (−178.1, 164.9), p = 0.116 12wk: 77.5 mL (−242.1, 87.1) vs. 81.8 mL (−137.2, 300.7), p = 0.056 reduction in the UAB-Q score (95%CI): 4 wk: −4.3 (−9.1, 0.4) vs. 0.4 (−1.8, 1.0), p = 0.025 12wk: −2.7 (−5.5, 0.1) vs. −0.2 (−3.5, 3.1), p = 0.091 |
IVES: intravesical electrical stimulation; UTI: urinary tract infection; PPBC-S: Patient Perception of Bladder Condition Scale; AUA-SI-QoL: American Urological Association Symptom Index Quality of Life; BCI: bladder contractility index = Pdet@Qmax + 5Qmax; IFES: transcutaneous interferential electrical stimulation; NOV: number of voiding; SD: standard deviation; BC: bladder capacity; PVR: post-void residual; ESWT: extracorporeal shock wave therapy; UAB-Q: underactive bladder questionnaire.