Efecto de la electroestimulación del nervio tibial en la musculatura del piso pélvico de pacientes con síndrome de vejiga hiperactiva
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i4.419Palabras clave:
Vejiga hiperactiva, Neuromodulación tibial, PTNS, Electromiografía del piso pélvicoResumen
Antecedentes y Objetivos: El Síndrome de Vejiga Hiperactiva (svh) presenta alteraciones motoras como hipertonía de la musculatura del piso pélvico (mpp). El objeto del estudio es demostrar las características de la electromiografía de superficie (emgs) del mpp en el svh tratados con electro-estimulación percutánea del nervio tibial (ptns).
Material y Método: Estudio prospectivo, observacional, controlado. Se realizó emgs de mpp a 17 voluntarios con svh rebelde a tratamiento, antes, durante la ptns y 72 horas después. Se asignaron 2 grupos: Catorce voluntarios del grupo ptns, y 3 voluntarios del grupo placebo. Se incluyeron pacientes con evolución mínima de 6 meses, frecuencia urinaria de 8 o más, sin toma de medicamentos. Se excluyeron pacientes con urocultivo/espermocultivo positivos, litiasis, biopsia y/o cirugía de órganos pélvicos ó cáncer pélvico, y lesiones del snc. Las variables se analizaron mediante Anova y Tukey pos hoc test, 95% ic, usando el software spss 10.1.
Resultados: Media de edad 34.23±12.90 años, media del tiempo de evolución 19.58±12.08 meses, sin diferencia estadística en entre grupos. La diferencia de las medias en el promedio de emg (avgemg) del grupo ptns pre vs trans de 0.125 µV y de pre vs 72 horas de 0.171 µV fueron significativas (p<0.05), mientras que en el grupo placebo la diferencia de las medias avgemg de 0.013 µV y 0.006 µV sin diferencia estadística (p>0.05).
Conclusiones: El cambio inmediato sobre la mpp que permanece hasta 72 horas después de la ptns, es un posible mecanismo de acción de neuroplasticidad de la neuromodulación del nervio tibial.
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