Evaluation of Functional Magnetic Stimulation Parameters and Effectiveness for Neurogenic Detrusor Overactivity: A Systematic Review and Network Meta-Analysis.
Hongxia Pan, Xin Sun, Liang Zhu et al.
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In 30 seconds
This systematic review and network meta-analysis compared functional magnetic stimulation (FMS) protocols for neurogenic detrusor overactivity (NDO) in 20 randomized controlled trials involving 1,316 participants. Sacral magnetic stimulation (SMS) improved maximum cystometric capacity (MCC) versus control (mean difference [MD], 31.94 mL; 95% CI, 8.18-55.71) and reduced postvoid residual volume. Across evaluated parameters, 15-Hz stimulation and an eight-week regimen ranked highest for MCC improvement, although these parameters were assessed independently. SMS also had the strongest ranking for reducing daily urinary incontinence episodes.
Key findings
- SMS improved MCC versus control (MD: 31.94 mL; 95% CI, 8.18-55.71).
- SMS reduced postvoid residual urine volume versus control (MD: 24.33 mL; 95% CI, -42.89 to -5.77).
- MCC improvement was greatest with 15 Hz (+39.41 mL; 95% CI, 15.09-63.74) and an eight-week regimen (+46.16 mL; 95% CI, 11.79-80.51), assessed independently.
- SMS ranked highest for reducing daily urinary incontinence episodes (surface under the cumulative ranking curve: 0.86).
Why it matters
NDO can involve impaired bladder storage and urinary incontinence. This synthesis compares stimulation sites and treatment parameters across randomized trials, suggesting that SMS may offer a favorable profile for these outcomes. The parameter rankings may help frame future comparative research, but they do not establish that combining the highest-ranked site, frequency, and duration will produce the greatest benefit.
What to keep in mind
The stimulation parameters were analyzed independently; evidence on combined effects and interactions across stimulation sites is limited.