Objective To explore the practicability,safety,and efficacy of appropriate electrophysiological techniques in the treatment of refractory overactive bladder(OAB)by percutaneous low-frequency neuromuscular electrical stimulation.Methods From September 2019 to July 2022,36 patients with refractory OAB were enrolled in the department of urology and lower urinary tract and male outpatient clinic of the First Affiliated Hospital of Jinan University.There were 28 females and 8 males,aged from 29 to 83(43.94±2.68)years,with a disease duration of(4.19±2.43)years.Among the female patients,there were 8 cases of pelvic organ prolapse,1 case with history of pelvic surgery combined with pelvic organ prolapse,1 case with sleep disorders combined with history of pelvic surgery,1 case with major depressive disorder,2 cases with hypertension,1 case with diabetes,1 case with hypertension combined with diabetes,3 cases with urge incontinence,and 10 cases with simple refractory OAB.Among the male patients,there were 2 cases with chronic prostatitis,1 case with urgent incontinence,and 5 cases with simple refractory OAB.All patients received percutaneous low-frequency neuromuscular electrical stimulation.The scores of quality of life(QOL)scale,scores of Overactive Bladder Symptom Scale(OABSS),and urination diary were collected before and after treatment.The above indicators were statistically analyzed and the efficacy was evaluated.Follow-up data of 1 month and 3 months after treatment were analyzed to analyze the persistence of short-term clinical effect and recurrence rate in patients with OAB treated by percutaneous low-frequency neuromuscular electrical stimulation.Paired t test and Cox regression analysis were used.Results After treatment,the QOL score of the refractory OAB patients was higher than that before treatment,and the OABSS score was lower than that before treatment,with statistically significant differences(t=1.327 and 102.244,both P＜0.05);the frequency of urination was decreased after treatment compared with that before treatment,with a statistically significant difference(t=10.246,P＜0.05);the single urine volume and single maximum urine volume were higher than those before treatment,with statistically significant differences(t=45.467 and 103.344,both P＜0.05).The clinical symptoms of 29 patients with refractory OAB were improved after treatment,and the clinical effective rate reached 80.55％(29/36).In the 1-month and 3-month follow-up OABSS score data,the regression coefficients showed level significance results(P=0.033 and 0.002),indicating the short-term clinical efficacy of percutaneous low-frequency neuromuscular electrical stimulation for refractory OAB patients.The results of Cox regression analysis showed that the lower the OABSS score after 1 month and 3 months of treatment,the longer the validity period,the less likely to relapse.All patients had no discomfort during or after treatment.Conclusions Percutaneous low-frequency neuromuscular electrical stimulation in the treatment of refractory OAB can significantly improve the patients'quality of life,reduce the score of OABSS,reduce the frequency of urination,increase the single urine volume and the single maximum urine volume.The treatment is safe and has significant short-term clinical efficacy.However,the long-term efficacy should be followed up with the increase of the number of cases.
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