Efficacy of sacral nerve magnetic stimulation in preventing urinary retention after total hysterectomy: a randomised controlled trial

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Background Urinary retention following total hysterectomy is a prevalent postoperative complication that significantly impacts patient recovery and quality of life. Current prevention methods have limitations, prompting exploration of more effective strategies. Sacral nerve magnetic stimulation (SMS), an innovative, non-invasive approach, has shown potential in managing urinary disorders.Methods In this single-centre, prospective, randomised controlled trial, 100 patients undergoing surgery for gynaecological malignancies were randomly assigned to receive either standard care (control group) or SMS treatment plus standard care (intervention group). The primary outcome was the incidence of post-operative urinary retention (POUR) (the number of patients with residual urine volume over 100 mL or inability to void divided by the total number of patients in each group, expressed as a percentage), with secondary outcomes including time to spontaneous voiding, re-catheterisation rate and pelvic floor muscle strength.Results The intervention group had a significantly lower POUR incidence (14% vs. 36%, p = .002), shorter time to spontaneous voiding (1.5 days vs. 2.5 days, p < .001) and lower re-catheterisation rate (12% vs. 30%, p = .012) compared to the control group. Pelvic floor muscle strength also improved in the intervention group (p = .03). No serious adverse events related to SMS were reported.Conclusions SMS can significantly reduce the incidence of POUR and shortened the time to spontaneous voiding, while also decreasing the re-catheterisation rate compared to the control group.

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