Valiquette L, Paquin J M, Perreault J P, Guertin B, Simard J, Trudel C
Département de Chirurgie, Hôpital Saint-Luc, Montréal, Québec, Canada.
Ann Chir. 1991;45(9):816-21.
Twenty patients suffering from urinary stress incontinence were treated by perineal reeducation. The assessment included a medical and urological questionnaire, a physical examination, a urine analysis and culture, a cystoscopy, urinary flow and cystometry, a urethral pressure profile and a subjective evaluation of the perineal musculature. The 20 patients selected had documented stress incontinence, had never been operated on for incontinence and had a stable bladder at urodynamic assessment. Treatment was identical for all patients and included 12 biofeedback and electrostimulation sessions over a 4 to 6 week period. The questionnaire, urodynamic and perineal assessment were repeated at the end of treatment. No complication occurred. Micturition frequency decreased in all patients. Clinical correction of incontinence was observed in ten patients, improvement in nine and no change in one for an overall cure or improvement rate of 95%. The urethrocystocele evaluation did not change. Perineal evaluation and urodynamic parameters were only slightly improved. At follow-up evaluation 6 to 9 months post treatment, a 75% cure or improvement rate was still present. Perineal reeducation is a non morbid and effective modality to correct urinary stress incontinence. Its long term efficacy and its use for other types of incontinence has to be demonstrated.
20例压力性尿失禁患者接受了会阴再教育治疗。评估包括医学和泌尿学问卷调查、体格检查、尿液分析与培养、膀胱镜检查、尿流率和膀胱测压、尿道压力描记以及会阴肌肉组织的主观评估。所选的20例患者均有压力性尿失禁记录，从未因尿失禁接受过手术，且在尿动力学评估中膀胱稳定。所有患者的治疗方法相同，包括在4至6周内进行12次生物反馈和电刺激治疗。治疗结束时重复进行问卷调查、尿动力学和会阴评估。未发生并发症。所有患者的排尿频率均降低。观察到10例患者的尿失禁得到临床纠正，9例改善，1例无变化，总体治愈或改善率为95%。尿道膀胱膨出评估无变化。会阴评估和尿动力学参数仅略有改善。在治疗后6至9个月的随访评估中，仍有75%的治愈或改善率。会阴再教育是纠正压力性尿失禁的一种无创伤且有效的方法。其长期疗效及其在其他类型尿失禁中的应用有待证实。
