Miller Janis M, Sampselle Carolyn, Ashton-Miller James, Hong Gwi-Ryung Son, DeLancey John O L
School of Nursing, University of Michigan, Ann Arbor, MI, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jun;19(6):773-82. doi: 10.1007/s00192-007-0525-3.
The aim of the study was to determine the immediate effect of timing a pelvic muscle contraction with the moment of expected leakage (the Knack maneuver) to preempt cough-related stress incontinence. Women performed a standing stress test using three hard coughs without and then with the Knack maneuver. Volume of urine loss under both conditions was quantified with paper-towel test. Two groups of women were tested: nonpregnant women (n = 64) and pregnant women (n = 29). In nonpregnant women, wetted area decreased from a median (range) of 43.2 (0.2-183.7) cm2 without the Knack maneuver to 6.9 (range of 0 to 183.7 cm2) with it (p < 0.0001); while in pregnant women it decreased from 14.8 (0-169.7) cm2 to 0 (0-96.5) cm2, respectively (p = 0.001). This study confirms the effect from the Knack maneuver as immediate and provides a partial explanation for early response to widely applied pelvic muscle training regimens in women with stress incontinence.
该研究的目的是确定在预期漏尿时刻进行盆底肌肉收缩（诀窍动作）对预防咳嗽相关压力性尿失禁的即时效果。女性在不进行诀窍动作以及进行诀窍动作的情况下，通过三次用力咳嗽进行站立压力测试。两种情况下的尿量损失均通过纸巾测试进行量化。对两组女性进行了测试：非孕妇（n = 64）和孕妇（n = 29）。在非孕妇中，未进行诀窍动作时浸湿面积的中位数（范围）为43.2（0.2 - 183.7）cm²，进行诀窍动作后降至6.9（范围为0至183.7 cm²）（p < 0.0001）；而在孕妇中，浸湿面积分别从14.8（0 - 169.7）cm²降至0（0 - 96.5）cm²（p = 0.001）。本研究证实了诀窍动作的即时效果，并为压力性尿失禁女性对广泛应用的盆底肌肉训练方案的早期反应提供了部分解释。
