Simard Catherine, Tu Le Mai
Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke QC.
Division of Urology, Department of Surgery, Université de Sherbrooke, Sherbrooke QC.
J Obstet Gynaecol Can. 2010 Dec;32(12):1163-1166. doi: 10.1016/S1701-2163(16)34740-5.
To determine the efficacy of pelvic floor muscle (PFM) rehabilitation for elderly women with urinary incontinence after five years of follow-up, and to assess the adherence to PFM exercises five years after physiotherapy.
We conducted a retrospective chart review of women ≥ 60 years old who underwent PFM physiotherapy for urinary incontinence between September 1999 and February 2004. PFM rehabilitation techniques were taught to patients by a certified physiotherapist. The mean number of sessions was eight. Telephone surveys were conducted at two months, six months, and one to five years after physiotherapy. Objective data on the efficacy of treatment (number of voids, incontinence, use of pads) and on adherence to PFM exercises were collected using a uniform grid. Data were used to determine the continence status at follow-up and compared with the data collected at the end of the PFM training sessions (improved, maintained, or deteriorated).
Of 89 older women (mean age 70 years; range 60 to 81) treated during the study period, 40 were followed up to five years and were suitable for analysis. At five years of follow-up, 27.5% had improved, 57.5% remained stable, and 15% had deteriorated compared with their post-treatment continence status. Twenty-nine patients (72.5%) were continuing their PFM exercises, and 42.5% were performing the exercises daily. All adherent patients had "improved" or "stable" status after five years versus 45.5% of non-adherent patients (P < 0.05).
Pelvic floor muscle rehabilitation for urinary incontinence remains highly effective for up to five years in older women. Most women continue to perform PFM exercises five years after completing their physiotherapy education sessions.
确定盆底肌肉（PFM）康复对老年尿失禁女性患者随访五年后的疗效，并评估物理治疗五年后患者对PFM锻炼的依从性。
我们对1999年9月至2004年2月间接受PFM物理治疗的60岁及以上尿失禁女性患者进行了回顾性病历审查。由认证物理治疗师向患者传授PFM康复技术。平均疗程为8次。在物理治疗后2个月、6个月以及1至5年进行电话调查。使用统一表格收集关于治疗效果（排尿次数、失禁情况、护垫使用情况）和PFM锻炼依从性的客观数据。这些数据用于确定随访时的控尿状态，并与PFM训练课程结束时收集的数据进行比较（改善、维持或恶化）。
在研究期间接受治疗的89名老年女性（平均年龄70岁；范围60至81岁）中，40名患者接受了五年随访且适合分析。在五年随访时，与治疗后的控尿状态相比，27.5%的患者病情改善，57.5%保持稳定，15%恶化。29名患者（72.5%）继续进行PFM锻炼，42.5%的患者每天进行锻炼。所有坚持锻炼的患者在五年后病情为“改善”或“稳定”，而非坚持锻炼的患者中这一比例为45.5%（P<0.05）。
盆底肌肉康复治疗老年女性尿失禁在长达五年内仍具有高效性。大多数女性在完成物理治疗课程五年后仍继续进行PFM锻炼。
