Divisão de Clínica Ginecológica, Ginecologia Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Clinics (Sao Paulo). 2011;66(5):785-91. doi: 10.1590/s1807-59322011000500013.
To evaluate vaginal cone therapy in two phases, passive and active, in women with stress urinary incontinence.
A prospective study was conducted at the Department of Obstetrics and Gynecology, São Paulo University, Brazil. Twenty-four women with a clinical and urodynamic diagnosis of stress urinary incontinence were treated with vaginal cones in a passive phase (without voluntary contractions of the pelvic floor) and an active phase (with voluntary contractions), each of which lasted three months. Clinical complaints, a functional evaluation of the pelvic floor, a pad test, and bladder neck mobility were analyzed before and after each phase.
Twenty-one patients completed the treatment. The reduction in absolute risk with the pad test was 0.38 (p<0.034) at the end of the passive phase and 0.67 (p<0.0001) at the end of the active phase. The reduction in absolute risk with the pelvic floor evaluation was 0.62 (p<0.0001) at the end of the passive phase and 0.77 (p<0.0001) at the end of the active phase. The reduction in absolute risk of bladder neck mobility was 0.38 (p<0.0089) at the end of the passive phase and 0.52 (p<0.0005) at the end of the active phase. Complete reversal of symptomatology was observed in 12 (57.1%) patients, and satisfaction was expressed by 19 (90.4%).
Using vaginal cones in the passive phase, as other researchers did, was effective. Inclusion of the active phase led to additional improvement in all of the study parameters evaluated in women with stress urinary incontinence. Randomized studies are needed, however, to confirm these results.
评估阴道锥在两个阶段，被动和主动，在压力性尿失禁的妇女。
一项前瞻性研究在巴西圣保罗大学妇产科进行。24 名有临床和尿动力学诊断为压力性尿失禁的妇女接受阴道锥被动阶段（无骨盆底的自愿收缩）和主动阶段（自愿收缩）的治疗，每个阶段持续三个月。在每个阶段前后分析临床症状、骨盆底功能评估、垫试验和膀胱颈活动度。
21 例患者完成治疗。垫试验的绝对风险降低在被动阶段结束时为 0.38（p<0.034），在主动阶段结束时为 0.67（p<0.0001）。在骨盆底评估的绝对风险降低在被动阶段结束时为 0.62（p<0.0001），在主动阶段结束时为 0.77（p<0.0001）。膀胱颈活动度的绝对风险降低在被动阶段结束时为 0.38（p<0.0089），在主动阶段结束时为 0.52（p<0.0005）。12 例（57.1%）患者完全逆转症状，19 例（90.4%）表示满意。
与其他研究人员一样，在被动阶段使用阴道锥是有效的。在主动阶段纳入治疗可使压力性尿失禁妇女所有研究参数的改善得到进一步提高。然而，需要进行随机研究来证实这些结果。
