Department of Sports Medicine, Norwegian School of Sport Sciences, Ullevål Stadion, Oslo, Norway.
World J Urol. 2012 Aug;30(4):437-43. doi: 10.1007/s00345-011-0779-8. Epub 2011 Oct 9.
The objectives of the present review was to present and discuss evidence for pelvic floor muscle (PFM) training on female stress urinary incontinence (SUI), pelvic organ prolapse (POP) and sexual dysfunction.
This manuscript is based on conclusions and data presented in systematic reviews on PFM training for SUI, POP and sexual dysfunction. Cochrane reviews, the 4th International Consultation on Incontinence, the NICE guidelines and the Health Technology Assessment were used as data sources. In addition, a new search on Pubmed was done from 2008 to 2011. Only data from randomized controlled trials (RCTs) published in English language is presented and discussed.
There is Level 1, Grade A evidence that PFM training is effective in treatment of SUI. Short-term cure rates assessed as <2 g of leakage on pad testing vary between 35 and 80%. To date there are 5 RCTs showing significant effect of PFM training on either POP stage, symptoms or PFM morphology. Supervised and more intensive training is more effective than unsupervised training. There are no adverse effects. There is a lack of RCTs addressing the effect of PFM training on sexual dysfunction.
PFM training should be first line treatment for SUI and POP, but the training needs proper instruction and close follow-up to be effective. More high quality RCTs are warranted on PFM training to treat sexual dysfunction.
本综述旨在呈现和讨论盆底肌（PFMs）训练对女性压力性尿失禁（SUI）、盆腔器官脱垂（POP）和性功能障碍的证据。
本研究基于关于 PFMs 训练治疗 SUI、POP 和性功能障碍的系统评价中的结论和数据。Cochrane 评价、第四次国际尿控协会会议、NICE 指南和卫生技术评估被用作数据来源。此外，还对 2008 年至 2011 年的 Pubmed 进行了新的检索。仅呈现和讨论以英语发表的随机对照试验（RCTs）的数据。
有 1 级，A级证据表明，PFMs 训练对 SUI 的治疗有效。短期治愈率（通过垫料测试评估<2g 的漏尿）在 35%至 80%之间。迄今为止，有 5 项 RCT 显示 PFMs 训练对 POP 分期、症状或 PFMs 形态有显著影响。监督和更密集的训练比非监督训练更有效。没有不良反应。缺乏 RCT 研究 PFMs 训练对性功能障碍的影响。
PFMs 训练应该是 SUI 和 POP 的一线治疗方法，但为了有效，训练需要适当的指导和密切的随访。需要更多高质量的 RCT 来研究 PFMs 训练对性功能障碍的治疗效果。
