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绝经后压力性尿失禁患者使用阴道锥的随机对照试验。

Vaginal cone for postmenopausal women with stress urinary incontinence: randomized, controlled trial.

机构信息

Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil.

出版信息

Climacteric. 2012 Feb;15(1):45-51. doi: 10.3109/13697137.2011.593211. Epub 2011 Nov 8.

Abstract

OBJECTIVE

To investigate the effect of vaginal cones and pelvic floor muscle training (PFTM) in postmenopausal women with stress urinary incontinence.

METHODS

This randomized, controlled study included postmenopausal women, who complained of stress urinary incontinence. Forty-five women were allocated to three groups: a group given therapy with vaginal cones (n = 15), a group receiving therapy with PFTM (n = 15), and the control group (n = 15). Subjects in the intervention groups were treated for 6 weeks with twice-weekly sessions of 40 min. Women in the vaginal cone group carried out the pelvic floor muscle strengthening with vaginal cones. The control group did not receive any treatment during the corresponding time. They were evaluated before, at the end of treatment and 6 weeks after treatment completion for primary outcomes (1-h pad test for urinary loss and pelvic floor muscle pressure) and secondary outcomes (quality of life with King's Health Questionnaire, satisfaction with treatment, and continuity of training).

RESULTS

For urinary leakage, there were statistical differences between the treated groups and the control group at the end of treatment and 6 weeks after treatment (all p < 0.01; effect size: vaginal cone group 20.97; PFMT group 20.96). The same behavior was shown for treatment with pelvic floor muscle pressure (all p < 0.01; effect size: vaginal cone group 22.58; PFMT group 21.68). There were no differences between the vaginal cone and PFMT groups in any of the evaluations. In outcomes for quality of life, significant differences were observed for incontinence impact and gravity domains when both treated groups were compared with the control group after treatment. Both groups reported similar satisfaction levels and the vaginal cone group demonstrated lower training continuity.

CONCLUSION

Based on this study, there were similar positive results for treatment with the vaginal cone and pelvic floor muscle training for urinary leakage, pelvic floor muscle pressure and quality of life for postmenopausal women with stress urinary incontinence after 6 weeks.

摘要

目的

研究阴道球和盆底肌训练(PFTM)对绝经后压力性尿失禁患者的影响。

方法

本随机对照研究纳入了主诉压力性尿失禁的绝经后女性。45 名女性被分为三组:阴道球治疗组(n=15)、PFTM 治疗组(n=15)和对照组(n=15)。干预组每周接受两次、每次 40 分钟的治疗。阴道球组通过阴道球进行盆底肌强化训练。对照组在相应时间内不接受任何治疗。在治疗前、治疗结束时和治疗结束后 6 周评估主要结局(1 小时尿垫试验漏尿量和盆底肌压力)和次要结局(King's 健康问卷生活质量、治疗满意度和训练连续性)。

结果

在治疗结束时和治疗结束后 6 周,治疗组与对照组在尿漏方面存在统计学差异(均 p<0.01;效应量:阴道球组 20.97;PFMT 组 20.96)。盆底肌压力的治疗也表现出相同的行为(均 p<0.01;效应量:阴道球组 22.58;PFMT 组 21.68)。在任何评估中,阴道球组和 PFMT 组之间均无差异。在生活质量结局方面,治疗后,与对照组相比,两组在尿失禁影响和严重程度域方面均有显著差异。两组报告的满意度相似,但阴道球组的训练连续性较低。

结论

根据本研究,在治疗绝经后压力性尿失禁患者的尿漏、盆底肌压力和生活质量方面,阴道球和盆底肌训练的效果相似,治疗 6 周后均有阳性结果。

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