Pauls Rachel N, Crisp Catrina C, Novicki Kathleen, Fellner Angela N, Kleeman Steven D
Department of Obstetrics and Gynecology, TriHealth Good Samaritan Hospital, Cincinnati, OH, USA.
Female Pelvic Med Reconstr Surg. 2013 Sep-Oct;19(5):271-7. doi: 10.1097/SPV.0b013e31829c64ea.
Although pelvic floor physical therapy (PFPT) can be beneficial for complaints after vaginal reconstructive surgery, it is not routinely offered to all patients. We sought to evaluate the role of perioperative PFPT in improving quality of life and function after prolapse repairs.
This randomized controlled trial compared PFPT to standard care after vaginal reconstructive surgery. The intervention group received PFPT 2 weeks preoperatively and 2, 4, 6, 8, and 12 weeks postoperatively, as well as a physician assessment. Control subjects underwent a physician's assessment alone at the same time points postoperatively. Both groups completed pelvic organ prolapse quantification examinations, intravaginal electromyography (EMG), voiding diaries, and validated questionnaires at baseline and 12 weeks. The primary outcome was change in the World Health Organization Quality of Life-BREF scale after surgery.
Forty-nine women completed the study: 24 women in the PFPT group and 25 women in the control group. At 12 weeks, condition-specific questionnaires improved for the entire sample, confirming effectiveness of surgery. Nevertheless, no significant differences were noted between the groups despite therapy with PFPT. However, intravaginal EMG measures were notably affected by the intervention. The PFPT group showed significantly lower averages across all measurements of rest, indicating positive impact on muscle function. Pearson correlations revealed associations with better scores on the World Health Organization Quality of Life-BREF physical domain and greater EMG relaxation, supporting effects from PFPT on quality of life.
Pelvic symptoms improved in all subjects after vaginal reconstructive surgery. Whereas PFPT did not result in detectable subjective differences in this short-term study, superior muscular function suggested benefit from the intervention.
尽管盆底物理治疗（PFPT）对阴道重建手术后的不适症状可能有益，但并非所有患者都会常规接受该治疗。我们旨在评估围手术期PFPT在改善脱垂修复术后生活质量和功能方面的作用。
本随机对照试验比较了阴道重建手术后PFPT与标准护理的效果。干预组在术前2周以及术后2、4、6、8和12周接受PFPT治疗，并接受医生评估。对照组仅在术后相同时间点接受医生评估。两组在基线和12周时均完成盆腔器官脱垂定量检查、阴道内肌电图（EMG）、排尿日记以及经过验证的问卷调查。主要结局指标是术后世界卫生组织生活质量简表（WHOQOL-BREF）的变化。
49名女性完成了研究：PFPT组24名女性，对照组25名女性。在12周时，整个样本的特定病情问卷有所改善，证实了手术的有效性。然而，尽管进行了PFPT治疗，两组之间未发现显著差异。但是，阴道内EMG测量值明显受到干预的影响。PFPT组在所有静息测量中的平均值显著较低，表明对肌肉功能有积极影响。Pearson相关性分析显示，与世界卫生组织生活质量简表身体领域得分更高以及EMG放松程度更大相关，支持PFPT对生活质量的影响。
阴道重建手术后所有受试者的盆腔症状均有所改善。尽管在这项短期研究中PFPT未导致可检测到的主观差异，但肌肉功能的改善表明该干预措施有益。
