Madill Stéphanie J, Pontbriand-Drolet Stéphanie, Tang An, Dumoulin Chantale
School of Physical Therapy, University of Saskatchewan, 1121 College Drive, Saskatoon, SK, S7N 0W3, Canada,
Int Urogynecol J. 2015 Feb;26(2):277-83. doi: 10.1007/s00192-014-2507-6. Epub 2014 Sep 25.
The purpose of this study was to evaluate the effects of a pelvic floor muscle (PFM) rehabilitation program on the striated urethral sphincter in women over 60 years with stress urinary incontinence (SUI). We hypothesized that the PFM rehabilitation program would also exercise the striated urethral sphincter and that this would be demonstrated by hypertrophy of the sphincter on magnetic resonance imaging (MRI).
Women with at least weekly episodes of SUI were recruited. Participants were evaluated before and after a 12-week group PFM rehabilitation intervention with T2-weighted fast-spin-echo MRI sequences recorded in the axial plane at rest to assess urethral sphincter size. Data on SUI symptoms and their bother were also collected. No control group was included.
Seventeen women participated in the study. The striated urethral sphincter increased significantly in thickness (21%, p < 0.001), cross-sectional area (20%, p = 0.003), and volume (12%, p = 0.003) following the intervention. The reported number of incontinence episodes and their bother also decreased significantly.
This study appears to demonstrate that PFM training for SUI also trains the striated urethral sphincter and that improvement in incontinence signs and symptoms is associated with sphincter hypertrophy in older women with SUI. These findings support previous ultrasound (US) data showing an increase in urethral cross-sectional area following PFM training and extend the previous findings by more specifically assessing the area of hypertrophy and by demonstrating that older women present the same changes as younger women when assessed using MRI data.
本研究旨在评估盆底肌（PFM）康复计划对60岁以上压力性尿失禁（SUI）女性的尿道横纹括约肌的影响。我们假设PFM康复计划也会锻炼尿道横纹括约肌，并且这将通过磁共振成像（MRI）显示括约肌肥大来证明。
招募至少每周出现一次SUI发作的女性。在进行为期12周的PFM康复小组干预之前和之后，使用轴向平面上记录的T2加权快速自旋回波MRI序列对参与者进行评估，以评估尿道括约肌大小。还收集了SUI症状及其困扰的数据。未设对照组。
17名女性参与了该研究。干预后，尿道横纹括约肌的厚度（增加21%，p < 0.001）、横截面积（增加20%，p = 0.003）和体积（增加12%，p = 0.003）均显著增加。报告的尿失禁发作次数及其困扰也显著减少。
本研究似乎表明，针对SUI的PFM训练也能训练尿道横纹括约肌，并且在老年SUI女性中尿失禁体征和症状的改善与括约肌肥大有关。这些发现支持了先前的超声（US）数据，即PFM训练后尿道横截面积增加，并通过更具体地评估肥大区域以及证明老年女性在使用MRI数据评估时与年轻女性呈现相同变化，扩展了先前的研究结果。
