Kolberg Tennfjord M, Hilde G, Staer-Jensen J, Siafarikas F, Engh M Ellström, Bø K
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway.
BJOG. 2016 Mar;123(4):634-42. doi: 10.1111/1471-0528.13823. Epub 2015 Dec 22.
Evaluate effect of pelvic floor muscle training (PFMT) on vaginal symptoms and sexual matters, dyspareunia and coital incontinence in primiparous women stratified by major or no defects of the levator ani muscle.
Randomised controlled trial (RCT).
Akershus University Hospital, Norway.
About 175 primiparous women with a singleton vaginal delivery.
Two-armed assessor blinded parallel group RCT from 6 weeks to 6 months postpartum comparing effect of PFMT versus control.
International Consultation on Incontinence Modular Questionnaire-vaginal symptoms questionnaire (ICIQ-VS) and ICIQ sexual matters module (ICIQ-FLUTSsex).
Overall, analysis (n = 175) showed no difference between training and control groups in women having vaginal symptoms or symptoms related to sexual dysfunction 6 months postpartum. The majority of women (88%) had intercourse and there was no difference between groups. Unadjusted subgroup analysis of women with a major defect of the levator ani muscle (n = 55) showed that women in the training group had 45% less risk of having the symptom 'vagina feels loose or lax' compared with the control group (relative risk 0.55, 95% confidence interval 0.31, 0.95; P = 0.03).
Unadjusted analysis showed that in women with major defect of the levator ani muscle, significantly fewer in the training group had the symptom 'vagina feels loose or lax' compared with the control group. No difference was found between groups for symptoms related to sexual dysfunction. More studies are needed to explore effect of PFMT on vaginal symptoms and sexual dysfunction.
Unadjusted analysis shows that PFMT might prevent symptoms of 'vagina feels loose or lax'.
评估盆底肌肉训练(PFMT)对初产妇阴道症状、性相关问题、性交疼痛和性交失禁的影响,这些初产妇根据肛提肌有无严重缺陷进行分层。
随机对照试验(RCT)。
挪威阿克什胡斯大学医院。
约175名单胎阴道分娩的初产妇。
产后6周-6个月进行双臂评估者盲法平行组RCT,比较PFMT与对照组的效果。
国际尿失禁咨询委员会模块化问卷-阴道症状问卷(ICIQ-VS)和ICIQ性相关问题模块(ICIQ-FLUTSsex)。
总体而言,分析(n = 175)显示,产后6个月有阴道症状或性功能障碍相关症状的女性,训练组和对照组之间无差异。大多数女性(88%)有性生活,两组之间无差异。对肛提肌有严重缺陷的女性(n = 55)进行的未调整亚组分析显示,与对照组相比,训练组女性出现“阴道感觉松弛”症状的风险降低45%(相对风险0.55,95%置信区间0.31,0.95;P = 0.03)。
未调整分析显示,与对照组相比,肛提肌有严重缺陷的女性中,训练组出现“阴道感觉松弛”症状的人数明显更少。两组在性功能障碍相关症状方面未发现差异。需要更多研究来探讨PFMT对阴道症状和性功能障碍的影响。
未调整分析表明,PFMT可能预防“阴道感觉松弛”症状。