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多模式阴道调理对压力性尿失禁患者膀胱症状及生活质量的影响

Multimodal vaginal toning for bladder symptoms and quality of life in stress urinary incontinence.

作者信息

de la Torre Sarah, Miller Larry E

机构信息

Seattle OB/GYN Group, 1101 Madison Street, Suite 950, Seattle, WA, 98104, USA.

Miller Scientific Consulting, Asheville, NC, USA.

出版信息

Int Urogynecol J. 2017 Aug;28(8):1201-1207. doi: 10.1007/s00192-016-3248-5. Epub 2016 Dec 29.

Abstract

INTRODUCTION AND HYPOTHESIS

Treatment options for women with stress urinary incontinence (SUI) have limitations. We hypothesized that multimodal vaginal toning therapy would improve bladder symptoms and quality of life in women with postpartum SUI and sexual function complaints.

METHODS

Patients self-administered 24 sessions of multimodal vaginal toning therapy lasting 10 min each over 50 days. Outcomes included 1-h pad weight test, Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Female Sexual Distress Scale-Revised 2005 (FSDS-R), Female Sexual Function Index (FSFI), pelvic floor muscle strength, patient satisfaction, and adverse events.

RESULTS

Of the 55 patients enrolled (safety population), 48 completed the study per-protocol (PP population). A total of 38 (79%) patients had a positive 1-h pad weight test at baseline. In this group, urine leakage was moderate or severe in 82% of patients at baseline, but in only 18% after treatment. Treatment success was 84%, defined as >50% improvement in pad weight relative to baseline. In the PP population, mean UDI-6 score improved by 50% (p < 0.001) and IIQ-7 score improved by 69% (p < 0.001). Sexual function quality of life improved by 54% for FSDS-R and 15% for FSFI (both p < 0.001). Pelvic floor muscle strength significantly improved (p < 0.001). Patient satisfaction with therapy was reported in 83% of patients. In the safety population, 2 (3.6%) adverse events were reported-1 urinary tract infection and 1 report of discomfort due to excessive warmth.

CONCLUSIONS

Multimodal vaginal toning therapy yields clinically meaningful improvements in bladder symptoms, pelvic floor muscle strength, and quality of life in women with SUI.

摘要

引言与假设

压力性尿失禁(SUI)女性的治疗选择存在局限性。我们假设多模式阴道紧致疗法可改善产后SUI且伴有性功能障碍主诉女性的膀胱症状及生活质量。

方法

患者在50天内自行进行24次多模式阴道紧致治疗,每次持续10分钟。结果指标包括1小时护垫重量试验、泌尿生殖系统困扰量表简表(UDI - 6)、尿失禁影响问卷简表(IIQ - 7)、2005年修订版女性性功能障碍量表(FSDS - R)、女性性功能指数(FSFI)、盆底肌肉力量、患者满意度及不良事件。

结果

纳入的55例患者(安全人群)中,48例按方案完成研究(符合方案人群)。共有38例(79%)患者在基线时1小时护垫重量试验结果为阳性。在该组中,82%的患者在基线时漏尿程度为中度或重度,但治疗后仅为18%。治疗成功率为84%,定义为护垫重量相对于基线改善>50%。在符合方案人群中,平均UDI - 6评分改善50%(p < 0.001),IIQ - 7评分改善69%(p < 0.001)。FSDS - R的性功能生活质量改善54%,FSFI改善15%(均p < 0.001)。盆底肌肉力量显著改善(p < 0.001)。83%的患者报告对治疗满意。在安全人群中,报告了2例(3.6%)不良事件——1例尿路感染和1例因过热导致的不适报告。

结论

多模式阴道紧致疗法可使SUI女性的膀胱症状、盆底肌肉力量及生活质量在临床上得到有意义的改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31fb/5514206/ad4c002d9625/192_2016_3248_Fig1_HTML.jpg

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