Fitz Fátima, Sartori Marair, Girão Manoel João, Castro Rodrigo
Department of Gynecology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Rev Assoc Med Bras (1992). 2017 Dec;63(12):1032-1038. doi: 10.1590/1806-9282.63.12.1032.
Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms.
To verify the effects of isolated PFMT on the symptoms of OAB.
Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-of-Life Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data.
There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003). In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL.
The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.
盆底肌肉训练（PFMT）包括耻骨直肠肌、肛门括约肌和尿道外肌的收缩，抑制逼尿肌收缩，这证明了其在治疗膀胱过度活动症（OAB）症状中的应用合理性。
验证单独的PFMT对OAB症状的影响。
对27名混合性尿失禁（MUI）女性进行前瞻性临床试验，这些女性以OAB症状为主，且在尿垫试验中丢失量≥2克。评估了：盆底肌肉（PFMs）功能（指诊和压力测定）；泌尿系统症状（夜尿、尿频和尿失禁）；OAB症状的不适程度；以及生活质量（尿失禁生活质量问卷[I-QoL]）。PFMT计划包括24次门诊治疗（每周2次+家庭PFMT）。使用Mann-Whitney和Wilcoxon检验（显著性水平为5%）分析数据。
尿垫试验中的泌尿系统症状（5.8±9.7，p<0.001）、尿失禁（0.7±1.1，p=0.005）和夜尿（0.8±0.9，p=0.011）有显著改善。根据OAB-V8问卷，泌尿系统症状的不适程度有所降低（10.0±7.7，p=0.001）。PFMs功能也有显著结果：牛津评分（3.6±0.9，p=0.001）、耐力（5.2±1.8，p<0.001）、快速收缩（8.9±1.5，p<0.001）和压力测定（26.6±15.8，p=0.003）。此外，I-QoL评估的三个领域的生活质量有显著改善。
无任何额外指导的PFMT可改善有OAB症状女性的症状、PFMs功能和生活质量。
