Elmelund Marlene, Biering-Sørensen Fin, Due Ulla, Klarskov Niels
Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Havnevej 25, 3100, Hornbæk, Denmark.
Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
Int Urogynecol J. 2018 Nov;29(11):1597-1606. doi: 10.1007/s00192-018-3630-6. Epub 2018 Mar 24.
Urinary incontinence is a prevalent problem in women with spinal cord injury. The aim of this study was to examine the effect of pelvic floor muscle training (PFMT) alone and combined with intravaginal electrical stimulation (IVES) on urinary incontinence in women with incomplete spinal cord injury.
In this investigator-blinded randomized clinical trial, we recruited women aged 18-75 with incomplete spinal cord injury and urinary incontinence from a single spinal cord injury clinic in Denmark. Women were randomly assigned to either PFMT or PFMT combined with IVES daily at home for 12 weeks. All women were trained by a physiotherapist using vaginal palpation and electromyography biofeedback. Outcome measures were recorded at baseline (week 0), post-intervention (week 12) and follow-up (week 24) and included change in the total score on the International Consultation on Incontinence Questionnaire urinary incontinence short form (ICIQ-UI-SF) and daily episodes of urinary incontinence.
From 27 April 2015-9 September 2016, we randomly assigned 36 women (17 in the PFMT group and 19 in the PFMT+IVES group); 27 completed the interventions (13 in the PFMT group and 14 in the PFMT+IVES group). The results showed no difference between the groups on ICIQ-UI-SF or episodes of urinary incontinence at 12 and 24 weeks. Only the PFMT group had a significant change from baseline on ICIQ-UI-SF [-2.4 (95% CI -4.3--0.5), p = 0.018] and daily episodes of urinary incontinence [-0.4 (95% CI -0.8--0.1), p = 0.026] at 12 weeks.
PFMT+IVES is not superior to PFMT alone in reducing urinary incontinence in women with incomplete spinal cord injury.
尿失禁是脊髓损伤女性中的常见问题。本研究的目的是探讨单独盆底肌训练（PFMT）以及联合阴道内电刺激（IVES）对不完全性脊髓损伤女性尿失禁的影响。
在这项研究者设盲的随机临床试验中，我们从丹麦一家脊髓损伤诊所招募了18至75岁、患有不完全性脊髓损伤且有尿失禁的女性。女性被随机分配至PFMT组或PFMT联合IVES组，在家中每天进行12周的训练。所有女性均由物理治疗师使用阴道触诊和肌电图生物反馈进行训练。在基线（第0周）、干预后（第12周）和随访（第24周）记录结果指标，包括国际尿失禁咨询委员会尿失禁简表（ICIQ-UI-SF）总分的变化以及每日尿失禁发作次数。
从2015年4月27日至2016年9月9日，我们随机分配了36名女性（PFMT组17名，PFMT + IVES组19名）；27名完成了干预（PFMT组13名，PFMT + IVES组14名）。结果显示，两组在第12周和第24周时ICIQ-UI-SF或尿失禁发作次数方面无差异。仅PFMT组在第12周时ICIQ-UI-SF从基线有显著变化[-2.4（95%CI -4.3--0.5），p = 0.018]，且每日尿失禁发作次数也有显著变化[-0.4（95%CI -0.8--0.1），p = 0.026]。
在减少不完全性脊髓损伤女性尿失禁方面，PFMT联合IVES并不优于单独的PFMT。
