From the HUMAP - UFMS, Campo Grande - MS, Brazil (AL); University of Campinas - UNICAMP, Campinas, São Paulo, Brazil (AL, BPD, MHBdML, CALD); and Escola Superior de Ciência da Santa Casa de Misericórdia de Vitória - EMESCAM, Vitória, Espírito Santo, Brazil (CBL).
Am J Phys Med Rehabil. 2019 Apr;98(4):275-279. doi: 10.1097/PHM.0000000000001065.
The aims of this study were to investigate whether detrusor overactivity can be influenced by a pelvic floor muscle contraction in multiple sclerosis-associated overactive bladder and idiopathic overactive bladder volunteers and to compare urodynamic findings between the two groups.
Eighteen women with multiple sclerosis-associated overactive bladder and 17 women with overactive bladder responded the overactive bladder V8 questionnaire and performed urodynamic study with electromyography of pelvic floor muscle to confirm the presence of a 15-sec pelvic floor muscle contraction during a detrusor overactivity, when present. Variables were the following: overactive bladder-V8 questionnaire, maximum cystometric capacity, volume at first detrusor overactivity, maximum detrusor overactivity amplitude, and percentage of detrusor overactivity pressure reduction.
All participants had a reduction in detrusor overactivity pressure when pelvic floor muscle contraction was requested. Multiple sclerosis-associated overactive bladder group showed significant higher detrusor overactivity amplitude than overactive bladder group (P = 0.02). Overactive bladder group had their detrusor overactivity pressure reduced in a greater extent when compared with multiple sclerosis-associated overactive bladder group (P = 0.01).
The results suggest that pelvic floor muscle contraction is able to reduce detrusor overactivity pressure in multiple sclerosis-associated overactive bladder and overactive bladder population.
本研究旨在探讨逼尿肌过度活动是否可通过多发性硬化相关性膀胱过度活动症和特发性膀胱过度活动症志愿者的盆底肌收缩来影响,并比较两组之间的尿动力学发现。
18 名多发性硬化相关性膀胱过度活动症女性和 17 名膀胱过度活动症女性对膀胱过度活动症 V8 问卷作出回应,并进行尿动力学研究,同时对盆底肌肌电图进行检查,以确认在逼尿肌过度活动期间存在 15 秒的盆底肌收缩(若存在)。变量包括:膀胱过度活动症 V8 问卷、最大膀胱容量、首次逼尿肌过度活动时的容量、最大逼尿肌过度活动幅度以及逼尿肌过度活动压力降低的百分比。
当要求盆底肌收缩时,所有参与者的逼尿肌过度活动压力均降低。多发性硬化相关性膀胱过度活动症组的逼尿肌过度活动幅度显著高于膀胱过度活动症组(P = 0.02)。与多发性硬化相关性膀胱过度活动症组相比,膀胱过度活动症组的逼尿肌过度活动压力降低幅度更大(P = 0.01)。
研究结果表明,盆底肌收缩可降低多发性硬化相关性膀胱过度活动症和膀胱过度活动症患者的逼尿肌过度活动压力。