Division of Urogynecology, Harvard Medical School, Mount Auburn Hospital, Cambridge, Massachusetts.
Renovia Inc, Boston, Massachusetts.
Neurourol Urodyn. 2019 Sep;38(7):1944-1952. doi: 10.1002/nau.24097. Epub 2019 Jul 16.
To assess the effectiveness and patient satisfaction of pelvic floor muscle training (PFMT) guided by an intravaginal accelerometer-based system for the treatment of female urinary incontinence (UI).
Premenopausal women with mild-to-moderate stress or mixed UI were recruited to participate in PFMT with an accelerometer-based system for 6 weeks with supervision. Objective outcomes included pelvic floor muscle (PFM) contraction duration, number of contractions in 15 seconds, and angular displacement of the accelerometer relative to earth during PFM contraction. Subjective outcomes and quality-of-life were assessed with validated, condition-specific questionnaires. Results are presented as means, standard error of the mean, and 95% confidence intervals unless otherwise indicated.
Twenty-three women (age 42.0 ± 10.7 years, mean ± standard deviation) completed the study. Scores on the Urogenital Distress Inventory (UDI) decreased from 36.7 ± 4.7 at baseline to 1.45 ± 0.8 at 6 weeks (P < .0001). The Patient's Global Impression of Severity score decreased from 1.5 ± 0.1 to 0.2 ± 0.1 (P < .0001) at study endpoint. At 6 weeks, the PFM contraction duration increased from 13 ± 2.6 at baseline to 187 ± 9.6 seconds (P < .0001). Repeated contractions in 15 seconds increased from 5.9 ± 0.4 at enrollment to 9.6 ± 0.5 at 6 weeks (P < .0001). Maximum pelvic floor angle (a measure of lift) increased from 65.1 ± 2.0° to 81.1 ± 1.8° (P < .0001). Increasing PFM contraction duration and maximum pelvic floor angle correlated with decreasing UDI-6 scores, r = -0.87, P = .01; r = -0.97, P = .0003, respectively. No device-related adverse events occurred.
Pilot testing of this accelerometer-based system demonstrates improvements in objective PFM measures, patient-reported UI severity and condition-specific quality of life, with results evident after 1 week of use.
评估基于阴道内加速度计的系统指导下的盆底肌训练(PFMT)治疗女性尿失禁(UI)的有效性和患者满意度。
招募绝经前患有轻至中度压力性或混合性 UI 的女性,进行为期 6 周的基于加速度计的 PFMT 治疗,并进行监督。客观结果包括盆底肌(PFM)收缩持续时间、15 秒内收缩次数和 PFM 收缩期间加速度计相对于地球的角位移。使用经过验证的、特定于疾病的问卷评估主观结果和生活质量。结果以平均值、平均值的标准误差和 95%置信区间表示,除非另有说明。
23 名女性(年龄 42.0±10.7 岁,平均值±标准差)完成了研究。尿失禁问卷(UDI)评分从基线时的 36.7±4.7 分降至 6 周时的 1.45±0.8 分(P<.0001)。患者总体严重程度评分从研究终点时的 1.5±0.1 分降至 0.2±0.1 分(P<.0001)。6 周时,PFM 收缩持续时间从基线时的 13±2.6 秒增加到 187±9.6 秒(P<.0001)。15 秒内重复收缩次数从入组时的 5.9±0.4 次增加到 6 周时的 9.6±0.5 次(P<.0001)。最大盆底角度(衡量提升程度)从 65.1±2.0°增加到 81.1±1.8°(P<.0001)。PFM 收缩持续时间和最大盆底角度的增加与 UDI-6 评分的降低相关,r=-0.87,P=0.01;r=-0.97,P=0.0003。未发生与设备相关的不良事件。
该基于加速度计的系统的初步测试显示,客观 PFM 指标、患者报告的 UI 严重程度和特定于疾病的生活质量均得到改善,并且在使用 1 周后即可观察到结果。