Rodrigues Marina P, Barbosa Lia J F, Paiva Luciana L, Mallmann Suzana, Sanches Paulo R S, Ferreira Charles F, Ramos José G L
Graduate Program in Health Sciences: Gynecology and Obstetrics. Hospital de Clínicas de Porto Alegre. School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Undergraduate Program in Physiotherapy, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Eur J Obstet Gynecol Reprod Biol X. 2019 May 12;3:100022. doi: 10.1016/j.eurox.2019.100022. eCollection 2019 Jul.
According to the International Urogynecological Association and International Continence Society people with normal pelvic floor muscle function should have the ability to voluntarily and involuntarily contract and relax these muscles. However, many women are unaware of their pelvic floor, and it is estimated that about 30-50% do not know how to actively contract these muscles. Within this context, therapeutic strategies to improve pelvic floor muscle strength and function are particularly relevant.
To compare the use of an intravaginal vibratory stimulus (IVVS) versus intravaginal electrical stimulation (IVES) on pelvic floor muscle functionality in women with pelvic floor dysfunctions who cannot voluntarily contract these muscles.
Randomized clinical trial performed at a tertiary care hospital from June 2016 to September 2017. The sample comprised adult women with pelvic floor dysfunction who were unable to contract their pelvic floor muscles voluntarily. Women with latex allergy or other allergies in the pelvic region, vaginal or urinary tract infection, gynecological cancer, significant pain on palpation, or pelvic floor training over the preceding 6 months were excluded. After baseline assessment, women that met the inclusion criteria were randomized to receive once-weekly 20-minute sessions of IVVS or IVES for 6 weeks.
Twenty-one women were randomly assigned to each group; 18 completed the IVVS and 17 completed the IVES protocols. The IVVS group presented a significant increase in PFM strength in relation to the IVES group (p = 0.026). There was a significant interaction between time and type of intervention for the same variable (p = 0.008) in the IVVS group.
Both techniques were beneficial, but IVVS was significantly superior to IVES in improving pevic floor muscle strength. Additional studies are warranted to consolidate the utility of IVVS as a treatment modality for pelvic floor dysfunction.
根据国际尿控协会和国际尿失禁协会,盆底肌肉功能正常的人应具备自主和非自主收缩及放松这些肌肉的能力。然而,许多女性对自己的盆底情况并不了解,据估计约30%-50%的女性不知道如何主动收缩这些肌肉。在此背景下,改善盆底肌肉力量和功能的治疗策略尤为重要。
比较阴道内振动刺激(IVVS)与阴道内电刺激(IVES)对无法自主收缩盆底肌肉的盆底功能障碍女性盆底肌肉功能的影响。
2016年6月至2017年9月在一家三级护理医院进行的随机临床试验。样本包括无法自主收缩盆底肌肉的成年盆底功能障碍女性。排除有乳胶过敏或盆腔区域其他过敏、阴道或尿路感染、妇科癌症、触诊时有明显疼痛或在过去6个月内进行过盆底训练的女性。在基线评估后,符合纳入标准的女性被随机分为两组,每周接受一次20分钟的IVVS或IVES治疗,共6周。
每组随机分配21名女性;18名完成了IVVS方案,17名完成了IVES方案。与IVES组相比,IVVS组的盆底肌肉力量有显著增加(p = 0.026)。IVVS组中,同一变量的时间和干预类型之间存在显著交互作用(p = 0.008)。
两种技术都有益,但在改善盆底肌肉力量方面,IVVS明显优于IVES。需要进一步研究以巩固IVVS作为盆底功能障碍治疗方式的效用。