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盆底手术需要术前康复治疗(PREHAB)吗?专题综述

Is PREHAB in Pelvic Floor Surgery Needed? A Topical Review.

作者信息

Szymański Jacek K, Starzec-Proserpio Małgorzata, Słabuszewska-Jóźwiak Aneta, Jakiel Grzegorz

机构信息

1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Żelazna 90 str., 00-004 Warsaw, Poland.

Department of Gynecology, St. Sophia Hospital, Żelazna Medical Center, Żelazna 90 str., 00-004 Warsaw, Poland.

出版信息

Medicina (Kaunas). 2020 Nov 6;56(11):593. doi: 10.3390/medicina56110593.

Abstract

Pelvic organ prolapse and urinary incontinence affect approximately 6-11% and 6-40% of women, respectively. These pathologies could result from a weakness of pelvic floor muscles (PFM) caused by previous deliveries, aging or surgery. It seems reasonable that improving PFM efficacy should positively impact both pelvic floor therapy and surgical outcomes. Nonetheless, the existing data are inconclusive and do not clearly support the positive impact of preoperative pelvic floor muscle training on the improvement of surgical results. The restoration of deteriorated PFM function still constitutes a challenge. Thus, further well-designed prospective studies are warranted to answer the question of whether preoperative PFM training could optimize surgical outcomes and if therapeutic actions should focus on building muscle strength or rather on enhancing muscle performance.

摘要

盆腔器官脱垂和尿失禁分别影响约6% - 11%和6% - 40%的女性。这些病症可能是由既往分娩、衰老或手术导致的盆底肌肉(PFM)薄弱引起的。改善PFM功能应该对盆底治疗和手术结果产生积极影响,这似乎是合理的。然而,现有数据尚无定论,并未明确支持术前盆底肌肉训练对改善手术效果的积极影响。恢复退化的PFM功能仍然是一项挑战。因此,有必要进行进一步精心设计的前瞻性研究,以回答术前PFM训练是否能优化手术结果,以及治疗措施是否应侧重于增强肌肉力量还是提高肌肉性能这一问题。

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