Department of Obstetrics and Gynecology, St. Olavs University Hospital, Trondheim, Norway.
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Int Urogynecol J. 2021 Oct;32(10):2787-2794. doi: 10.1007/s00192-021-04684-3. Epub 2021 Feb 13.
Pelvic floor muscle training (PFMT) improves urinary incontinence and mild pelvic organ prolapse (POP). We aimed to investigate the effect of preoperative PFMT on urinary and colorectal-anal distress and related quality of life (QoL) in women with severe POP scheduled for surgery.
Randomized controlled trial of 159 women scheduled for POP surgery (intervention = 81, controls = 78). Intervention consisted of daily PFMT from inclusion to the day of surgery. Symptoms and QoL were assessed at inclusion, day of surgery and 6 months postoperatively using the Urinary Distress Inventory (UDI-6), Colorectal-Anal Distress Inventory (CRADI-8), Urinary Impact Questionnaire (UIQ) and Colorectal-Anal Impact Questionnaire (CRAIQ) (range 0-100). Mixed model statistical analyses were used.
One hundred fifty-one (95%) women completed the study (intervention = 75, controls = 76). Mean waiting times until surgery and follow-up were 22 and 28 weeks. There was no difference in mean postoperative symptom and QoL scores (95% CI) between the intervention and control group: UDI-6 16 (12-21) vs. 17 (13-22), CRADI-8 15 (11-18) vs. 13 (10-16), UIQ 11 (7-15) vs. 10 (6-13) and CRAIQ 5 (2-7) vs. 6 (4-9), all p > 0.05. Overall mean scores were reduced from baseline to postoperative follow-up: UDI-6 37 (33-41) vs. 17 (14-20), CRADI-8 22 (19-25) vs. 14 (11-16); UIQ 28 (24-32) vs. 10 (7-13) and CRAIQ 16 (12-19) vs. 5 (3-7), all p < 0.01.
We found no added effect of preoperative PFMT on symptoms or QoL related to urinary and colorectal-anal distress in women scheduled for POP surgery. They achieved symptomatic improvement postoperatively regardless of PFMT.
The study was registered in clinicaltrials.gov: NCT 03,064,750.
骨盆底肌肉训练（PFMT）可改善尿失禁和轻度盆腔器官脱垂（POP）。我们旨在研究术前 PFMT 对接受手术治疗的严重 POP 女性的尿和肛肠窘迫以及相关生活质量（QoL）的影响。
对 159 名计划接受 POP 手术的女性进行随机对照试验（干预组=81 名，对照组=78 名）。干预措施包括从纳入到手术当天每天进行 PFMT。使用尿失禁困扰量表（UDI-6）、肛肠窘迫量表（CRADI-8）、尿失禁影响问卷（UIQ）和肛肠影响问卷（CRAIQ）在纳入时、手术当天和术后 6 个月评估症状和 QoL（范围 0-100）。采用混合模型统计分析。
151 名（95%）女性完成了研究（干预组=75 名，对照组=76 名）。手术和随访的平均等待时间分别为 22 周和 28 周。干预组和对照组的术后平均症状和 QoL 评分（95%置信区间）无差异：UDI-6 16（12-21）vs. 17（13-22），CRADI-8 15（11-18）vs. 13（10-16），UIQ 11（7-15）vs. 10（6-13）和 CRAIQ 5（2-7）vs. 6（4-9），所有 p 值均>0.05。总体平均评分从基线到术后随访均降低：UDI-6 37（33-41）vs. 17（14-20），CRADI-8 22（19-25）vs. 14（11-16）；UIQ 28（24-32）vs. 10（7-13）和 CRAIQ 16（12-19）vs. 5（3-7），所有 p 值均<0.01。
我们发现术前 PFMT 对计划接受 POP 手术的女性的尿和肛肠窘迫相关症状或 QoL 无额外作用。无论是否接受 PFMT，她们在术后都有症状改善。
该研究在 clinicaltrials.gov 上注册：NCT 03,064,750。
