Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, No. 707, Chung-Yang Rd., Sec. 3, Hualien, Taiwan, ROC.
Sci Rep. 2021 Jul 2;11(1):13757. doi: 10.1038/s41598-021-93283-9.
Dysfunctional voiding (DV), a voiding dysfunction due to hyperactivity of the external urethral sphincter or pelvic floor muscles leading involuntary intermittent contractions during voiding, is not uncommon in neurologically normal women with lower urinary tract symptoms (LUTS). We aimed to investigate the therapeutic efficacy of biofeedback pelvic floor muscle training (PFMT) in female patients with DV and to identify the therapeutic efficacy. Thirty-one patients diagnosed with DV. All participates completed the 3-month biofeedback PFMT program, which was conducted by one experienced physiotherapist. At 3 months after treatment, the assessment of treatment outcomes included global response assessment (GRA), and the changes of clinical symptoms, quality of life index, and uroflowmetry parameters. 25 (80.6%) patients had successful outcomes (GRA ≥ 2), and clinical symptoms and quality of life index significantly improved after PFMT. Additionally, uroflowmetry parameters including maximum flow rate, voided volume, voiding efficiency, total bladder capacity, voiding time, and time to maximum flow rate significantly improved after PFMT treatment. Patients with the history of recurrent urinary tract infection in recent 1 year were found to have unsatisfied therapeutic outcomes. In conclusion, biofeedback PFMT is effective in female patients with DV with significant improvements in clinical symptoms, quality of life, and uroflowmetry parameters. The history of urinary tract infection in recent 1 year is a negative predictor of successful outcome.
排尿功能障碍（DV），一种由于尿道外括约肌或盆底肌肉过度活跃导致排尿时不自主间歇性收缩的排尿功能障碍，在有下尿路症状（LUTS）的神经正常女性中并不少见。我们旨在研究生物反馈盆底肌肉训练（PFMT）对女性 DV 患者的治疗效果，并确定其疗效。31 名被诊断为 DV 的患者。所有参与者都完成了为期 3 个月的生物反馈 PFMT 计划，由一位经验丰富的物理治疗师进行。治疗 3 个月后，通过总体反应评估（GRA）评估治疗效果，并评估临床症状、生活质量指数和尿流动力学参数的变化。25 名（80.6%）患者有成功的结果（GRA≥2），PFMT 后临床症状和生活质量指数显著改善。此外，PFMT 治疗后最大流量、排尿量、排尿效率、膀胱总容量、排尿时间和最大流量时间等尿流动力学参数均显著改善。在过去 1 年内有复发性尿路感染史的患者发现治疗效果不满意。总之，生物反馈 PFMT 对女性 DV 患者有效，可显著改善临床症状、生活质量和尿流动力学参数。最近 1 年内尿路感染史是治疗成功的负面预测因素。
