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评价单独使用和联合使用经皮胫神经电刺激治疗混合性尿失禁女性患者对盆底肌训练的满意度:一项随机、单盲临床试验。

Evaluation of satisfaction of pelvic floor muscle training isolated and associated with tibial nerve stimulation in women with mixed urinary incontinence: A randomized, single-blinded clinical trial.

机构信息

Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2021 Oct;265:60-65. doi: 10.1016/j.ejogrb.2021.06.024. Epub 2021 Jun 24.

Abstract

OBJECTIVES

To compare the satisfaction degree and pelvic floor manometry after pelvic floor muscle training isolated and associated with tibial nerve stimulation in women with mixed urinary incontinence (MUI).

STUDY DESIGN

A randomized, single-blinded clinical trial was conducted. 24 women diagnosed with MUI were equally divided into two groups: pelvic floor muscle training isolated and associated to transcutaneous tibial nerve stimulation (TTNS). The study occurred in four stages: 1) evaluation: general information, pelvic floor manometry, the International Consultation on Incontinence Questionnaire - Urinary Incontinence - Short Form (ICIQ-UI-SF) and International Consultation on Incontinence Questionnaire - Overactive Bladder (OAB) application; 2) intervention: carried out over 2 months twice a week; 3) post-intervention evaluation: vaginal manometry, reapplication of the questionnaires and the Patient Global Impression (PGI) application at the end of the 2-month intervention; and, 4) follow-up: evaluation after 1 month of the end of the intervention. The primary outcome was the ICIQ-UI-SF and the secondary outcomes were ICIQ-OAB, vaginal manometry, and PGI. The repeated measures ANOVA was used to assess the time-to-group interaction by assigning a significance level of 5%.

RESULTS

There was no interaction between time and group for ICIQ-UI-SF (p = 0.17) and manometry (p = 0.56). There was interaction for ICIQ-OAB (p < 0.01). PGI was reported as "much better" with 41.67% in the PFMTG + TTNS and 16.67% in the PFMTG after the intervention (p = 0.04).

CONCLUSIONS

The results showed weak evidence that TTNS, in combination with PFMT, may be an intervention that can be used to treat MUI. The satisfaction degree was better with associated intervention.

摘要

目的

比较盆底肌训练(PFMT)单独应用与联合胫神经刺激(TTNS)治疗混合性尿失禁(MUI)女性患者的满意度和盆底肌压力。

研究设计

这是一项随机、单盲的临床试验。将 24 例 MUI 患者等分为两组:PFMT 单独应用组和 PFMT 联合 TTNS 治疗组。研究分为四个阶段:1)评估:一般资料、盆底肌压力、国际尿失禁咨询问卷 - 尿失禁简短问卷(ICIQ-UI-SF)和国际尿失禁咨询问卷 - 膀胱过度活动症(OAB)问卷应用;2)干预:每周 2 次,共 2 个月;3)干预后评估:阴道压力、再次应用问卷和患者总体印象(PGI)评分;4)随访:干预结束后 1 个月评估。主要结局指标为 ICIQ-UI-SF,次要结局指标为 ICIQ-OAB、阴道压力和 PGI。采用重复测量方差分析,以 5%的显著性水平评估时间-组间交互作用。

结果

在 ICIQ-UI-SF 方面,时间与组间无交互作用(p=0.17),在阴道压力方面也无交互作用(p=0.56)。在 ICIQ-OAB 方面存在交互作用(p<0.01)。干预后,PFMTG+TTNS 组的 PGI 评分有 41.67%为“明显改善”,而 PFMTG 组为 16.67%(p=0.04)。

结论

结果表明,TTNS 联合 PFMT 治疗 MUI 的疗效证据较弱。联合干预的满意度更好。

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