Nursing Division, Toranomon Hospital, Tokyo, Japan.
Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Drug Discov Ther. 2022;16(1):23-29. doi: 10.5582/ddt.2022.01015.
Previous studies have proposed that pelvic misalignment may be associated with stress urinary incontinence through a decrease in the contractile function of the pelvic floor muscles; however, this relationship remains unclear. This study aimed to clarify the relationship between low back pain, an indication of pelvic misalignment, and stress urinary incontinence at 3 months postpartum. We conducted a cross-sectional study of women who gave birth to full-term babies between July 2008 and July 2009. Stress urinary incontinence was defined as urinary leakage when coughing, sneezing, or exercising. Low back pain was defined as pain between the ribs and gluteal sulcus in the preceding 2 months. Of the 228 subjects included in the study, the prevalence of stress urinary incontinence was 22.8% (n = 52). The prevalence of low back pain in the stress urinary incontinence group was significantly higher than that in the non-stress urinary incontinence group (78.8% [n = 41] vs. 57.4% [n = 101]; p = 0.005). Stress urinary incontinence was associated with older age, primiparity, vaginal delivery, and low back pain at 3 months. In conclusion, low back pain was associated with stress urinary incontinence after adjusting for pregnancy and delivery factors, suggesting pelvic misalignment contributes to the development of stress urinary incontinence. We propose that including care for pelvic misalignment in pelvic floor muscle training, the treatment of choice for stress urinary incontinence, could be beneficial.
先前的研究提出，骨盆错位可能通过降低盆底肌肉的收缩功能与压力性尿失禁有关；然而，这种关系仍不清楚。本研究旨在阐明产后 3 个月时，下背痛（骨盆错位的指征）与压力性尿失禁之间的关系。我们对 2008 年 7 月至 2009 年 7 月间足月分娩的妇女进行了一项横断面研究。压力性尿失禁的定义为咳嗽、打喷嚏或运动时出现漏尿。下背痛的定义为肋骨和臀沟之间的疼痛，持续时间在 2 个月内。在纳入研究的 228 名受试者中，压力性尿失禁的患病率为 22.8%（n=52）。压力性尿失禁组的下背痛患病率显著高于非压力性尿失禁组（78.8%[n=41]比 57.4%[n=101]；p=0.005）。压力性尿失禁与年龄较大、初产妇、阴道分娩和产后 3 个月的下背痛有关。结论，调整妊娠和分娩因素后，下背痛与压力性尿失禁相关，提示骨盆错位可能导致压力性尿失禁的发生。我们建议在盆底肌肉训练中加入对骨盆错位的治疗，盆底肌肉训练是治疗压力性尿失禁的首选方法，这可能是有益的。
