Faculty of Medicine, Department of Urology, Kütahya Health Science University, Kutahya, Turkey.
Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Kütahya Health Science University, Kutahya, Turkey.
Int Urogynecol J. 2022 Aug;33(8):2299-2306. doi: 10.1007/s00192-022-05279-2. Epub 2022 Jul 2.
We aimed to reveal the effectiveness of the combination of behavioral therapy (BT), drug therapy, and pelvic floor muscle training (PFMT) in patients with the diagnosis of overactive bladder (OAB) who did not respond to drug therapy.
Seventy female patients aged between 18 and 65 years diagnosed with wet-type OAB, who did not respond to drug therapy, were included in our study, which was planned as a prospective randomized controlled trial. The patients were randomly assigned to one of two groups. BT and a combination of anticholinergic + beta3-agonist was implemented in the control group for 12 weeks. BT and PFMT were applied with a combination of anticholinergic + beta3-agonist in the active therapy group for 12 weeks. Post-treatment changes in OAB, ICIQ-SF scores, and frequency and nocturia were compared.
The age and BMI averages of the groups were similar (p>0.01). After the treatment, no significant decrease was observed in OAB scores in the control group (p = 0.06), but a significant decrease was observed in the active therapy group (p<0.01). The mean ICIQ-SF scores and the number of nocturia were found to decrease in both groups after 12 weeks of treatment (p<0.01). There was no significant decrease in frequency in the control group (p = 0.054). It regressed significantly in the active therapy group (p<0.01). After the treatment, 3 of 30 the patients in control group (10%) and 11 of the 32 patients in the active therapy group (34.3%) said that their complaints had regressed and that they were pleased with their current situation. Although after the treatment, 4 patients in the control group were dry (13.3%), 10 patients in the active therapy group were dry (31.25%).
We demonstrated that drug therapy, BT, and PFMT, which are recommended in the first-line treatment of OAB reduce the need for invasive treatments when they are well explained to the patients and combined.
我们旨在揭示行为疗法（BT）、药物治疗和盆底肌肉训练（PFMT）联合应用于对药物治疗无反应的膀胱过度活动症（OAB）患者的有效性。
本研究为前瞻性随机对照试验，共纳入 70 例年龄在 18-65 岁之间、被诊断为湿型 OAB 且对药物治疗无反应的女性患者。将患者随机分为两组。对照组接受 BT 和抗胆碱能药物+β3-激动剂联合治疗 12 周，治疗组接受 BT 和抗胆碱能药物+β3-激动剂联合 PFMT 治疗 12 周。比较两组治疗后 OAB、ICIQ-SF 评分、频率和夜尿症的变化。
两组年龄和 BMI 平均值相似（p>0.01）。治疗后，对照组 OAB 评分无显著下降（p=0.06），而治疗组有显著下降（p<0.01）。两组治疗 12 周后，ICIQ-SF 评分和夜尿症次数均有下降（p<0.01）。对照组频率无显著下降（p=0.054），治疗组显著下降（p<0.01）。治疗后，对照组 30 例患者中有 3 例（10%）、治疗组 32 例患者中有 11 例（34.3%）表示症状缓解，对现状满意。虽然治疗后对照组有 4 例（13.3%）患者完全缓解，治疗组有 10 例（31.25%）患者完全缓解。
我们证实，药物治疗、BT 和 PFMT 是 OAB 的一线治疗方法，当向患者充分解释并联合应用时，可以减少侵入性治疗的需求。
