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电刺激联合盆底肌训练治疗女性压力性尿失禁的随机对照研究

Effects of external electrical stimulation added to pelvic floor muscle training in women with stress urinary incontinence: A randomized controlled study.

机构信息

Department of Therapy and Rehabilitation, Vocational School of Health Services, Giresun University, Giresun, Turkey.

Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Ordu University, Ordu, Turkey.

出版信息

Neurourol Urodyn. 2022 Nov;41(8):1781-1792. doi: 10.1002/nau.25022. Epub 2022 Aug 18.

Abstract

OBJECTIVE

In this study, the combination of external electrical stimulation (EES) with pelvic floor muscle training (PFMT) was assessed to determine if it yielded better results than PFMT or EES alone for treatment of stress urinary incontinence (SUI).

STUDY DESIGN

Fifty-one women with SUI were randomly allocated to EES + PFMT (n = 17), PFMT (n = 17), or EES groups (n = 17) for 8 weeks of treatment. Personal, demographic, and clinical characteristics of the patients were recorded. Outcome measures included self-reported improvement, severity of incontinence, symptom distress, quality of life (QOL), urinary incontinence episodes, pelvic floor muscle strength (PFMS) and endurance (PFME) and dysfunction. All evaluations were made pre- and posttreatment. Data were analyzed using the Chi-square, marginal homogeneity, Kruskal-Wallis, Wilcoxon signed-rank or paired t test and Dunn-Bonferroni post hoc tests.

RESULTS

In the 8th week, there were significant changes in self-reported improvement, severity of incontinence, symptom distress score, urinary incontinence episodes, PFMS, PFME, pelvic floor dysfunction and all areas of QoL in all groups (p < 0.05). Combined therapy was not superior to PFMT and EES for overall outcome measures, except for the incontinence impact subdomain of the QoL score (p < 0.05).

CONCLUSIONS

Our study supports the idea that PFMT should be preferred as the first line therapy for women with SUI. However, the acceptable EES method can be recommended in addition to PFMT to increase motivation and treatment compliance in patients with insufficient or inaccurate pelvic floor muscle contractions.

摘要

目的

本研究旨在评估电刺激(EES)联合盆底肌训练(PFMT)与单独进行 PFMT 或 EES 治疗压力性尿失禁(SUI)的效果,以确定其是否优于单独治疗。

研究设计

将 51 例 SUI 患者随机分为 EES+PFMT 组(n=17)、PFMT 组(n=17)和 EES 组(n=17),分别接受 8 周的治疗。记录患者的个人、人口统计学和临床特征。疗效评估指标包括患者自我报告的改善情况、尿失禁严重程度、症状困扰程度、生活质量(QOL)、尿失禁发作次数、盆底肌力量(PFMS)和耐力(PFME)以及功能障碍。所有评估均在治疗前后进行。数据分析采用卡方检验、边际同质性检验、Kruskal-Wallis 检验、Wilcoxon 符号秩检验或配对 t 检验和 Dunn-Bonferroni 事后检验。

结果

在第 8 周时,所有组患者的自我报告改善情况、尿失禁严重程度、症状困扰评分、尿失禁发作次数、PFMS、PFME、盆底功能障碍以及 QOL 的所有领域均发生显著变化(p<0.05)。除 QOL 评分的尿失禁影响子域(p<0.05)外,联合治疗在整体疗效评估方面并不优于 PFMT 和 EES。

结论

本研究支持将 PFMT 作为 SUI 患者的一线治疗方法的观点。然而,对于盆底肌收缩不足或不准确的患者,可以在接受 PFMT 的基础上,推荐使用可接受的 EES 方法,以增加患者的治疗积极性和依从性。

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