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产后尿失禁的物理治疗进展:系统评价。

Update on Physiotherapy in Postpartum Urinary Incontinence. A Systematic Review.

机构信息

Departamento de Bioloxía Funcional e Ciencias da Saúde, Facultade de Fisioterapia, Universidade de Vigo, Campus A Xunqueira s/n, 36005 Pontevedra, Spain.

Grupo de Investigación REMOSS, Universidade de Vigo, 36005 Pontevedra, Spain.

出版信息

Arch Esp Urol. 2023 Feb;76(1):29-39. doi: 10.56434/j.arch.esp.urol.20237601.2.

Abstract

BACKGROUND

Urinary incontinence in the postpartum period is related to biomechanical and hormonal changes that occur during the obstetric period and also related to perineal trauma during childbirth. Physiotherapy is currently presented as one of the conservative options for the treatment of urinary incontinence at this stage, so this review aims to go over scientific literature to assess the effect of physiotherapy on postpartum urinary incontinence.

MATERIAL AND METHODS

In February 2022, a bibliographic search was carried out in PubMed, Scopus, Medline, PeDRO and Sport Discuss databases. Studies published within the last 10 years and randomized clinical trials that used physiotherapy techniques for the treatment of postpartum urinary incontinence were identified, but those articles that differ from the objective of the work and those that were duplicated in the databases were excluded.

RESULTS

Out of the 51 articles identified, 8 were finally included that fit the criteria and the subject of the study. Regarding the intervention, we have found that all the articles refer to pelvic floor muscle training. In addition to urinary incontinence, these studies evaluated other variables such as strength, resistance, quality of life and sexual function, obtaining significant results in 6 out of all the studies consulted.

CONCLUSIONS

Pelvic floor muscle training is beneficial for the treatment of urinary incontinence in the postpartum period, then supervised and controlled exercise combined with a home training routine is recommended. It is not clear whether the benefits are maintained over time.

摘要

背景

产后尿失禁与产科期间发生的生物力学和激素变化有关,也与分娩时的会阴创伤有关。目前,物理疗法是治疗该阶段尿失禁的保守选择之一,因此,本综述旨在查阅科学文献,评估物理疗法对产后尿失禁的影响。

材料和方法

2022 年 2 月,在 PubMed、Scopus、Medline、PeDRO 和 Sport Discuss 数据库中进行了文献检索。确定了在过去 10 年内发表的、使用物理疗法技术治疗产后尿失禁的随机临床试验,但排除了与工作目标不同的文章和数据库中重复的文章。

结果

在确定的 51 篇文章中,最终有 8 篇符合标准和研究主题。关于干预措施,我们发现所有文章都提到了盆底肌肉训练。除了尿失禁,这些研究还评估了其他变量,如力量、阻力、生活质量和性功能,在所有咨询的研究中,有 6 项研究得出了显著结果。

结论

盆底肌肉训练有益于治疗产后尿失禁,然后建议进行监督和控制的运动,并结合家庭训练常规。目前尚不清楚这些益处是否能持续很长时间。

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