Okui Nobuo, Erel Tamer, Okui Machiko Aurora
Dentistry, Kanagawa Dental University, Yokosuka, JPN.
Department of Obstetrics and Gynecology, Istanbul University, Cerrahpasa School of Medicine, Istanbul, TUR.
Cureus. 2023 Aug 30;15(8):e44364. doi: 10.7759/cureus.44364. eCollection 2023 Aug.
Introduction This study aimed to identify predictive factors for successful return to sports among elite female athletes (EFAs) experiencing stress urinary incontinence (SUI). We used machine learning to analyze these predictors. Methods This study was conducted at Yokosuka Urogynecology and Urology Clinic, located in Yokosuka City, Kanagawa, Japan. A total of 153 EFAs with postpartum SUI were included in this retrospective cohort study. Information regarding the frequency of pelvic floor muscle training (PFMT), treatment approaches, rates of return to sports after one year, and one-hour pad test (1HrPadtest) at three months were collected. Results At three months, 26.8% of the EFAs improved in SUI; after one year, 28.1% returned to their respective sports successfully. The equation for predicting return to sports (logit(p)) involved several factors: (a) serum total testosterone, (b) PFMT frequency per week, (c) 1HrPadtest at three months, and (d) vaginal erbium-doped yttrium aluminum garnet laser (VEL) + urethral EL (UEL) treatment. The equation was as follows: -126 - 0.07276a + 25.98b - 1.947c - 25.32d, with a logit(p) cutoff point at 0.5. The optimal cutoff values and the four influential factors were determined through a receiver operating characteristic (ROC) analysis and the random forest model, respectively. Conclusions For EFAs with severe SUI to successfully return to their sports activities, the PFMT frequency was paramount. Patients who exhibited unsatisfactory results in the 1HrPadtest at the three-month mark benefited from the VEL+UEL treatment. Serum total testosterone proved to be an effective discerning criterion.
引言 本研究旨在确定压力性尿失禁（SUI）的精英女性运动员（EFA）成功恢复运动的预测因素。我们使用机器学习来分析这些预测因素。方法 本研究在位于日本神奈川县横须贺市的横须贺妇产科和泌尿科诊所进行。本回顾性队列研究共纳入153名产后SUI的EFA。收集了盆底肌肉训练（PFMT）频率、治疗方法、一年后恢复运动的比例以及三个月时的一小时垫试验（1HrPadtest）等信息。结果 三个月时，26.8%的EFA的SUI症状有所改善；一年后，28.1%的EFA成功恢复各自的运动项目。预测恢复运动的方程（logit(p)）涉及几个因素：（a）血清总睾酮，（b）每周PFMT频率，（c）三个月时的1HrPadtest，以及（d）阴道掺铒钇铝石榴石激光（VEL）+尿道EL（UEL）治疗。方程如下：-126 - 0.07276a + 25.98b - 1.947c - 25.32d，logit(p)截止点为0.5。通过受试者操作特征（ROC）分析和随机森林模型分别确定了最佳截止值和四个影响因素。结论 对于患有严重SUI的EFA要成功恢复体育活动，PFMT频率至关重要。在三个月时1HrPadtest结果不理想的患者从VEL+UEL治疗中获益。血清总睾酮被证明是一个有效的鉴别标准。
