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生物反馈和电刺激保守治疗对盆底功能障碍的有益效果。

The beneficial effects of conservative treatment with biofeedback and electrostimulation on pelvic floor disorders.

作者信息

Chen Mei-Chen, Lai Pei-Hsuan, Ding Dah-Ching

机构信息

Department of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan.

Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.

出版信息

Tzu Chi Med J. 2023 Sep 22;36(3):291-297. doi: 10.4103/tcmj.tcmj_174_23. eCollection 2024 Jul-Sep.

Abstract

OBJECTIVES

Pelvic floor disorders (PFDs) such as stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can be managed through conservative treatments, such as conservative management involving biofeedback (BF) and electrostimulation. This study aimed to investigate the therapeutic effects of conservative treatments on PFDs.

MATERIALS AND METHODS

A retrospective cohort study was conducted. Women with PFD who underwent 1-3 months of BF and electrostimulation between January 1, 2020, and January 31, 2021, were included in the study. BF treatment was administered using three sensors to monitor pelvic floor muscle activity, providing patients with immediate feedback and guidance on muscle exercises. One session lasted for 5-10 min. Electrostimulation treatment utilized a specially made pelvic belt with electrode sheets to stimulate and contract pelvic floor muscles passively. One session lasted for 15 min. Six therapies in 1 month were prescribed. Pre- and post-treatment Pelvic Floor Distress Inventory (PFDI-20) scores, including POP distress inventory 6 (POPDI-6), colorectal-anal distress inventory (CRAD-8), and urinary distress inventory 6 (UDI-6) scores, were compared. Subgroup analysis by age, menopause, body mass index (BMI), and child delivery mode was performed.

RESULTS

The study included 51 women with PFDs (SUI, POP, frequency or urgency or nocturia, and pain) treated with BF and electrostimulation, with a mean age of 49.94 ± 13.63 years. Sixteen patients (37.1%) were menopausal, with a mean menopause age of 50 ± 5.20 years. Twenty-six patients (68.4%) had a history of normal vaginal delivery. The mean PFDI-20 scores before and after treatment were 32.67 (standard deviation [SD] 10.05) and 25.99 (SD 9.61), respectively ( < 0.001). This decrease in scores reflected an improvement in subjective perceptions of symptoms and quality of life. The POPDI-6, CRAD-8, and UDI-6 scores significantly decreased after treatment. Subgroup analysis of scores change regarding age, menopause, BMI, and child delivery mode was not statistically significant.

CONCLUSION

The study demonstrated the effectiveness of BF and electrostimulation for treating women with PFDs. The findings contributed to the understanding of treatment duration, patient characteristics, and the potential benefits of a multimodal approach. Moreover, the study's diverse participant population and the use of validated outcome measures enhance the generalizability and scientific rigor of the findings.

摘要

目的

盆底功能障碍(PFDs),如压力性尿失禁(SUI)和盆腔器官脱垂(POP),可通过保守治疗来管理,如涉及生物反馈(BF)和电刺激的保守管理。本研究旨在调查保守治疗对盆底功能障碍的治疗效果。

材料与方法

进行了一项回顾性队列研究。纳入2020年1月1日至2021年1月31日期间接受1 - 3个月生物反馈和电刺激治疗的盆底功能障碍女性患者。生物反馈治疗使用三个传感器监测盆底肌肉活动,为患者提供肌肉锻炼的即时反馈和指导。一次治疗持续5 - 10分钟。电刺激治疗使用带有电极片的特制盆腔带被动刺激和收缩盆底肌肉。一次治疗持续15分钟。每月规定进行6次治疗。比较治疗前后盆底功能障碍困扰量表(PFDI - 20)评分,包括盆腔器官脱垂困扰量表6(POPDI - 6)、结肠 - 肛门困扰量表(CRAD - 8)和尿路困扰量表6(UDI - 6)评分。按年龄、绝经状态、体重指数(BMI)和分娩方式进行亚组分析。

结果

该研究纳入了51例接受生物反馈和电刺激治疗的盆底功能障碍患者(压力性尿失禁、盆腔器官脱垂、尿频或尿急或夜尿症以及疼痛),平均年龄为49.94±13.63岁。16例患者(37.1%)处于绝经状态,平均绝经年龄为50±5.20岁。26例患者(68.4%)有正常阴道分娩史。治疗前后的平均PFDI - 20评分分别为32.67(标准差[SD]10.05)和25.99(SD 9.61)(<0.001)。评分的降低反映了症状主观感受和生活质量的改善。治疗后POPDI - 6、CRAD - 8和UDI - 6评分显著降低。关于年龄、绝经状态、BMI和分娩方式的评分变化亚组分析无统计学意义。

结论

该研究证明了生物反馈和电刺激治疗盆底功能障碍女性患者的有效性。这些发现有助于理解治疗持续时间、患者特征以及多模式方法的潜在益处。此外,该研究多样的参与者群体和使用经过验证的结局指标增强了研究结果的普遍性和科学严谨性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5b7/11236079/2308a3eeb0fd/TCMJ-36-291-g001.jpg

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