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盆底物理治疗在绝经后尿失禁女性中的作用综述。

A review of the role for pelvic floor physiotherapy in postmenopausal women with urinary incontinence.

作者信息

Walgren Lauren A, Wade Corinne, Dessaulles Melissa, Martin Ginis Kathleen, Locke Jennifer

机构信息

Department of Medicine, University of British Columbia Southern Medical Program, Kelowna, BC, Canada.

Division of Urology, Kelowna General Hospital, Kelowna, BC, Canada.

出版信息

Post Reprod Health. 2024 Dec;30(4):239-245. doi: 10.1177/20533691241272830. Epub 2024 Aug 11.

Abstract

Urinary incontinence is a prevalent condition affecting women. Pelvic floor physiotherapy is a specialized field of physiotherapy dedicated to assessing and treating pelvic floor muscles. This therapy has demonstrated benefits in addressing stress urinary incontinence in premenopausal women, with numerous studies supporting its efficacy in this population. However, pelvic floor physiotherapy in the treatment of postmenopausal women is less well-established, and furthermore, the types of urinary incontinence in postmenopausal women are much broader. We provide a comprehensive review of recent literature investigating the effectiveness of pelvic floor physiotherapy therapy for various conditions in postmenopausal women, including urinary incontinence, urgency urinary incontinence, pelvic organ prolapse, genitourinary syndrome of menopause, sexual dysfunction, and urinary incontinence in the context of obesity, frailty, mobility, and dementia. After evaluating the current literature, it is evident that there is insufficient data to definitively endorse or dismiss the utilization of Pelvic floor physiotherapy for treating urinary incontinence in postmenopausal women. Nevertheless, considering the low associated risks of pelvic floor physiotherapy, we advocate for the initiation of comprehensive, large-scale randomized studies aimed at evaluating its effectiveness in addressing urinary incontinence in postmenopausal women with special attention to vulnerable subgroups, including individuals who are obese, frail or experiencing cognitive impairment.

摘要

尿失禁是一种影响女性的常见病症。盆底物理治疗是物理治疗的一个专门领域,致力于评估和治疗盆底肌肉。这种疗法已证明在解决绝经前女性的压力性尿失禁方面有好处,众多研究支持其在这一人群中的疗效。然而,盆底物理治疗在绝经后女性治疗中的应用尚不太成熟,而且,绝经后女性的尿失禁类型更为广泛。我们对近期文献进行了全面综述,这些文献研究了盆底物理治疗对绝经后女性各种病症的有效性,包括尿失禁、急迫性尿失禁、盆腔器官脱垂、绝经泌尿生殖综合征、性功能障碍,以及肥胖、虚弱、行动不便和痴呆背景下的尿失禁。在评估当前文献后,很明显,没有足够的数据来明确支持或否定使用盆底物理治疗来治疗绝经后女性的尿失禁。尽管如此,考虑到盆底物理治疗相关风险较低,我们主张开展全面、大规模的随机研究,旨在评估其在解决绝经后女性尿失禁方面的有效性,特别关注包括肥胖、虚弱或有认知障碍的个体在内的脆弱亚组。

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