Zhang Zhijie, Zhou Xiang, Yang Zhichao, Tang Yuhang, Hong Anjie, Wei Chongrui, Wang Jian, Ye Liangwen, Hou Xiangyi, Xu Wei, Suo Xianghui, Zhang Li
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China,
Hong Kong Baptist University, Hong Kong, Hong Kong, China.
Urol Int. 2025;109(1):34-44. doi: 10.1159/000539813. Epub 2024 Sep 12.
To study the clinical symptoms and psychological status of biofeedback electrical stimulation combined with pelvic floor muscle training during the treatment of mild stress urinary incontinence (SUI) after holmium laser enucleation of the prostate (HoLEP).
Group A was treated by biofeedback and electrical stimulation; Group B was treated by pelvic floor muscle training; and Group C was treated by biofeedback and electrical stimulation combined with pelvic floor muscle training. Patients in the 3 groups had follow-up evaluations every 8, 16, and 24 weeks. Clinical symptoms of urinary incontinence were assessed using the 24-h urinary pad test, the Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI-SF); and psychological status was evaluated using the modified Hospital Anxiety Depression Scale (HADS).
The results of ICIQ-UI-SF showed that there were differences within and between the three groups at 8 weeks, 16 weeks, and 24 weeks (p < 0.05). The results of the 24-h pad tests were similar (p < 0.05), except for no difference between group B and group C at 8 weeks (p > 0.05). In the study with the score of HADS >35, the differences among the three groups were statistically significant (p < 0.05). There was no significant difference among the three groups at 0 and 8 weeks (p > 0.05). There were differences in the results between group C and the other two groups at 16 and 24 weeks of treatment (p < 0.05). For patients with HADS <35 at week 0, the results were basically the same except for the difference between groups at week 8. HADS of all patients were no statistical difference (p > 0.05).
Biofeedback electrical stimulation combined with pelvic floor muscle training is an efficient nonsurgical combination therapy for the symptoms of SUI after HoLEP for benign prostatic hyperplasia. In addition, the recovery of the patient's psychological state does not coincide with the recovery of urinary incontinence; therefore, we propose that patients still need additional psychological treatment after SUI disappears.
研究钬激光前列腺剜除术（HoLEP）后生物反馈电刺激联合盆底肌训练治疗轻度压力性尿失禁（SUI）的临床症状及心理状态。
A组采用生物反馈及电刺激治疗；B组采用盆底肌训练治疗；C组采用生物反馈电刺激联合盆底肌训练治疗。三组患者分别在第8、16和24周进行随访评估。采用24小时尿垫试验、尿失禁问卷简表（ICIQ-UI-SF）评估尿失禁临床症状；采用改良医院焦虑抑郁量表（HADS）评估心理状态。
ICIQ-UI-SF结果显示，三组在第8周、16周和24周组内及组间均有差异（p<0.05）。24小时尿垫试验结果相似（p<0.05），但第8周时B组和C组无差异（p>0.05）。在HADS评分>35的研究中，三组间差异有统计学意义（p<0.05）。三组在0周和8周时无显著差异（p>0.05）。治疗第16周和24周时，C组与其他两组结果有差异（p<0.05）。对于0周时HADS<35的患者，除第8周组间有差异外，结果基本相同。所有患者的HADS无统计学差异（p>0.05）。
生物反馈电刺激联合盆底肌训练是治疗良性前列腺增生症HoLEP术后SUI症状的一种有效的非手术联合治疗方法。此外，患者心理状态的恢复与尿失禁的恢复不一致；因此，我们建议尿失禁消失后患者仍需额外的心理治疗。
