Lai Fengping, Liu Hui, Wang Huihua
Department of Gynaecology and Obstetrics, Ganzhou People's Hospital, 341000 Ganzhou, Jiangxi, China.
Imaging Department, Affiliated Hospital of Jinggangshan University, 343000 Ji'an, Jiangxi, China.
Arch Esp Urol. 2024 Nov;77(9):992-998. doi: 10.56434/j.arch.esp.urol.20247709.141.
Hysterectomy is associated with stress urinary incontinence (SUI), pelvic floor muscle weakness and sexual dysfunction. Pelvic floor exercises have emerged as a potential intervention for addressing these challenges, with remote guided programs offering personalised care. This retrospective study aimed to assess the effect of a nurse-led remote guided pelvic floor exercise program on in patients after total hysterectomy.
A retrospective analysis was conducted on 81 patients who underwent pelvic floor exercises after total hysterectomy. The patients were divided into regular pelvic floor exercise group (n = 40) and nurse-led remote guided pelvic floor exercise group (n = 41). The severity of SUI in patients was assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF). The strength and endurance of pelvic floor muscles were assessed using a pressure sensor before and after treatment, and sexual function was evaluated using the Female Sexual Function Index (FSFI) questionnaire.
The baseline characteristics showed no significant differences between the two groups. The nurse-led remote guided pelvic floor exercise group had a significantly greater reduction in urinary incontinence severity (65.00% vs. 85.37%, χ = 4.516, = 0.034) and a lower post-treatment SUI frequency (1.76 ± 0.75 vs. 2.15 ± 0.95, t = 2.059, = 0.043). Additionally, this group showed better improvements in muscle strength and endurance (25.61 ± 5.69 vs. 23.19 ± 5.02, t = 2.036, = 0.045) and FSFI score (29.67 ± 4.05 vs. 27.91 ± 3.83, t = 2.011, = 0.048).
The study demonstrates that a nurse-led remote guided pelvic floor exercise program is associated with significant improvements in SUI, pelvic floor muscle function and sexual well-being in patients after total hysterectomy.
子宫切除术与压力性尿失禁（SUI）、盆底肌肉无力和性功能障碍有关。盆底肌锻炼已成为应对这些挑战的一种潜在干预措施，远程指导方案可提供个性化护理。本回顾性研究旨在评估护士主导的远程指导盆底肌锻炼方案对全子宫切除术后患者的影响。
对81例全子宫切除术后进行盆底肌锻炼的患者进行回顾性分析。患者分为常规盆底肌锻炼组（n = 40）和护士主导的远程指导盆底肌锻炼组（n = 41）。使用国际尿失禁咨询委员会尿失禁简表（ICIQ-UI SF）评估患者SUI的严重程度。治疗前后使用压力传感器评估盆底肌肉的力量和耐力，并使用女性性功能指数（FSFI）问卷评估性功能。
两组的基线特征无显著差异。护士主导的远程指导盆底肌锻炼组尿失禁严重程度的降低幅度显著更大（65.00%对85.37%，χ = 4.516，P = 0.034），治疗后SUI频率更低（1.76±0.75对2.15±0.95，t = 2.059，P = 0.043）。此外，该组在肌肉力量和耐力（25.61±5.69对23.19±5.02，t = 2.036，P = 0.045）和FSFI评分（29.67±4.05对27.91±3.83，t = 2.011，P = 0.048）方面的改善更好。
该研究表明，护士主导的远程指导盆底肌锻炼方案与全子宫切除术后患者的SUI、盆底肌肉功能和性健康状况的显著改善相关。
