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PURPOSE: This study is aimed at assessing the effect of postoperative electrical stimulation (ES) plus biofeedback therapy on patient rehabilitation after pelvic floor reconstructive surgery. METHODS: Patients with pelvic organ prolapse (POP) who had received pelvic floor reconstructive surgery were randomly allocated to the intervention group and the control group at a 1:1 ratio. Patients in the control group received routine postoperative nursing care. Patients in the intervention group underwent ES plus biofeedback therapy. The outcomes included the recovery of urination function, the improvement of pelvic floor muscle (PFM) strength, and the change of Pelvic Floor Distress Inventory Questionnaire-20 (PFDI-20) scores. The study outcomes were evaluated at pre-intervention (T0, 2 months after surgery), 3 months after surgery (T1), and 6 months after surgery (T2). RESULTS: A total of 60 patients with POP were included in this study. For the urination function evaluation, the intervention group had a higher recovered rate than the control group at the time point of T2 (p = 0.038). For the EMG results, the changes of flick-max and tonic-mean values from T0 to T2 were much higher in the intervention group comparing to the control group. Corresponding to the EMG results, digital palpation showed that intervention group had a much higher proportion of patients who had elevated PFM strength. Furthermore, the intervention group also had more significant PFDI-20 score improvements compared with control group. CONCLUSIONS: Postoperative ES plus biofeedback therapy could significantly improve urination function, PFM strength, and patient's reported QoL. TRIAL REGISTRATION: Clinical registration number: hiCTR2000032432.
Assuntos
Diafragma da Pelve , Cirurgia Plástica , Humanos , Qualidade de Vida , Micção , Biorretroalimentação Psicológica , Estimulação ElétricaRESUMO
OBJECTIVE: The aim of the study is to determine whether the use of labor analgesia had a higher risk of pelvic floor functional problems after delivery. STUDY DESIGN: All primiparas who delivered at our hospital between June 2019 and May 2020 were enrolled in the study. They were divided into two groups according to their choices: delivery with labor analgesia (analgesia group, n = 76), and delivery without labor analgesia (nonanalgesia group, n = 78). The primary outcome of the study was to test the pelvic floor function by electromyography (EMG) at postpartum 6 to 8 weeks. Participants also completed questionnaires including Pelvic Floor Distress Inventory (PFDI-20), International Consultation on Incontinent Questionnaire-Short Form (ICIQ-SF), and Overactive Bladder Symptom Score (OABSS) at postpartum 6 to 8 weeks. RESULTS: Primiparas in the analgesia group experienced longer first and second stages of labor (p< 0.05), and had significantly higher PFDI-20 scores at postpartum 6 to 8 weeks (p< 0.05). But the differences in ICIQ-SF, OABSS scores, and Pelvic Organ Prolapse Quantification (POP-Q) system between the two groups were not significant (p > 0.05). No statistically significant difference was found in class II and class I muscles, scores of pretest resting baseline, and posttest resting baseline between primiparas with or without labor analgesia (p > 0.05). CONCLUSION: Our results strongly confirmed that labor analgesia did not increase the risk of pelvic floor dysfunction up to 6 to 8 weeks after delivery, although symptom burden might be increased after labor analgesia. KEY POINTS: · Labor analgesia did not increase risk of pelvic floor muscle dysfunction after delivery.. · There are longer first and second stages of labor in primiparas with labor analgesia.. · Primiparas with labor analgesia had more obvious subjective symptoms of PFD..
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OBJECTIVES: There have been a number of controversies about which treatment of neuromuscular electrical stimulation (NMES) is more beneficial for overactive bladder (OAB). An attempt to investigate the therapeutic effect of NMES with different pulse widths for OAB in elderly women has been made in this study. MATERIAL AND METHODS: The postmenopausal elderly women without pelvic organ prolapse (POP) who received transvaginal NMES in Beijing Hospital from November 2020 to December 2020 were randomly divided into two groups (Group A and Group B). Patients from Group A accepted the treatment with NMES by pulse width of 300 µs and patients from Group B accepted the treatment with NMES by pulse width of 200 µs. Myoelectric potential of Type I and Type II muscle fibers at pelvic floor and overactive bladder symptom score (OABSS) were valued. RESULTS: There were 46 patients eligible for the study and randomly divided into Group A and Group B, 23 patients for each group. OABSS were significantly reduced in both groups after the treatment of NEMS. And OABSS in Group A (after treated by pulse width of 300 µs) were significantly decreased greater than those in Group B (after treated with pulse width of 200 µs). Both Group A and Group B had no significant difference in the mean myoelectric potential at pre-resting state when compared before and after the treatment of NEMS. Myoelectric potential of Type I muscle fiber and the maximum myoelectric potential of Type II muscle fibers were significantly increased after the treatment of NEMS than before the treatment in the two groups, respectively. And myoelectric potential of Type I muscle fiber and the maximum myoelectric potential of Type II muscle fibers in group A (after treated with pulse width of 300 µs) were increased significantly much higher than those in Group B (after treated with pulse width of 200 µs). CONCLUSIONS: Comparing the indicators before and after the treatments of NMES, our study has preliminarily confirmed that NMES has its advantages in treating with OAB. And NMES by pulse width of 300 µs were more effective in improving pelvic floor muscle strength than NMES by pulse width of 200 µs.