Comparative efficacy of behavioral interventions in the management of female urinary incontinence
Comparative efficacy of behavioral interventions in the management of female urinary incontinence
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DOI：
10.1016/s0002-9378(98)70206-6
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发表时间：
1998-10-01
影响因子：
9.8
通讯作者：
Bump, RC
中科院分区：
文献类型：
--
作者：
Wyman, JF;Fantl, JA;Bump, RC
目的：我们比较了膀胱训练、生物反馈辅助指导的骨盆肌肉锻炼以及联合治疗对女性尿失禁的疗效。主要的假设是，联合治疗将是最有效的减少失禁epission.Study设计：一个随机临床试验，三个治疗组进行了妇科的做法在两所大学的医疗中心。204名被诊断为真正的压力性尿失禁（n = 145）和/或逼尿肌不稳定（n = 59）的女性接受了为期12周的干预计划（6周每周办公室访问和6周的邮件/电话联系），并立即和3个月的随访。结果变量包括失禁发作次数、生活质量、感知改善和满意度。数据分析包括协方差分析，使用基线值作为协变量和卡方（2）test.RESULTS：联合治疗组有显着减少失禁发作，更好的生活质量，更大的治疗满意度治疗后立即。3个月后未观察到组间差异。真正的压力性尿失禁的妇女有更大的改善生活的影响，和那些逼尿肌不稳定的症状困扰在立即跟进，否则，没有差异，指出诊断，尿失禁的严重程度，或治疗situ.Conclusions：无论尿动力学诊断的女性尿失禁的管理中有最大的即时疗效。然而，3种干预措施中的每一种在治疗后3个月都有类似的效果。结果表明，具体的治疗可能不如具有教育，咨询和频繁的患者接触的结构化干预计划重要。
OBJECTIVE: We compared the efficacy of bladder training, pelvic muscle exercise with biofeedback-assisted instruction, and combination therapy, on urinary incontinence in women. The primary hypothesis was that combination therapy would be the most effective in reducing incontinent episodes.STUDY DESIGN: A randomized clinical trial with three treatment groups was conducted in gynecologic practices at two university medical centers. Two hundred and four women diagnosed with genuine stress incontinence (n = 145) and/or detrusor instability (n = 59) received a 12-week intervention program (6 weekly office visits and 6 weeks of mail/telephone contact) with immediate and 3-month follow-up. Outcome variables included number of incontinent episodes, quality of life, perceived improvement, and satisfaction. Data analyses consisted of analysis of covariance using baseline values as covariates and chi(2) tests.RESULTS: The combination therapy group had significantly fewer incontinent episodes, better quality of life, and greater treatment satisfaction immediately after treatment. No differences among groups were observed 3 months later. Women with genuine stress incontinence had greater improvement in life impact, and those with detrusor instability had less symptom distress at the immediate follow-up; otherwise, no differences were noted by diagnosis, incontinence severity, or treatment site.CONCLUSIONS: Combination therapy had the greatest immediate efficacy in the management of female urinary incontinence regardless of urodynamic diagnosis. However, each of the 3 interventions had similar effects 3 months after treatment. Results suggest that the specific treatment may not be as important as having a structured intervention program with education, counseling, and frequent patient contact.