Who will benefit from pelvic floor muscle training for stress urinary incontinence?
Who will benefit from pelvic floor muscle training for stress urinary incontinence?
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DOI：
10.1016/j.ajog.2004.05.012
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发表时间：
2004-10-01
影响因子：
9.8
通讯作者：
Amy, JJ
中科院分区：
文献类型：
--
作者：
Cammu, H;Van Nylen, M;Amy, JJ
目的：本研究的目的是确定盆底肌肉训练治疗压力性尿失禁前哪些患者特征可预测预后。研究设计：这是一项在比利时布鲁塞尔的单中心室外患者诊所进行的观察性研究，包括447名患有尿压力性失禁的女性，年龄在26至80岁之间（平均52.7岁）。所有的女性都在同一位理疗师的指导下接受了骨盆底肌肉的单独训练。22个患者的特征被考虑用于结果测量。结果：49%的女性认为她们的治疗是成功的；51%的妇女只经历了一些改善，没有改变，或病情恶化或中断治疗。治疗失败的三个独立预测因子分别大于或等于治疗前每天2次渗漏（P < 0.0001）、长期使用精神药物（P = 0.002）和首次咳嗽时基线应激试验阳性（P = 0.042）。当这三个预测因素同时存在时，单个患者成功治疗的几率只有15%。结论：盆底肌肉训练对半数采用这种方式治疗的患者是有益的。基线时每天两次或两次以上的泄漏和长期使用精神药物显著预示治疗失败。(C) 2004爱思唯尔公司版权所有。
Objective: The purpose of this study was to determine which patient characteristics are predictive of outcome before pelvic floor muscle training for stress urinary incontinence.Study design: This was an observational study at a single-center outdoor patient clinic in Brussels, Belgium, that comprised 447 women, aged 26 to 80 years (mean, 52.7 years), who had urinary stress incontinence. All the women received individual pelvic floor muscle training under the guidance of the same physiotherapist. Twenty-two patient characteristics were considered for outcome measurements.Results: Forty-nine percent of the women considered their treatment to be successful; 51% of the women had experienced only some improvement, no change, or a worsening of their condition or had interrupted therapy. Three independent predictors of treatment failure were greater than or equal to2 leakages per day before treatment (P < .0001), the chronic use of psychotropic medication (P = .002), and a baseline positive stress test result at first cough (P = .042). The odds were only 15% for an individual patient to be treated successfully when these 3 predictors were present.Conclusion: Pelvic floor muscle training is beneficial in one half of the patients who are treated in this manner. Two or more leakages per day at baseline and the chronic use of psychotropic medication significantly predicted therapy failure. (C) 2004 Elsevier Inc. All rights reserved.