Effectiveness of ultrasound guided pelvic floor muscle training in improving prolonged urinary incontinence after robot-assisted radical prostatectomy
Effectiveness of ultrasound guided pelvic floor muscle training in improving prolonged urinary incontinence after robot-assisted radical prostatectomy
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DOI：
10.5582/ddt.2022.01004
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发表时间：
2022-02-01
影响因子：
3.1
通讯作者：
Igawa, Yasuhiko
中科院分区：
文献类型：
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作者：
Matsunaga, Akiko;Yoshida, Mikako;Igawa, Yasuhiko
机器人辅助前列腺癌根治术(RARP)后持续性尿失禁(UI)是一个令人困扰的问题，因为它对患者的生活质量(QOL)产生了负面影响。本研究旨在评价经会阴超声(TPUS)引导的盆底肌训练(PFMT)对RARP后延长的UI的影响。30名在RARP后持续1年的应激性尿失禁患者接受了生物反馈的PFMT，每2-3周使用一次TPUS，为期3个月。使用超声成像评估持续盆底肌肉收缩的频率和持续时间。采用24小时尿垫试验和大小便失禁生活质量(I-QOL)问卷对尿路感染的严重程度和尿路感染相关的生活质量进行评估。24名男性(平均年龄72.2岁)完成了TPUS引导下的PFMT。从RARP到PFMT的平均时间为1,228.9天。平均累积疗程4.6次，总持续时间73.3天。与移植前相比，移植后PFM收缩频率和持续收缩时间明显改善(p<；0.05)。此外，经皮腔内超声引导的经皮肾移植术后尿漏总量显著减少(248.6+/-280.6 g比397.0+/-427.0 g，p=0.024)。治疗后I-QOL评分显著增加(72.1+/-16.8vs.61.0+/-19.0，p<；0.001)。TPUS引导下的PFMT可有效改善RARP后1年发生的延迟性尿失禁。
Persistence of urinary incontinence (UI) after robot-assisted radical prostatectomy (RARP) is a bothersome problem because of its negative effect on the patient's quality of life (QOL). This study aimed to evaluate the effect of transperineal ultrasound (TPUS)-guided pelvic floor muscle training (PFMT) on prolonged UI after RARP. Thirty men with stress UI persisting for > 1 year after RARP underwent biofeedback PFMT using TPUS once every 2-3 weeks for 3 months. The frequency and duration of sustaining pelvic floor muscle (PFM) contractions were assessed using ultrasound imaging. The severity of Ul and UI-related QOL were evaluated using a 24-hour pad test and the incontinence quality of life (I-QOL) questionnaire. Twenty-four men (mean age, 72.2 years) completed the TPUS-guided PFMT. The mean duration from RARP to PFMT was 1,228.9 days. The mean cumulative session and the total duration of TPUS-guided PFMT were 4.6 times and 73.3 days, respectively. Compared with the data before TPUS-guided PFMT, the frequency of PFM contractions and duration of sustaining contraction significantly improved after TPUS-guided PFMT (p < 0.05). Additionally, the total amount of urinary leakage after TPUS-guided PFMT was reduced significantly (248.6 +/- 280.6 g vs. 397.0 +/- 427.0 g, p = 0.024). The I-QOL score was significantly increased after TPUS-guided PFMT (72.1 +/- 16.8 vs. 61.0 +/- 19.0, p < 0.001). TPUS-guided PFMT may be effective in improving prolonged UI occurring > 1 year after RARP.