Pelvic Floor Muscle Training for Female Stress Urinary Incontinence: Five Years Outcomes
Pelvic Floor Muscle Training for Female Stress Urinary Incontinence: Five Years Outcomes
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DOI：
10.1002/nau.22888
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发表时间：
2017-01-01
影响因子：
2
通讯作者：
Groutz, Asnat
中科院分区：
文献类型：
--
作者：
Beyar, Netta;Groutz, Asnat
目的：评价女性压力性尿失禁（SUI）患者接受盆底肌训练（PFMT）5年后的临床状况、下尿路症状（LUTS）和生活质量（QOL）。研究方法：208名连续接受指导性PFMT项目作为SUI一线治疗的妇女在治疗5年后被邀请参加一项基于药物的结局研究。主要结局指标包括PFMT的依从性、SUI的中期手术以及患者对LUTS和QOL的自我评估。结果如下：132名（63%）女性完成了所有问卷，其中55名（41.7%，平均年龄52.1 ± 10.8）报告遵守PFMT，75名（56.8%，平均年龄49.8 ± 10.8）停止培训，2名（1.5%）接受手术。对76名无应答者的进一步分析显示，还有6名患者接受了手术。因此，总体而言，8例患者（占原始队列的3.8%）在完成培训计划后5年内接受了手术。除了接受手术的患者外，几乎所有女性均报告SUI，但其ICIQ-UI渗漏频率和渗漏量评分较低（分别为2.2 +/- 0.9，1.18 +/- 1.04），I-QOL评分较高（96.2 +/- 13.6）。所有调查的参数和领域，在三个问卷中的每一个和所有妇女中，始终表现出低严重程度的下尿路症状和相对较高的大陆相关的生活质量。在支持PFMT依从性方面没有统计学显著差异。结论：虽然我们的患者中5年训练依从性相对较高，但这种依从性与上级治疗结局无关。需要进一步的研究来确定PFMT对SUI的长期疗效。(C)2015 Wiley Periodicals，Inc.
Aim: To evaluate the clinical status, lower urinary tract symptoms (LUTS) and quality of life (QOL) 5 years after completion of a pelvic floor muscle training (PFMT) program for female stress urinary incontinence (SUI). Methods: Two hundred and eight consecutive women who underwent a guided PFMT program as first-line management of SUI were invited to participate in a questionnaire-based outcome study 5 years after treatment. Primary outcome measures comprised of adherence to PFMT, interim surgery for SUI, and patients' self-assessment of LUTS and QOL. Results: One hundred and thirty-two (63%) women completed all questionnaires, 55 of whom (41.7%, mean age 52.1 +/- 10.8) reported adherence to PFMT, 75 (56.8%, mean age 49.8 +/- 10.8) discontinued training, and two (1.5%) underwent surgery. Further analysis of the 76 non-responders revealed six more patients who underwent surgery. Thus, overall, eight patients (3.8% of the original cohort) underwent surgery within 5 years after completion of the training program. Except for those who underwent surgery, almost all women reported SUI, however their ICIQ-UI scores for frequency and amount of leakage were low (2.2 +/- 0.9, 1.18 +/- 1.04, respectively) and I-QOL score was high (96.2 +/- 13.6). All investigated parameters and domains, in each of the three questionnaires and among all women, consistently demonstrated low severity of LUTS and relatively high continence-associated QOL. There were no statistically significant differences in favor of adherence to PFMT. Conclusions: Although relatively high rates of 5-year adherence to training were demonstrated among our patients, this adherence was not associated with superior treatment outcomes. Further studies are needed to establish the long-term efficacy of PFMT for SUI. (C) 2015 Wiley Periodicals, Inc.