Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction
Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction
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DOI：
10.1007/s00345-011-0779-8
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发表时间：
2012-08-01
影响因子：
3.4
通讯作者：
Bo, Kari
中科院分区：
文献类型：
--
作者：
Bo, Kari
本综述的目的是介绍和讨论女性压力性尿失禁（SUI），盆腔器官脱垂（POP）和性功能障碍的盆底肌（PFM）训练的证据，这篇文章是基于PFM训练对SUI，POP和性功能障碍的系统评价的结论和数据。数据来源包括科克伦综述、第4届国际胰岛素治疗咨询会、NICE指南和卫生技术评估。此外，2008年至2011年在Pubmed上进行了一次新的检索。本文仅对英文版随机对照试验（RCT）的数据进行了介绍和讨论。1级A级证据表明PFM训练对SUI的治疗有效。短期治愈率评估为< 2 g的垫上泄漏测试在35%和80%之间变化。迄今为止，有5项RCT显示PFM训练对POP分期、症状或PFM形态有显著影响。有监督的强化训练比无监督的训练更有效。无不良反应。目前还缺乏关于PFM训练对性功能障碍影响的随机对照试验。PFM训练应该是SUI和POP的一线治疗，但训练需要适当的指导和密切的随访才能有效。需要更多高质量的随机对照试验研究PFM训练治疗性功能障碍。
The objectives of the present review was to present and discuss evidence for pelvic floor muscle (PFM) training on female stress urinary incontinence (SUI), pelvic organ prolapse (POP) and sexual dysfunction.This manuscript is based on conclusions and data presented in systematic reviews on PFM training for SUI, POP and sexual dysfunction. Cochrane reviews, the 4th International Consultation on Incontinence, the NICE guidelines and the Health Technology Assessment were used as data sources. In addition, a new search on Pubmed was done from 2008 to 2011. Only data from randomized controlled trials (RCTs) published in English language is presented and discussed.There is Level 1, Grade A evidence that PFM training is effective in treatment of SUI. Short-term cure rates assessed as < 2 g of leakage on pad testing vary between 35 and 80%. To date there are 5 RCTs showing significant effect of PFM training on either POP stage, symptoms or PFM morphology. Supervised and more intensive training is more effective than unsupervised training. There are no adverse effects. There is a lack of RCTs addressing the effect of PFM training on sexual dysfunction.PFM training should be first line treatment for SUI and POP, but the training needs proper instruction and close follow-up to be effective. More high quality RCTs are warranted on PFM training to treat sexual dysfunction.