Study on neuromuscular stimulation combined with vaginal cones treatment in patients with postpartum stress urinary incontinence / 中国基层医药

Objective To study the clinical effect of neuromuscular stimulation combined with vaginal cones treatment in patients with postpartum stress urinary incontinence ( SUI) .Methods 100 cases using random sampling method were divided into vaginal cones ( control group ) in 50 cases and neuromuscular stimulation combined with va-ginal cones training (observation group) in 50 cases,by each treatment for 8 weeks,The treatment effect of SUI before and after of the two groups was evaluated .Results The change of pelvic floor muscle strength before treatment in the two groups was no statistically significant differences (χ2 =5.49,P >0.05);The change of pelvic floor muscle strength after treatment in the observation group than the control group obviously improve (χ2 =23.11,P<0.05);The of pelvic floor muscle strengthscore score (4.88 ±0.77)point after 12 week in the observation group were significant-ly higher than those control group (3.88 ±0.69)/point (t=3.55,P<0.05);The incidence rate (10%) of urinary incontinence after 12 week in the observation group were significantly lower than those in the control group ( 18%) (χ2 =4.33,P<0.05);The muscles contraction strength [(37.55 ±7.98)μV] after treatment in the observation group were markedly increased compared to the control group [(37.55 ±7.98)μV] (t=5.13,P<0.05).Conclusion The incidence rate of urinary incontinence postpartum can reduce postpartum stress urinary incontinence , and pelvic floor muscle strength were increased by treatment in neuromuscular stimulation combined with vaginal cones .

Métodos de avaliação do assoalho pélvico / Methods of evaluation of pelvic floor

O assoalho pélvico é formado por um grupo de músculos e ligamentos que têm a função básica de sustentar os órgãos pélvicos e abdominais. O objetivo da pesquisa foi verificar e discutir os métodos de avaliação do assoalho pélvico existentes na literatura nos últimos 20 anos. A pesquisa se deu a partir de uma revisão bibliográfica da literatura nas bases de dados SciELO, Medline, Lilacs, Pubmed e em livros de Uroginecologia entre setembro e novembro de 2011. Várias são as maneiras de avaliar a função dos músculos do assoalho pélvico e, nos últimos 20 anos, as técnicas foram aperfeiçoadas para um melhor conforto, tanto do paciente como do terapeuta. Palpação bidigital, cones vaginais, perineometria, eletromiografia são técnicas importantes, por promoverem feedback sensorial ao paciente. Ultrassom e ressonância magnética também são métodos louváveis por avaliar dinamicamente o assoalho pélvico, porém são utilizados experimentalmente, pelo grande dispêndio de dinheiro...

Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence

PURPOSE: To compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence. PATIENTS AND METHODS: One hundred eighteen subjects were randomly selected to recieve pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response. RESULTS: In the objective evaluation, we observed a statistically significant reduction in the pad test (p=0.003), in the number of stress urinary episodes (p<0.001), and a significant improvement in the quality of life (p<0.001) in subjects who used pelvic floor exercises, electrical stimulation, and vaginal cones compared to the control group. No significant difference was found between groups in the urodynamic parameters. In the subjective evaluation, 58 percent, 55 percent, and 54 percent of women who had used pelvic floor exercises, electrical stimulation, and vaginal cones, respectively, reported being satisfied after treatment. In the control group, only 21 percent patients were satisfied with the treatment. CONCLUSION: Based on this study, pelvic floor exercises, electrical stimulation, and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence.