Does Pelvic Floor Muscle Exercise Change the Hemodynamic Responses of the Inferior Vena Cava in Pregnant Women? A Prospective-Controlled Study.

INTRODUCTION AND HYPOTHESIS: This study was aimed at exploring the immediate impacts of pelvic floor muscle exercises (PFMEs) on various maternal physiological parameters in pregnant women. METHODS: The study included a total of 52 women, 26 pregnant (Pregnant group: 28.04±6.01 years; 26.83±3.81 kg/m2) and 26 nonpregnant (Control group: 29.42±5.73 years; 25.41±3.03 kg/m2) individuals. All women received PFME as follows: PFME was performed for 5 min (6-s holding contraction, 10 s of relaxation, 3 rapid PFM contractions). Evaluations were conducted before, immediately after, and 5 min post-exercise, with measurements including inferior vena cava (IVC) diameters and pulsatility index, blood pressure, oxygen saturation, and heart rates. Two-way analysis of variance was performed for group and time comparisons in repeated measurements. RESULTS: In both groups, the IVC collapsibility index values were lower 5 min after exercise, although this decrease, although clinically significant, did not reach statistical significance (p = 0.057). Post-exercise systolic blood pressure significantly decreased in both groups, whereas diastolic blood pressure decreased significantly in the pregnant group (p = 0.001, p = 0.023). CONCLUSIONS: The study found no statistically significant changes in the collapsibility index of the IVC after PFME but observed a clinically suggestive decrease. The clinical decrease in the collapsibility index can be interpreted as PFME in the supine position increasing venous return. Additionally, PFME was found not to alter maternal and fetal heart rates but contributed to the decrease in maternal systolic and diastolic blood pressure. Our study supports the view that the acute effects of PFME neither induce fetal stress nor pose maternal risks.

Effect of Electroacupuncture Combined with Pelvic Floor Muscle Exercise on Urinary Symptoms, Sexual Dysfunction and Pelvic Floor Muscle Strength in Female Patients with Overactive Bladder: A Retrospective Study.

OBJECTIVE: This study aimed to investigate the effect of electroacupuncture combined with pelvic floor muscle exercise in the treatment of female overactive bladder (OAB). METHODS: The clinical data of 134 female patients with OAB admitted to our hospital from April 2022 to June 2023 were retrospectively analysed. The patients were divided into the combination group (n = 74) and the single group (n = 60). The general demographic data, total effective rate, pad weight, female sexual function index (FSFI) score, oxford muscle grading scale and incontinence impact questionnaire short form (IIQ-7) were collected. Propensity score matching (PSM) was used to match the baseline data of the two groups at 1:1 ratio, and t test, chi-square test and analysis of variance were used for calculation. RESULTS: A total of 90 patients were selected after PSM. No significant difference in baseline data was found between the two groups (p > 0.05). Before treatment, no significant difference in FSFI score, oxford muscle grading scale and IIQ-7 score was found between the two groups (p > 0.05). The total effective rate of the combination group was higher than that of the single group (p < 0.05). After 3 weeks and 1 month of treatment, in addition to orgasm and sexual desire, the scores of sexual excitement and sexual satisfaction in the combination group were higher than those in the single group (p < 0.05). The combination group displayed higher oxford muscle grading scale and lower IIQ-7 and pad weight than the single group, and the differences were statistically significant (p < 0.05). CONCLUSIONS: The effect of electroacupuncture stimulation combined with pelvic floor muscle exercise is more significant, which can alleviate urinary symptoms, reduce urine leakage, enhance pelvic floor muscle strength and alleviate sexual dysfunction.

Effects of Pelvic Floor Muscle Training on Urinary Incontinence During the Third Trimester of Nulliparous Pregnant Women: a Randomized Controlled Trial.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate the effects of pelvic floor muscle training (PFMT) on urinary incontinence (UI) and quality of life (QoL) during the late third trimester of pregnancy. METHODS: A total of 131 singleton nulliparous women without pre-existing UI who attended the antenatal clinic at Rajavithi Hospital between August 2019 and May 2020 were randomly allocated into PFMT (n=63) or usual care (n=68; controls). The PFMT group watched the video education and was taught to contract the pelvic floor muscle. The control group received standard routine care. Baseline characteristics were recorded. At the gestational age of 36-38 weeks before delivery, UI was evaluated using the Urogenital Distress Inventory (UDI-6), and a score of at least 16.7 was used as a cut-off for diagnosing UI. Incontinence-related QoL was evaluated by the Incontinence Impact Questionnaire (IIQ-7). RESULTS: Baseline characteristics between groups were similar. The mean age of women in the PFMT group was 23.7 years versus 24.1 years in the control group. Pre-pregnancy body mass index was 21.1 kg/m2 and 21.3 kg/m2 in the PFMT and control groups respectively. The PFMT group reported fewer UI than the control group (20.6% vs 94.1%, p<0.001). The PFMT group also had a lower UDI-6 score (5.5 vs 27.7, p<0.001) and lower IIQ-7 score (0 vs 14.3, p<0.001) compared with the control group. CONCLUSIONS: From this study, the PFMT program is effective at preventing UI in the late third trimester of pregnancy and improves QoL. Therefore, we encourage PFMT to be implemented in clinical practice.

Electrical Acupoint Stimulation with Low-Frequency Pulse in the Treatment of Urinary Incontinence after Prostatectomy.

OBJECTIVE: This study aimed to explore the clinical effect of electrical acupoint stimulation with low-frequency pulse in the treatment of urinary incontinence after prostatectomy. METHODS: This study selected 104 patients who underwent radical prostatectomy in Pujiang People Hospital from April 2019 to April 2022 as the research subjects, and they were divided into the study group (SG, n = 51, electrical acupoint stimulation with low-frequency pulse) and the control group (CG, n = 53, traditional pelvic floor muscle exercise) in accordance with the therapeutic regimen. In addition, clinical and follow-up data were analysed, and the number of urine pads used before and after treatment, recovery time of urinary continence, scores of 36-Item Short-form Health Survey (SF-36), clinical curative efficacy and incidence of adverse reactions in both groups were compared. RESULTS: Before treatment, no remarkable difference in the number of urine pads used was observed between the two groups (p > 0.05). After treatment, the number of urine pads used in the two groups was less than that before treatment, and the number of urine pads used in the SG was less than that in the CG (p < 0.001). The SG had overtly shorter recovery time of urinary continence, higher scores in eight dimensions of SF-36 and higher treatment efficiency than the CG (all p < 0.05), with no remarkable difference in the incidence of adverse reactions in both groups (p > 0.05). CONCLUSIONS: Electrical acupoint stimulation with low-frequency pulse, as a safe and ideal treatment, can shorten the recovery time of postoperative urinary continence ability, reduce the incidence of urinary incontinence and improve the quality of life of patients.

Electrical Acupoint Stimulation with Low-Frequency Pulse in the Treatment of Urinary Incontinence after Prostatectomy

Objective: This study aimed to explore the clinical effect of electrical acupoint stimulation with low-frequency pulse in the treatment of urinary incontinence after prostatectomy. Methods: This study selected 104 patients who underwent radical prostatectomy in Pujiang People Hospital from April 2019 to April 2022 as the research subjects, and they were divided into the study group (SG, n = 51, electrical acupoint stimulation with low-frequency pulse) and the control group (CG, n = 53, traditional pelvic floor muscle exercise) in accordance with the therapeutic regimen. In addition, clinical and follow-up data were analysed, and the number of urine pads used before and after treatment, recovery time of urinary continence, scores of 36-Item Short-form Health Survey (SF-36), clinical curative efficacy and incidence of adverse reactions in both groups were compared. Results: Before treatment, no remarkable difference in the number of urine pads used was observed between the two groups (p > 0.05). After treatment, the number of urine pads used in the two groups was less than that before treatment, and the number of urine pads used in the SG was less than that in the CG (p < 0.001). The SG had overtly shorter recovery time of urinary continence, higher scores in eight dimensions of SF-36 and higher treatment efficiency than the CG (all p < 0.05), with no remarkable difference in the incidence of adverse reactions in both groups (p > 0.05). Conclusions: Electrical acupoint stimulation with low-frequency pulse, as a safe and ideal treatment, can shorten the recovery time of postoperative urinary continence ability, reduce the incidence of urinary incontinence and improve the quality of life of patients (AU)

Pelvic Floor Disorders and Pelvic Floor Muscle Exercise: A Survey on Knowledge, Attitude, and Practice among Pregnant Women in Northwest Ethiopia.

The purpose of the study was to investigate 1: overall knowledge of pelvic organ prolapse (POP) and urinary incontinence (UI) as well as knowledge, attitudes, and practice of pelvic floor muscle exercise (PFME); and 2: the association of these factors with parity in pregnant women in Gondar, Ethiopia. A facility-based cross-sectional study was performed in the Central Gondar zone, northwest Ethiopia between February and April 2021. The associations between parity and knowledge of POP and UI, and knowledge, attitude, and practice towards PFME were estimated using logistics regression models and presented as crude and adjusted odds ratios with 95% confidence intervals. Nulliparous women were used as the reference. Adjustments were made for maternal age, antenatal care visits, and level of education. The study sample comprised 502 pregnant women: 133 nulliparous, and 369 multiparous. We found no association between parity and knowledge of POP, UI, or knowledge, attitude, and practice toward PFME. The sum score indicated poor knowledge about both POP, UI, and PFME in the study population, and poor attitude and practice of PFME. Despite a high attendance in antenatal care services, knowledge, attitude, and practice were poor, indicating a need for quality improvement of the services.

Management of Intractable Functional Constipation in Children by Interferential Therapy: Transabdominal or Pelvic Floor.

BACKGROUND: To compare the effectiveness of pelvic floor interferential (IF) therapy with trans-abdominal IF therapy in children with intractable functional constipation. METHODS: Information of 64 children (38 boys, 26 girls; mean age: 6.6 ± 2.2) with functional constipation who had been treated with IF therapy were considered for this retrospective study. Group A (n = 32) underwent pelvic IF electrical stimulation + pelvic floor muscle (PFM) exercises while the group B (n = 32) received transabdominal IF therapy + PFM exercises. A complete bowel habit diary, a constipation score questionnaire and a seeable pain scores had been recorded before, after the ending of treatment courses and six months later for children in both groups. Additionally, children had been assessed with a constipation-related quality of life questionnaire before and six months after treatment. RESULTS: The number of patients who compiled the diagnostic criteria for constipation significantly decreased in both groups after treatment, in which 27/32 (84.3%) of patients in each group had no constipation after the ending of therapy courses (P = 1). Fecal soiling episodes reduced in both groups after treatment, this finding was significantly higher in group A than in group B after the ending of therapy courses (P = 0.05) and six months later (P = 0.01). CONCLUSION: Results of this study showed that using IF therapy both pelvic floor and transabdominal significantly boosts the effects of treatment among patients with functional constipation. Pelvic floor IF therapy is more effective in patients who had concomitant fecal soiling.

Attitudes and barriers to pelvic floor muscle exercises of women with stress urinary incontinence.

BACKGROUND: Pelvic floor muscle exercise (PFME) is a first-line treatment for stress urinary incontinence (SUI), but adherence to PFME is often problematic. The aim of this study was to better understand the attitudes and barriers to practicing pelvic floor muscle exercise among women with SUI. METHODS: We conducted a qualitative study using semi-structured interviews. Purposive sampling was used to approach eligible participants. The interview included questions focused on women's perceptions regarding SUI and PFME, sources of information, support, and barriers and motivators of PFME. In-depth interviews were conducted until data saturation occurred. After several readings of written interview transcripts, codes were retrieved, and thematic analysis was conducted. RESULTS: Seven women participated in the study (average age 53.2 years), and most (4/7) were retired. Three salient themes emerged from the data: (1) perception of SUI, (2) barriers to PFME, and (3) motivators to exercise. Participants highlighted various barriers to PFME: (1) lack of self-discipline owing to both intrinsic and extrinsic factors, (2) lack of confidence in how to perform the exercises properly, and (3) skepticism regarding the efficacy of treatment according to women's direct and indirect experiences. Achievement of desired outcomes, symptom severity, women's expectations, and fear of surgery were motivators to regularly perform PFME. CONCLUSIONS: The main barriers to regular PFME were inadequate self-discipline, knowledge, and confidence in performing the exercises, and a poor perception about the effectiveness of PFME.

Effect of Kegel Pelvic Floor Muscle Exercise Combined with Clean Intermittent Self-catheterization on urinary retention after radical hysterectomy for cervical cancer.

Objectives: To investigate the effect of Kegel pelvic floor muscle training combined with clean intermittent self-catheterization on patients with cervical cancer, and to analyze the risk factors affecting urinary retention. Methods: A total of 166 patients with cervical cancer admitted to our hospital from October 2016 to December 2019, all of whom received radical resection of cervical cancer, were divided into two groups according to the random number table method: the observation group and the control group, with 83 cases in each group. The control group underwent clean intermittent self-catheterization, while the observation group underwent Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization. The catheter replacement rate, bladder residual urine volume, self-perceived burden scale (SPB), Kolcaba general comfort questionnaire (GCQ), incidence of urinary tract infection, and urinary retention after catheter removal were compared between the two groups. Logistics regression analysis was utilized to analyze the risk factors affecting urinary retention. Results: The incidence of catheter replacement, urinary retention, dysuria and bladder residual urine volume in the observation group were significantly lower than those in the control group (P<0.05). Postoperative SPB score of the two groups decreased significantly, while the GCQ score increased significantly. Postoperative SPB score of the observation group was significantly lower than that of the control group, while the GCQ score was significantly higher than that of the control group (P<0.05). Statistically significant differences can be observed in the comparison of catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin between the two groups (P<0.05). Logistic regression analysis showed that catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin were independent risk factors affecting urinary retention (P<0.05). Conclusions: Catheter indwelling time, urinary tract infection, surgical incision infection and surgical margin are the risk factors for postoperative urinary retention in patients with cervical cancer. With Kegel pelvic floor muscle exercise combined with clean intermittent self-catheterization, a variety of benefits can be realized, such as improved bladder function, reduced incidence of urinary tract infections and urinary retention, as well as increased patient comfort.

Management of post-surgical faecal incontinence due to anorectal malformations by pelvic floor rehabilitation.

AIM: Many patients with anorectal malformations (ARM) experience a long-lasting problem with faecal incontinence (FI). We assessed the effectiveness of a pelvic floor rehabilitation program including transcutaneous functional electrical stimulation (TFES) in combination with pelvic floor muscle (PFM) exercises on post-surgical FI in children with ARM. METHODS: Data of 40 children at the age of 4 years or older who had undergone surgical correction for ARM and suffered from persistent FI referring for pelvic floor rehabilitation were analysed respectively. Patients underwent TFES and PFM exercises for 20 sessions. TFES was applied for 20-min during each session, two times a week. A paediatric FI score questionnaire and a bowel habit diary were completed both before and after the treatment for all children. We completed a FI quality of life questionnaire before the therapy and again after treatment for all patients. RESULTS: Twenty-two out of 40 (55%) patients responded completely to the treatment (100% reduction in FI episodes) after the completion of treatment sessions, sustained in 19/40 (47.5%) patients after 6 months. Mean ± SD of FI score was 4.9 ± 3.6 at baseline that significantly reduced to 2.4 ± 1.3 and 2.4 ± 1.8 after completion of treatment sessions and 6 months later, respectively (P < 0.05). CONCLUSIONS: Our results show that TFES and PFM exercises have a considerable beneficial impact on post-surgical FI in children with ARM.

Curative effect of pelvic floor muscle exercise on urinary incontinence after radical prostatectomy-Comparisons of different approaches at different time point.

Pelvic floor muscle exercise (PFME) is widely applied for urinary incontinence (UI) after radical prostatectomy (RP). This research aimed to explore the relationship between PFME and UI after RP. We searched databases for studies that met our requirements until 17/4/2021. The UI symptoms of the PFME group and the control group were compared at 1, 3, 6 and 12 months after the operation. Subgroup analysis based on surgical approach (open radical prostatectomy vs laparoscopy & robotics radical prostatectomy) and UI definition (questionnaire vs. pad weight) were also conducted. The UI rate in PFME group is significantly lower when compared with control group at each time point. According to subgroup analysis, PFME is more effective to alleviate UI after laparoscopy & robotics radical prostatectomy when compared with open RP at mid-term (3s and 6 months) whereas no significant difference was detected between two groups at short (1 month) or long (12 months) term. According to this meta-analysis, post-operation PFME treatment can effectively alleviate the symptoms of UI after RP at any time point; pre-operation PFME alone was not sufficient to relieve UI. Compared with open prostatectomy, PFME is more effective for the UI after laparoscopy & robotics radical prostatectomy.

Supervised pelvic floor muscle exercise is more effective than unsupervised pelvic floor muscle exercise at improving urinary incontinence in prostate cancer patients following radical prostatectomy - a systematic review and meta-analysis.

BACKGROUND: Urinary incontinence is one of the most clinically relevant side effects in the treatment of prostate cancer patients. The aim of this systematic review and meta-analysis was to analyze the specific exercise effects of supervised versus unsupervised pelvic floor muscle exercise (PFME) and exercise volume on urinary incontinence status after radical prostatectomy. METHODS: A systematic data search was performed for studies published from January 2000 to December 2020 using the following databases: PubMed, Embase, SciSearch, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews and Effects. The review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A random-effects meta-analysis of urinary incontinence remission was performed. The relation between time since surgery and urinary incontinence remission was analyzed using a non-linear dose-response meta-analysis. RESULTS: The meta-analysis included 20 randomized controlled trials involving 2188 men (n = 1105 in intervention groups; n = 1083 in control groups). PFME versus no PFME had a beneficial effect on urinary incontinence remission at 3 months, 3-6 months, and more than 6 months post-surgery, with risk differences ranging from 12 to 25%. These effects were particularly evident for higher volume, supervised PFME in the first 6 months post-surgery. Additional biofeedback therapy appeared to be beneficial but only during the first 3 months post-surgery. CONCLUSIONS: There is good evidence that the supervised PFME causes a decrease in short-term urinary incontinence rates. Unsupervised PFME has similar effects as no PFME in postoperative urinary incontinence. PFME programs should be implemented as an early rehabilitative measure to improve postoperative short-term urinary incontinence in patients with prostate cancer.IMPLICATIONS FOR REHABILITATIONProstate cancer, surgery, and urinary incontinenceThe surgical treatment of prostate cancer often leads to urinary incontinence.Pelvic floor training leads to a significant improvement of this situation.Exercise therapy support is very important in this context and is even more effective than unsupported training.

Device-assisted pelvic floor muscle postpartum exercise programme for the management of pelvic floor dysfunction after delivery.

BACKGROUND: Pelvic floor dysfunction (PFD) is a multifactorial condition that clinically manifests as the pelvic prolapse, urinary and/or rectal incontinence, and sexual dysfunction. AIM: We aimed to evaluate the efficacy of two pelvic floor trainers for the prevention of PFD in women during the postpartum period. MATERIALS AND METHODS: This was a prospective, randomized, open-label study in 70 women in the postpartum period. Participants were randomized to complete a daily, 20-min set of pelvic floor muscle exercises using the EmbaGYN (UK; Group 1, n = 40) or the Magic Kegel Master device (China; Group 2, n = 40) for 4 weeks. All participants anonymously completed the PFDI-20 questionnaire and FSFI form at baseline and last visit. Pelvic floor muscle strength was measured using the XFT-0010 device. RESULTS: After the completion of the 4-week pelvic floor muscle exercise program, there was a significant decrease in the rates of all PFD symptoms including pelvic organ prolapse and urinary and/or fecal incontinence in both groups. The rates of sexual dysfunction after the exercise program decreased significantly only in Group II (69.4 versus 25.0%; р =.001). After the program, Group I showed a significant reduction in the number of women with symptoms of urgent urinary incontinence versus baseline (35.3 versus 8.8% p = .009). Similarly, the rates of urine loss associated with coughing, sneezing or laughing in Group I decreased from 41.2% at baseline to 11.8% after the program (р =.006) and the rates of urine leakage independent of physical activity from 23.5 to 5.9% (p = .040), respectively. CONCLUSION: The 4-week postpartum pelvic floor muscle exercise program utilizing the EmbaGYN or Magic Kegel Master device has significantly increased the pelvic floor muscle strength and decreased the symptoms of pelvic organ prolapse, urinary and fecal incontinence. The use of the Magic Kegel Master device significantly reduced the symptoms of sexual dysfunction. The use of the EmbaGYN device was effective in addressing the individual symptoms of urinary incontinence.

The effects of pelvic floor muscle training combined with Kinesio taping on bladder symptoms, pelvic floor muscle strength, and quality of life in women with overactive bladder syndrome: A randomized sham-controlled trial.

Background: There is insufficient study using Kinesio taping (KT) in bladder problems. Objectives: To investigate the effects of pelvic floor muscle training (PFMT) combined with KT on bladder symptoms, pelvic floor muscle strength, and quality of life in women with overactive bladder (OAB) syndrome and compare this combination with PFMT plus sham tape (ST). Methods: Women with OAB were randomly allocated into PFMT+KT and PFMT+ST groups. All patients were given PFMT for 6 weeks and applied taping according to groups. Before and after treatment, the OAB symptoms with the Overactive Bladder Assessment Form (OAB-V8) and Patients' Perception of Intensity of Urgency Scale (PPIUS), bladder function with a 3-day voiding diary, pelvic floor muscle strength with the Modified Oxford Scale, and quality of life with the King's Health Questionnaire (KHQ) were assessed. Results: OAB-V8, PPIUS, and KHQ scores decreased and the MOS improved in both groups (P < .05) after treatment. The intergroup comparisons revealed a further decrease in voids/day, voids/night, incontinence episodes/day, and personal limitation scores of the KHQ in the PFMT+KT group compared to the PFMT+ST group (P < .05). Conclusion: PFMT+KT was more effective in reducing the OAB symptoms compared to PFMT+ST. KT could be a complementary application for reducing symptoms in OAB.

Pelvic floor muscle training as an adjunct to a midurethral sling: a single-blind randomised controlled trial.

INTRODUCTION AND HYPOTHESIS: This single-blind, randomised controlled trial was aimed at determining whether peri-operative physiotherapist-supervised pelvic floor muscle (PFM) training was superior to standard care (handout) in terms of improvements in stress urinary incontinence (SUI) symptoms, cure rate, and/or post-operative filling or voiding symptoms among women undergoing surgical mid-urethral sling (MUS) insertion for SUI. METHODS: Women with SUI were recruited from surgical wait lists at four participating urogynecology clinics. Participants were assessed at baseline (V1) then randomised (1:1 allocation) to receive supervised PFM training or a handout. Immediately following the 12-week intervention period (V2) and at 12 weeks following surgery (V3) the groups were compared based on the Female Lower Urinary Tract Symptoms (FLUTS) questionnaire total score and urinary incontinence, filling, and voiding subscale scores as well as on a standardised 30-min pad test administered by a blinded assessor. Intention-to-treat analyses were performed. RESULTS: A total of 52 participants were randomised to physiotherapy and 51 to the control group between December 2012 and August 2016. The groups were not different on any outcomes at V1 and all were improved at V3 compared with V1 (p < 0.001). At V3 the physiotherapy group reported significantly fewer UI symptoms (FLUTS UI subscale score) than the control group; yet, there were no group differences in FLUTS overall score or the pad test (p > 0.05). Based on a FLUTS UI subscale score <4, the cure rate at V3 was higher in the intervention group (73%) than in the control group (47%); (2.36 < OR < 3.47, p = 0.012). There were no group differences in cure rate at V3 based on a pad test (p = 0.27). No group differences were found in the filling or voiding symptoms at V3 (p > 0.05). No adverse events were reported. CONCLUSION: Physiotherapist-supervised PFM training improves SUI cure rates associated with surgical MUS insertion when considering symptoms of SUI, but does not improve post-operative continence function as measured by a pad test, nor does it lead to fewer post-operative voiding or filling symptoms.

Predictors for lower urinary tract symptoms in patients underwent radical prostatectomy: implications for postoperative nursing care.

AIMS AND OBJECTIVES: The aim of this study was to evaluate the risk factors for lower urinary tract symptoms in prostate cancer patients underwent radical prostatectomy, thus providing therapeutic evidence for post-operative nursing. BACKGROUND: Prostate cancer is one of the most commonly diagnosed male malignancy in recent years. With surgical treatments, patients with prostate cancer indeed have satisfying survival rate. However, the presence of postprostatectomy lower urinary tract symptoms which affect quality of life significantly is more worthy of attention. DESIGN: Patients underwent surgical therapies were followed up and the symptoms were recorded. METHODS: A total of 65 prostate cancer patients underwent radical prostatectomy from January 2019 to October 2020, and pathologically diagnosed with prostate cancer were enrolled in our study. These patients were followed up 3 months after surgery and their medical records were retrospectively collected and analysed. Results were reported according to the STROBE Statement. RESULTS: The incidence of post-operative lower urinary tract symptoms at 3 months after surgery is similar to that of pre-operation. Univariate and multivariate analyses revealed that the independent risk factor for postprostatectomy lower urinary tract symptoms is body mass index, whereas pelvic floor muscle exercise is a protective factor. CONCLUSIONS: The incidence of postprostatectomy lower urinary tract symptoms is non-negligible, which significantly affects quality of life. Body mass index is found as an independent risk factor for postprostatectomy lower urinary tract symptoms, while pelvic floor muscle exercise is a strong protector. RELEVANCE TO CLINICAL PRACTICE: Patients with prostate cancer would benefit from post-operative pelvic floor muscle exercise. These findings contribute to tailor post-operative nursing strategy.

Application of Snyder’s hope theory in patients with pelvic floor exercise after prophylactic stoma retraction / 中国实用护理杂志

Objective:To explore the effect of pelvic floor muscle functional exercise based on Snyder hope theory in patients after prophylactic stoma retraction.Methods:74 patients with low rectal cancer who underwent prophylactic stoma retraction from July 2019 to June 2021 were randomly divided into intervention group and control group. The patients in the control group received routine nursing and pelvic floor muscle functional exercise. The patients in the intervention group received functional exercise intervention based on Snyder′s hope theory on the basis of the control group. The hope level and self-care ability of the patients in the two groups were evaluated before the intervention and 3 months after stoma restitution. The anal function of the patients in the two groups was evaluated 1 month and 3 months after stoma restitution.Results:Before the intervention, there was no significant difference in the score of hope level and self-care ability between the two groups ( P>0.05). Three months after the operation, the score of hope level in the observation group was 36.20 ± 3.82, which was higher than that in the control group (31.26 ± 5.03) ( t = 4.63, P<0.05). Three months after the operation, the self-care ability score of the observation group was 123.57 ± 10.82, which was higher than that of the control group (108.23 ± 9.48) ( t = 6.31, P<0.05). One month and three months after stoma retraction, the anal function scores of the observation group were 12.03 ± 3.94, 5.91 ± 2.05 respectively, which were lower than those of the control group (13.86 ± 2.19, 7.26 ± 1.74) ( t = 2.40, 2.99, both P<0.05). Conclusion:Pelvic floor muscle functional exercise based on Snyder′s hope theory can improve the hope level of patients after stoma retraction, improve their anal function and improve their self-care ability.

Pelvic floor muscle exercise for prevention of pelvic floor disorders at each life stage in women / 体力科学

Pelvic floor muscles play an important role in inner unit functioning related to excretion, reproduction, support of pelvic organs, posture, and respiration, while their weakening is a characteristic health problem for many women. The pelvic floor is closely related to women’s life events, and protection and strengthening of the pelvic floor in accordance with life stages will lead to the prevention of pelvic floor disorders (pelvic frailty). Pelvic floor muscle exercises may be the first choice for prevention, improvement, and/or conservative treatment of pelvic organ prolapse caused by weakening of pelvic floor muscle groups. Also, pelvic floor muscle exercises can be done on a daily and continuous basis as a fitness activity; but proper assessment and practice with appropriate methods are important. In addition, an integrated program that includes lifestyle modification can enhance its effectiveness. In order to realize the lifelong well-being of women, there is a need to further develop effective pelvic floor exercises in creating a more comprehensive prevention-care health system for society.

Analysis of the YouTube videos on pelvic floor muscle exercise training in terms of their reliability and quality.

PURPOSE: The aim of this study was to evaluate the content, reliability and quality of YouTube videos related to pelvic floor muscle exercise training. METHOD: This study was carried out on the descriptive model in order to evaluate the content, reliability and quality of the videos on YouTube related to pelvic floor muscle exercise training. "Pelvic floor muscle exercise" was searched on YouTube in English in March 2020, and a total of 107 videos were watched. Quality Criteria for Consumer Health Information (DISCERN) survey was used to analyze the videos in terms of their reliabilities, and Global Quality Score (GQS) was used to evaluate their qualities. RESULTS: When the contents of 59 videos included in the study were examined, it was determined that 52 of them contained useful information and 7 of them contained misleading information. Comprehensiveness mean scores, DISCERN mean scores and GQS means of the useful videos were found to be statistically higher than that of the moderate and misleading videos (p < 0.05).When videos were analyzed according to the publishing sources, 84.62% (44/52) of the useful videos and 85.71% (6/7) of misleading video were observed to be published by independent health information websites. No statistically significant difference was found between the overall comprehensiveness mean scores, DISCERN mean scores, GQS means and the features of the videos according to their publishing sources. CONCLUSION: In this study, it was observed that the vast majority of YouTube videos on pelvic floor muscle exercise training were useful videos; the vast majority of these videos were published by independent health information websites and contained moderately safe, accurate and quality information.

Preoperative pelvic floor muscle exercise does not reduce the rate of postprostatectomy incontinence: evidence from a meta-analysis and a systematic review.

BACKGROUND: A growing number of researches suggested that preoperative pelvic floor muscle exercise (PFME) was beneficial for urinary incontinence (UI) after a prostatectomy. However, these studies are debatable and inconclusive. Hence, this article aimed to determine whether PFME improves UI after a radical prostatectomy (RP). METHODS: PubMed, Embase, Medline and Cochrane Library were searched for articles published from 2014 to October 2019 based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). This study was evaluated based on the Oxford Evidence-Based Medicine Center. A total of 1,269 subjects (experimental group: 628, control group: 641) in 18 studies met the inclusion criteria. In 18 studies, enough quantitative data on postoperative incontinence were available for meta-analysis. UI was analyzed at 1, 3, 6 and 12 months and all comparative studies were pooled using fixed and random effects models. Contour-enhanced funnel plots were used to assess publication bias. RESULTS: Pooled data revealed a total of 1,269 UI patients that underwent preoperative PFME, including PFME (N=628, 49.48%) and control group (N=641, 50.51%). There was no significant difference in the postoperative incontinence rates at 1 month (RR: 0.85, 95% CI: 0.66-1.09, P=0.031, I2=62.4%), 6 weeks (RR: 0.95, 95% CI: 0.85-1.05, P=0.618, I2=0.0%), 3 months (RR: 0.92, 95% CI: 0.63-1.34, P=0.000, I2=83.2%), 6 months (RR: 0.86, 95% CI: 0.69-1.08, P=0.364, I2=8.4%) or 12 months (RR: 0.83, 95% CI: 0.47-1.47, P=0.596, I2=0.0%) after operation. CONCLUSIONS: Contrary to previous work, the results presented here indicated that preoperative PFME protocols did not reduce the rate of UI. Further high-quality randomized controlled trials are necessary in the future to verify these findings.