生物反馈联合盆底肌训练治疗女性压力性尿失禁的疗效

目的:探讨生物反馈联合盆底肌训练治疗女性压力性尿失禁(Stress urinary incontinence,SUI)的临床效果.方法:2005年11月～2007年3月,对11例女性SUI患者使用生物反馈治疗仪进行生物反馈电刺激联合盆底肌训练治疗.治疗前通过病史、体检、尿动力学检查诊断为尿失禁.治疗每次20 min,每天1次,5次为1个疗程.结果:11例女性SUI患者中,7例症状消失,4例症状减轻.追踪观察6个月,无一例复发.结论:生物反馈联合盆底肌训练是一种安全、有效的治疗女性SUI的方法.     

新的盆底肌锻炼方式治疗女性压力性尿失禁的临床疗效分析

目的 探讨一种治疗女性压力性尿失禁(SUI)新的盆底肌锻炼方式的临床效果. 方法 采用前瞻性随机抽样的方法,选取轻、中度女性SUI患者60例,其中进行盆底肌锻炼30例(实验组),第八套广播操锻炼30例(对照组).应用国际尿失禁咨询委员会尿失禁问卷(ICI-Q-SF)、尿垫试验及尿动力学检测方法分别对两组患者锻炼前后的尿失禁程度、漏尿量、最大尿道闭合压和功能性尿道长度等指标进行测定.统计学比较组间各指标的差异. 结果 治疗前实验组尿失禁评分、漏尿量、最大尿道闭合压及功能尿道长度分别为(11.6±4.2)分、(5.9±2.2) ml、(39.4±12.5)cm H2O(1 cmH2O=0.098 kPa)和(2.5±1.2)cm,对照组分别为(10.3±2.2)分、(5.8±1.3)ml、(41.3±8.9)cm H2O和(2.1±0.5)cm,组间比较差异均无统计学意义(P＞0.05).治疗后实验组患者尿失禁评分、漏尿量及最大尿道闭合压分别为(7.7±2.7)分、(1.8±1.2)ml、(65.9±8.9)cm H2O,对照组分别为(10.1±2.1)分、(5.7±1.1)ml和(44.6±9.5)cm H2O,组间比较差异有统计学意义(P＜0.05). 结论 新的盆底肌锻炼方式能够缓解女性SUI患者的症状,推荐用于治疗轻、中度女性SUI患者的治疗.     

电刺激联合盆底肌训练治疗压力尿失禁的疗效观察

目的探讨观察电刺激联合盆底肌训练治疗压力性尿失禁（SUI）的疗效。方法选取经尿动力学检查证实为SUI患者56例,其中男9例,女47例,平均（46±5）岁。采用盆底生物反馈治疗仪进行电刺激联合盆底肌训练,每次32min,每天1次,6周为1疗程。记录治疗前、后患者排尿日记和尿动力学测定,并随访2个月疗效。结果56例全部完成治疗。其中尿失禁症状完全消失10例（17％）,漏尿点压测定无漏尿发生7例（13％）。治疗后总排尿次数（8±2）次／24h、总漏尿事件次数（7±2）次／24h,显著低于治疗前的（15±4）次／24h、（12±3）次／24h（均P〈0．05）;最大排尿量、正常尿意膀胱压测定容量、最大膀胱压测定容量、漏尿点压和最大尿道闭合压分别为（256±47）L、（260±48）mL、（277±46）mL、（96±10）cmH2O和（62±7）cmH,显著高于治疗前的（143±35）mL、（135±37）mL、（162±33）mL、（79±12）cmH2O和（54±6）cmH2O,差异有统计学意义（均P〈0．05）。治疗结束时和2个月后有效率为91％和88％,差异无统计学意义（P〉0．05）。结论电刺激联合盆底肌训练是治疗SUI的一种有效方法。     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

目的 探讨电刺激联合全程指导盆底肌训练治疗女性压力性尿失禁(SUI)合并特发性逼尿肌过度活动(IDO)的疗效.方法选取经尿动力学检查证实为SUI合并IDO女性患者70例.平均年龄(40±7)岁.采用神经肌肉电刺激治疗仪电刺激,每次60 min,每周3次.联合盆底肌训练,每次30 min,每天2次,疗程12周.记录治疗前后患者排尿日记,填写国际尿失禁咨询委员会尿失禁问卷简表(ICI-Q-SF)和尿动力学测定,并随访3个月疗效.结果 50例(71%)完成全程治疗.其中尿失禁症状完全消失8例(16%),IDO消失10例(20%),漏尿点压测定无漏尿发生6例(12%).治疗后总排尿次数、总漏尿事件次数、ICI-Q-SF评分、最大逼尿肌不随意收缩压和持续时间分别为(28±5)次/72 h、(10±5)次/72 h、(10±3)、(18±8)cm H2O和(8±3)s,显著低于治疗前的(43±8)次/72 h、(20±6)次/72 h、(17±3),(27±9)cm H2O和(13±6)s(P<0.01);最大排尿量、正常尿意膀胱压测定容量、最大膀胱压测定容量、漏尿点压和最大尿道闭合压分别为(225±48)、(210±48)、(247±48)ml、(94±11)和(59±8)cm H2O,显著高于治疗前的(159±37)、(141±39)、(178±36)ml、(81±15)和(55±8)cm H2O,差异有统计学意义(P<0.01).治疗结束时和3个月后有效率为66%和60%,差异无统计学意义(P>0.05).结论 电刺激联合盆底肌训练是一种治疗女性SUI合并IDO的有效方法.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

电刺激联合盆底肌训练治疗女性压力性尿失禁合并特发性逼尿肌过度活动的疗效观察

Objective To investigate the short-term efficacy of pelvic floor electrical stimulation (PFES) and pelvic floor training (PFT) for female with idiopathic detrusor overactivity (IDO) and stress urinary incontinence (SUI). Methods PFES and PFT were performed on 70 women (average age 40±7 years old) with IDO and SUI for twelve weeks. Urinary diary, International Continence In-quiring Committee's Questionnaire (ICI-Q-SF) scores were recorded and urodynamic study was per-formed before and after the treatment. Results Fifty women (71%) finally completed treatment for twelve weeks. Urinary incontinence disappeared in 8 (16%), detrusor overactivity disappeared in 10 (20 %). The leakage was not found in 6 (12 %) in leakage point pressure measurement. Moreover, the frequency of voiding (28±5 times/72 h), frequency of leakage (10±5 times/72 h), total scores of ICI-Q-SF(10±3), max detrusor uninhibited contraction pressure (18±8 cmH20) and detrusor unin-hibited contraction duration (8±3 s) were significantly lower than those before treatment (43±8 times/72 h, 20±6 times/72 h, 17±3, 27±9 cm H2O and 13±6s,P<0.01). Maximal voided vol-ume(225±48 ml), normal desired cystometric capacity (210±48 ml), maximal cystometric capacity (247±48 ml), Valsalva leak point pressure (94±11 cm H2O) and maximal urethral closure pressure (59±8 cm H2O) were significantly higher than those before treatment (159±37 ml, 141±39ml, 178±36ml, 81±15 cm H2O and 55±8 cm H2O, P<0.01). The effective rate during three months follow up was 60%, similar to time after treatment (P>0.05). Conclusions Pelvic floor electrical stimulation and pelvic floor training could be a useful therapy to treat women with IDO and SUI. It is both convenient and economical.     

盆底生物反馈联合电刺激治疗女性压力性尿失禁

目的探讨盆底生物反馈联合电刺激治疗女性压力性尿失禁（stress urinary incontincnce,SUI）和压力/急迫混合性尿失禁（mixed urinary incontinence,MUI）的临床效果。方法2006年5月-2007年6月对40例轻中度女性尿失禁患者（SUI 22例,MUI 18例）,采用生物反馈治疗仪进行盆底生物反馈联合电刺激的训练治疗,治疗时间20-30 min,3次/周,疗程2个月。结果40例均获随访,平均8.9（3-14）个月。治愈14例（35.0%）,改善16例（40.0%）,无效10例（25.0%）,总有效率为75.0%;其中SUI有效率为77.3%（17/22）,MUI有效率为72.2%（13/18）。除少数患者插入探头时有轻微不适感外,无其他明显不适,无阴道感染等不良反应发生。但有5例治疗有效的患者症状复发。结论盆底生物反馈联合电刺激治疗女性轻中度SUI或MUI安全有效、治愈率较高。治疗后如能继续坚持Kegel操盆底肌锻炼有助于预防尿失禁的复发。     

手术治疗女性压力性尿失禁及盆底器官脱垂对患者生活质量的影响

目的：研究手术治疗女性压力性尿失禁（SUI）及盆底器官脱垂（POP）对健康相关生活质量的影响。方法：选择自2001年1月~2007年1月接受TVT、经闭孔无张力吊带术（TVT-O）、前路植入网带及整体植入网带的患者共142例．109例人选并同意参加本研究。采用改良PFDI-20量表评估术前3个月、术后6～12个月及术后12个月以后患者生活质量,采用方差分析对不同性功能变化情况的PFDI-20评分进行比较。结果：PFDI-20总分及POP评分术后较术前显著降低（P〈0．0167）,但术后12个月以后与术后6～12个月相比差异元统计学意义（P〉0．0167）。术后6～12个月时肛直肠症状评分较术前降低,但差异无统计学意义（P;0．0169）。术后12个月以后以术前及术后6～12个月相比均显著改善（P〈0．01671。术后6～12个月及术后12个月以后泌尿系症状较术前显著降低（P〈0．0167）,并且12个月以后较术后6～12个月亦显著改善（P=0．003）．61例术前术后均有性生活。术后6～12个月,20例（37．0％〉术后性功能受损,11例（20．4％）改善．23例（42．6％）无变化;术后12个月以后,21例（34．4％）术后性功能受损,12例（19．7％）改善,28例（45．9％）无变化;术后12个月以后性功能与术后6～12个月相比,无进一步变化;未发现生活质量与性功能之间存在关系。105例（96．3％）患者对手术疗效满意。结论：TVT、TVT-O及经阴道网带治疗SUI及POP疗效显著,术后患者生活质量显著提高。     

健脾益肾方、生物反馈联合盆底肌功能训练治疗老年女性压力性尿失禁的效果观察

目的：观察健脾益肾方、生物反馈联合盆底肌功能训练治疗老年女性压力性尿失禁的效果。方法：将126例老年女性压力性尿失禁患者随机分为对照组和观察组,每组各63例。对照组给予盆底肌功能训练,观察组在对照组的基础上给予健脾益肾方联合盆底生物反馈内外合治,对比两组的尿流动力学相关参数、1 h尿失禁、24 h尿失禁次数、国际尿失禁咨询问卷简表（ICI-Q-SF）评分、盆底肌电位值、尿失禁生活质量量表(I-QOL)评分,监测血清中转化生长因子-β1(TGF-β1)、25羟维生素D(25-OHD)含量。结果：观察组患者的有效率显著高于对照组（P<0.05）;与对照组比较,观察组治疗后的尿流动力学相关参数ALPP、MUCP、BC、QMax、PMU、VMCC均显著升高（P<0.05）;1 h尿失禁量显著减少,24 h尿失禁次数显著下降（P<0.05）;治疗4周、8周后,观察组患者的ICI-Q-SF评分均显著低于对照组(P<0.05);观察组治疗后的盆底肌电位值（65.32±7.19）μV显著高于对照组的（54.25±5.36）μV(P<0.05);治疗4周、8周后,观察组患者...