盆底肌电刺激和凯格尔运动治疗老年女性尿失禁疗效比较

目的:评价盆底肌电刺激(PFES)和凯格尔运动(KE)治疗老年女性尿失禁的疗效,探讨PFES是否为老年女性尿失禁可取的治疗措施。方法:44例老年女性尿失禁患者随机分为两组,22例接受隔日1次的PFES,22例每天进行KE。PFES组采用神经肌肉电刺激治疗仪,皮肤表面电极;KE组每日两次做缩肛运动。总疗程16周。客观疗效评价指标:①漏尿量(标准尿垫试验);②尿动力学检查。主观疗效评价指标:病人自身对尿失禁改善的评价。结果:PFES组主观满意率高达91%,显著高于KE组(64%);PFES组和KE组治疗前后24 h尿垫试验改善的差异无统计学意义,但PFES组漏尿减少50%以上的发生率为77.3%,显著高于KE组(40.9%)。PFES组治疗后valsalva漏尿点压(VLPP)和最大尿道闭合压(MCP)的增加显著高于KE组。结论:PFES能有效治疗老年女性尿失禁,但长期疗效仍需进一步观察。

Study of pelvic floor electrical stimulation and Kegel exercises in treatment of elderly women with urinary incontinent

Objective:To evaluate the effective of pelvic floor electrical stimulation(PFES) and Kegel exercises(KE) on elderly women with urinary incontinence.Methods:In total,forty-four women were enrolled in a randomized clinical trial,a half of them treated with every-other-day PFES and the other women treated with a daily KE program.The duration of both PFES and KE were 16 weeks.Urinary leakage(during a standardized PAD test),urodynamic study and subjective assessment of change in urinary symptoms were carried out on all women before and after treatment.Results:Significant improvement of subjective assessment was observed in PFES group compared with KE group(91% vs 64%).No significant improvement was observed between two groups in PAD test,the catabatic episode of urinary leakage more than 50% occurred 77.3% in PFES group,significantly higher than that in KE group(40.9%).Significant improvement of both valsalva leak point pressure(VLPP) and max urethral closure pressure(MCP)in PFES group were observed compared with those in KE group.Conclusion:There is better effective on elder women with urinary by PFES compared by KE.