生物反馈电刺激仪治疗腹腔镜前列腺癌根治术后尿失禁☆

目的：应用生物反馈电刺激仪可以指导患者进行正确自主的盆底肌肉训练，观察其对腹腔镜前列腺癌根治术后控尿功能恢复的作用。 方法：选择2005-07/2007-06中山大学附属第三医院泌尿外科收治腹腔镜前列腺癌根治术后尿失禁患者41例，轻度12例，中度23例，重度6例。采用加拿大Laborie 公司生产的UROSTIM型盆腔生物反馈电刺激治疗仪电刺激联合盆底肌肉训练，生物反馈电刺激每日1次，5次为1个疗程，根据患者尿失禁程度分别治疗一两个疗程。疗效判定标准：治愈，自觉尿失禁症状消失、小便能自控，排尿正常，尿垫试验阴性；有效，自觉尿失禁次数明显减少、尿垫试验连续3次以上阴性；无效，尿失禁症状无明显改善，尿垫试验阳性。治疗结束后4周评价其治疗效果，追踪观察随访3~12个月。 结果：41例术后不同程度尿失禁患者，治愈23例(56.1%) ，有效11例(26.9%) ，无效7例(17.0%) ，总有效率为83%。轻度尿失禁患者，治愈11例，有效1例；中度尿失禁患者，治愈11例，有效8例，无效3例；重度尿失禁患者，治愈1例，有效2例，无效3例。 结论：应用生物反馈电刺激仪可促进前列腺癌根治术后患者控尿功能的恢复。

Biofeedback electrical stimulation for treatment of urinary incontinence after laparoscopic radical prostatectomy

AIM: To investigate the efficacy of biofeedback electrical stimulation and pelvic floor muscle training in the treatment of urinary incontinence after laparoscopic radical prostatectomy (LRP). METHODS: Forty-one patients who underwent LRP in Department of Urinary Surgery, Third Affiliated Hospital of Sun Yat-sen University from July 2005 to June 2007 were selected, including 12 with mild disease, 23 with moderate and 6 with severe. The patients were treated by UROSTIM biofeedback electrical stimulation (Laborie, Canada), once per day for five times and pelvic floor muscle training. One or two courses of treatment were performed according to the degree of urinary incontinence. Therapeutic outcome was assessed 4 weeks after treatment according to the criteria: recovery if self-conscious urinary incontinence disappeared, urine was controllable, urination was normal, and urinal pad test was negative; effective, if self-conscious urinary incontinence significantly decreased, and urinal pad test was negative for more than 3 successive times; ineffective, if urinary incontinence was not improved, and urinal pad test was positive. The patients were followed up for 3 to 12 months. RESULTS: Of the 41 patients, the total efficacy rate was 83% (34/41), curative rate was 56.1% (23/41), efficacy rate 26.9% (11/41) and ineffective rate 17.0% (7/41). Of the cases with mild urinary incontinence, 11 were cured and 1 was effectively improved; of the cases with moderate urinary incontinence, 11 were cured and 8 were significantly improved; of the cases with server urinary incontinence, 1 was cured, 2 were improved, and 3 were failed. CONCLUSION: Biofeedback electrical stimulation can facilitate rehabilitation of urinary control after prostatectomy.