Effects of Transcutaneous Electrical Stimulation on Physiological Symptoms and Psychological Satisfaction in Women With Stress Urinary Incontinence: A Preliminary Study
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder neck- symphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the “avoidance” subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the “desire” score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.
Abstract
Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder neck- symphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the “avoidance” subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the “desire” score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.
참고문헌 (33)
- Allen RE, "Pelvic floor damage and childbirth : A neurophysiological study", Br J Obstet Gynaecol, 97(9), pp.770~779 (1990)
- Appell RA, "Electrical stimulation for the treatment of urinary incontinence", Urology, 51(2), pp.24~26 (1998)
- Barber MD, "Sexual function in women with urinary incontinence and pelvic organ prolapse", Obstet Gynecol, 99(2), pp.281~289 (2002)
- Brubaker L, "Transvaginal electrical stimulation for female urinary incontinence", Am J Obstet Gynecol, 177(3), pp.536~540 (1997)
- Cammu H, "A 10 year follow up after kegel pelvic floor muscle exercises for genuine stress incontinence", BJU Int, 85(6), pp.655~658 (2000)
- Deindl FH, "Pelvic floor activity patterns: Comparison of nulliparous continent and parous urinary stress incontinent women. A kinesiological EMG study", Br J Urol, 73(4), pp.413~417 (1994)
- Dietz H, "The urethral pressure profile and ultrasound imaging of the lower urinary tract", Int Urogynecol J Pelvic Floor Dysfunct, 12(1), pp.38~41 (2001)
- Dimpfl T, "Myogenic changes of the levator ani muscle in premenopausal women : The impact of vaginal delivery and age", Neurourol Urodyn, 17(3), pp.197~205 (1998)
- Eriksen BC, "Changes in urodynamic measurements after successful anal electrostimulation in female urinary incontinence", Br J Urol, 59(1), pp.45~49 (1987)
- Fall M, "Functional electrical stimulation : Physiological basis and clinical principles", Int Urogynecol J Pelvic Floor Dysfunct, 5(5), pp.296~304 (1994)
- Paradiso Galatioto Giuseppe, "Sexual Function in Women with Urinary Incontinence Treated by Pelvic Floor Transvaginal Electrical Stimulation", The Journal of Sexual Medicine, 4(3), pp.702~707 (2007), Elsevier BV[DOI]
- Goode PS, "Effect of behavioral training with or without pelvic floor electrical stimulation on stress incontinence in women : A randomized controlled trial", JAMA, 290(3), pp.345~352 (2003)[DOI]
- Gosling JA, "A comparative study of the human external sphincter and periurethral levator ani muscles", Br J Urol, 53(1), pp.35~41 (1981)
- Gunnarsson M, "Female stress, urge, and mixed urinary incontinence are associated with a chronic and progressive pelvic floor", vaginal neuromuscular disorder : An investigation of 317 healthy and incontinent women using vaginal surface electromyography, 1999, pp.18(6), 613~621
- Hahn I, "A comparative study of pelvic floor training and electrical stimulation for the treatment of genuine female stress urinary incontinence", Neurourol Urodyn, 10(6), pp.545~554 (1991)
- Huffman JW, "Electrical stimulation in the treatment of intractable stress incontinence;a preliminary report", Arch Phys Med Rehab, 33(11), pp.674~676 (1952)
- Swati Jha, "Impact of pelvic floor muscle training on sexual function of women with urinary incontinence and a comparison of electrical stimulation versus standard treatment (IPSU trial): a randomised controlled trial", Physiotherapy, 104(1), pp.91~97 (2018), Elsevier BV[DOI]
- Klauser A, "Age‐related rhabdosphincter function in female urinary stress incontinence : Assessment of intraurethral sonography", J Ultrasound Med, 23(5), pp.631~637 (2004)
- Kobashi KC, "Stress urinary incontinence", Curr Opin Urol, 9(4), pp.285~290 (1999)
- Kuo H-C, "Transrectal sonography of the female urethra in incontinence and frequency‐urgency syndrome", J Ultrasound Med, 15(5), pp.363~370 (1996)
- Manabu Nishibayashi, "Bladder neck evaluation by perineal ultrasound before and after reconstructive surgery for pelvic organ prolapse", Journal of Medical Ultrasonics, 36(4), pp.193~199 (2009), Springer Science and Business Media LLC[DOI]
- Ingrid E. Nygaard, "Stress Urinary Incontinence", Obstetrics & Gynecology, 104(3), pp.607~620 (2004), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Peschers UM, "Levator ani function before and after childbirth", Br J Obstet Gynaecol, 104(9), pp.1004~1008 (1997)
- Petri E, "What is the place of ultrasound in urogynecology? A written panel", Int Urogunecol J, 10(4), pp.262~273 (1999)
- R. Rosen, "The Female Sexual Function Index (FSFI): A Multidimensional Self-Report Instrument for the Assessment of Female Sexual Function", Journal of Sex & Marital Therapy, 26(2), pp.191~208 (2011), Informa UK Limited[DOI]
- Talli Yehuda Rosenbaum, "Physiotherapy Treatment of Sexual Pain Disorders", Journal of Sex & Marital Therapy, 31(4), pp.329~340 (2005), Informa UK Limited[DOI]
- Karl-Dietrich Sievert, "Can we prevent incontinence?: ICI-RS 2011", Neurourology and Urodynamics, 31(3), pp.390~399 (2012), Wiley[DOI]
- Strasser H, "Anatomy and innervation of the rhabdosphincter of the male urethra", Prostate, 28(1), pp.24~31 (1996)
- Vakili B, "Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse", Am J Obstet Gynecol, 192(5), pp.1592~1598 (2005)
- Walters MD, "Psychosexual study of women with detrusor instability", Obstet Gynecol, 75(1), pp.22~26 (1990)
- Wyman JF, "Psychosocial impact of urinary incontinence in women", Obstet Gynecol, 70(3 Pt 1), pp.378~381 (1987)
- Yamanishi T, "Pelvic floor electrical stimulation in the treatment of stress incontinence : An investigational study and a placebo controlled double-blind trial", J Urol, 158(6), pp.2127~2131 (1997)
- Yang JM, "Discrimination of bladder disorders in female lower urinary tract symptoms on ultrasonographic cystourethrography", J Ultrasound Med, 21(11), pp.1249~1255 (2002)