G Legendre1, A Gonzalves2, J-M Levaillant3, D Fernandez4, F Fuchs3, H Fernandez3. 1. Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France; Service de gynécologie-obstétrique, CHU d'Angers, 49933 Angers cedex, France. Electronic address: g_legendre@hotmail.com. 2. Service de gynécologie-obstétrique, CHU d'Angers, 49933 Angers cedex, France. 3. Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France. 4. Cabinet de sage-femmes, 47, avenue Aristide-Briand, 92350 Le Plessis-Robinson, France.
Abstract
OBJECTIVE: Pelvic floor muscle training (PFMT) is the first step of treatment for stress urinary incontinence (SUI). Patients must perform self-retraining exercises of the perineal muscles at home in order to maintain the benefit of the physiotherapy. The aim of this study is to assess the benefit of a perineal electro-stimulator, using three-dimensional ultrasound, during this home-care phase. MATERIALS AND METHODS: A longitudinal prospective study was conducted between May 2012 and May 2013. All patients with de novo SUI benefited from PFMT followed by a self-maintenance of perineal rehabilitation at home with the Keat(®) Pro system. The primary endpoint was the biometric of the levator ani and it was assessed by three-dimensional perineal ultrasound at inclusion, after conventional rehabilitation and at the end of the study after self-rehabilitation. RESULTS: Ten patients were included. All patients (100%) showed a clinical improvement of SUI. The quality of life was significantly improved after PFMT vs. inclusion (P=0.014) and after self-rehabilitation vs. after PFMT (P=0.033). Levator ani muscles were significantly thicker after conventional rehabilitation than at baseline (P=0.004) and significantly thicker after self-rehabilitation than after PFMT (P=0.009). CONCLUSIONS: Conducting self-rehabilitation in addition to conventional PFMT objectively improves the perineal muscle building achieved after conventional rehabilitation.
OBJECTIVE: Pelvic floor muscle training (PFMT) is the first step of treatment for stress urinary incontinence (SUI). Patients must perform self-retraining exercises of the perineal muscles at home in order to maintain the benefit of the physiotherapy. The aim of this study is to assess the benefit of a perineal electro-stimulator, using three-dimensional ultrasound, during this home-care phase. MATERIALS AND METHODS: A longitudinal prospective study was conducted between May 2012 and May 2013. All patients with de novo SUI benefited from PFMT followed by a self-maintenance of perineal rehabilitation at home with the Keat(®) Pro system. The primary endpoint was the biometric of the levator ani and it was assessed by three-dimensional perineal ultrasound at inclusion, after conventional rehabilitation and at the end of the study after self-rehabilitation. RESULTS: Ten patients were included. All patients (100%) showed a clinical improvement of SUI. The quality of life was significantly improved after PFMT vs. inclusion (P=0.014) and after self-rehabilitation vs. after PFMT (P=0.033). Levator ani muscles were significantly thicker after conventional rehabilitation than at baseline (P=0.004) and significantly thicker after self-rehabilitation than after PFMT (P=0.009). CONCLUSIONS: Conducting self-rehabilitation in addition to conventional PFMT objectively improves the perineal muscle building achieved after conventional rehabilitation.
Authors: Licia P Cacciari; Mélanie Morin; Marie-Hélène Mayrand; Chantale Dumoulin Journal: Int J Environ Res Public Health Date: 2022-09-04 Impact factor: 4.614