PDF(Pubmed)
Abstract：
UNASSIGNED: Patients with cystocele of pelvic organ prolapse quantification (POP-Q) stage II and below can be treated conservatively, but there are few reports on non-surgical treatment for these patients. This study aimed to present the real-world clinical effectiveness of nonsurgical treatment, including pelvic floor muscle training (PFMT), PFMT combined with pessary (PFMT + P), or non-ablative radiofrequency (PFMT + RF) for female with POP-Q stage II cystocele.
UNASSIGNED: We retrospectively analyzed females with POP-Q stage II cystocele between January 2020 and January 2022 who received PFMT, PFMT + P, or PFMT + RF treatment and were followed up for 12 months. Clinical parameters including Pelvic Floor Distress Inventory-20 questionnaire (PFDI-20), Persian version urinary incontinence quality of life questionnaire (I-QOL), POP-Q, pelvic floor Glazer evaluation, and trans-labial ultrasound at different time points were analyzed.
UNASSIGNED: There were 147 participants enrolled. PFDI-20 and I-QOL scores were improved in all groups, but the mean decrement in the PFDI-20 scores (-14.28±8.57 and -9.78±8.25) was higher in the PFMT + P group than in the PFMT group and PFMT + RF group at both 6 and 12 months (P<0.05), and the mean I-QOL score (3.82±23.43 and 3.47±22.06) was higher in the PFMT + RP group at both 6 months and 12 months (P<0.05). The PFMT + P group also showed higher improvement rate (43.3%, P=0.03) in terms of changing the severity of cystocele (point Ba) and delta bladder neck-symphyseal distance (ΔBSD) (P<0.05) than the other 2 groups at 12 months. No statistical difference was found in the type-I and type-II myofiber function-based Glazer assessment among 3 groups.
UNASSIGNED: The combination of 2 treatment strategies seems to be superior to PFMT only for stage-II cystocele. Specific prolapse-related symptoms and objective indicators did improve more in the PFMT + P group, whereas stress urinary incontinence (SUI) symptoms and quality of life were improved in the PFMT + RP group.
UNASSIGNED: We retrospectively analyzed females with POP-Q stage II cystocele between January 2020 and January 2022 who received PFMT, PFMT + P, or PFMT + RF treatment and were followed up for 12 months. Clinical parameters including Pelvic Floor Distress Inventory-20 questionnaire (PFDI-20), Persian version urinary incontinence quality of life questionnaire (I-QOL), POP-Q, pelvic floor Glazer evaluation, and trans-labial ultrasound at different time points were analyzed.
UNASSIGNED: There were 147 participants enrolled. PFDI-20 and I-QOL scores were improved in all groups, but the mean decrement in the PFDI-20 scores (-14.28±8.57 and -9.78±8.25) was higher in the PFMT + P group than in the PFMT group and PFMT + RF group at both 6 and 12 months (P<0.05), and the mean I-QOL score (3.82±23.43 and 3.47±22.06) was higher in the PFMT + RP group at both 6 months and 12 months (P<0.05). The PFMT + P group also showed higher improvement rate (43.3%, P=0.03) in terms of changing the severity of cystocele (point Ba) and delta bladder neck-symphyseal distance (ΔBSD) (P<0.05) than the other 2 groups at 12 months. No statistical difference was found in the type-I and type-II myofiber function-based Glazer assessment among 3 groups.
UNASSIGNED: The combination of 2 treatment strategies seems to be superior to PFMT only for stage-II cystocele. Specific prolapse-related symptoms and objective indicators did improve more in the PFMT + P group, whereas stress urinary incontinence (SUI) symptoms and quality of life were improved in the PFMT + RP group.
摘要：
■盆腔器官脱垂定量（POP-Q）II期及以下患者可保守治疗，但是关于这些患者的非手术治疗的报道很少。本研究旨在展示非手术治疗的真实世界临床效果，包括盆底肌肉训练（PFMT），PFMT联合子宫托（PFMT+P），女性患有POP-QII期膀胱膨出的或非消融性射频（PFMTRF）。
我们回顾性分析了在2020年1月至2022年1月期间接受PFMT治疗的患有POP-QII期膀胱膨出的女性，PFMT+P,或PFMT+RF治疗，随访12个月。临床参数，包括盆底窘迫清单-20问卷（PFDI-20），波斯版尿失禁生活质量问卷（I-QOL），POP-Q,盆底Glazer评估，并对不同时间点的经唇超声进行分析。
■有147名参与者注册。所有组的PFDI-20和I-QOL得分均得到改善，但在6个月和12个月时，PFMT+P组PFDI-20评分的平均下降(-14.28±8.57和-9.78±8.25)高于PFMT组和PFMT+RF组(P<0.05)，PFMT+RP组在6个月和12个月时I-QOL平均评分(3.82±23.43和3.47±22.06)均较高(P<0.05)。PFMT+P组的改善率也较高(43.3%,P=0.03）在12个月时，膀胱膨出的严重程度（Ba点）和膀胱颈联合距离（ΔBSD）的变化（P<0.05）比其他2组。3组之间基于I型和II型肌纤维功能的Glazer评估无统计学差异。
■两种治疗策略的组合似乎仅在II期膀胱膨出中优于PFMT。特定脱垂相关症状和客观指标在PFMT+P组中改善更多，而压力性尿失禁（SUI）症状和生活质量在PFMT+RP组得到改善。
我们回顾性分析了在2020年1月至2022年1月期间接受PFMT治疗的患有POP-QII期膀胱膨出的女性，PFMT+P,或PFMT+RF治疗，随访12个月。临床参数，包括盆底窘迫清单-20问卷（PFDI-20），波斯版尿失禁生活质量问卷（I-QOL），POP-Q,盆底Glazer评估，并对不同时间点的经唇超声进行分析。
■有147名参与者注册。所有组的PFDI-20和I-QOL得分均得到改善，但在6个月和12个月时，PFMT+P组PFDI-20评分的平均下降(-14.28±8.57和-9.78±8.25)高于PFMT组和PFMT+RF组(P<0.05)，PFMT+RP组在6个月和12个月时I-QOL平均评分(3.82±23.43和3.47±22.06)均较高(P<0.05)。PFMT+P组的改善率也较高(43.3%,P=0.03）在12个月时，膀胱膨出的严重程度（Ba点）和膀胱颈联合距离（ΔBSD）的变化（P<0.05）比其他2组。3组之间基于I型和II型肌纤维功能的Glazer评估无统计学差异。
■两种治疗策略的组合似乎仅在II期膀胱膨出中优于PFMT。特定脱垂相关症状和客观指标在PFMT+P组中改善更多，而压力性尿失禁（SUI）症状和生活质量在PFMT+RP组得到改善。
