Conservative Treatment Of Postpartum Stress Urinary Incontinence With Different Severity And The Relationship Between Subjective And Objective Evaluation Criteria And Initial Pelvic Floor Electrophysiological Indexes

Objective:To investigate the effect of electrical stimulation combined with biofeedback pelvic floor exercise on postpartum stress urinary incontinence.To explore the relationship between subjective and objective evaluation criteria of urinary incontinence and initial pelvic floor electrophysiological indexes.Methods:From September 2016 to September 2017,54 patients who were diagnosed as stress urinary incontinence in Peking Union Medical College Hospital from September 2016 to September 2017 were enrolled in the study.According to the severity of stress urinary incontinence,the patients were divided into three groups:mild stress urinary incontinence group(15 cases),moderate stress urinary incontinence group(32 cases)and severe stress urinary incontinence group(7 cases).The difference of the initial indexes of the deep muscle strength of type I muscle fiber,the deep layer of II muscle fiber force and the dynamic pressure of pelvic floor.The pelvic floor muscles were trained by electrical stimulation and biofeedback for 6 weeks and followed up for 12 months.To evaluate the effect of stress urinary incontinence(IIQ-7)on the treatment of stress urinary incontinence,and to compare the effective rate of treatment between the two groups,the changes of physiological indexes,1 h urine pad test and the subjective index stress urinary incontinence questionnaire(IIQ-7)were observed to evaluate theConclusion:1.Objective evaluation of 1 hour urine pad test and evaluation of IIQ-7 subjective index showed that 6 cases were cured,7 cases were effective,and 86.7%were effective in mild postpartum SUI group,9 cases were cured and 17 cases were effective in moderate postpartum SUI group(32 cases).The effective rate was 81.25%,1 case was cured and 3 cases were effective in severe postpartum SUI group,the effective rate was 57.1%,the effective rate in mild and moderate postpartum SUI group was significantly higher than that in severe postpartum SUI group(P<0.05).2.Conservative treatment through electrical stimulation and biofeedback combined with pelvic floor muscle exercise,The therapeutic effect and electrophysiological indexes of pelvic floor were observed for half a year and one year:the pelvic floor type I,II muscle fiber muscle strength and IIQ-7 score were not improved significantly(P>0.05).The dynamic pressure of pelvic floor and 1 hour urine pad test were improved(P<0.05).The pelvic floor type I,II muscle fiber strength,pelvic floor dynamic pressure,IIQ-7 score and 1 hour urine pad test were improved in patients with moderate and severe postpartum stress urinary incontinence(P<0.05).The correlation of physiological indexes of pelvic floor was explored by multivariate linear regression analysis.The results showed that there was a negative correlation between the 11 h urine pad test and the pelvic floor dynamic pressure(P<0.05).There was a negative correlation between 11 h urine pad test and pelvic floor dynamic pressure(P<0.05).There was no significant correlation between the muscle strength of class I and II muscle fiber(P>0.05).There was a positive correlation between 1 hour urine pad test and IIQ-7 score(P<0.05).That is,for every 10 points added to IIQ-7,1.37 g was added to 1 hour urine pad test.3.The correlation of physiological indexes of pelvic floor was explored by multivariate linear regression analysis.The results showed that there was a negative correlation between the 11 h urine pad test and the pelvic floor dynamic pressure(P<0.05).For every 10 cm H 20 h urinary pad test,the pelvic floor dynamic pressure was increased by 0.66 g.There was no significant correlation with muscle strength of class I and II muscle fibers(P>0.05),but there was a positive correlation between 1 hour urine pad test and IIQ-7 score(P<0.05),that is,for every 10 points in IIQ-7,1.37 g was added to 1 hour urine pad test.