Comparative Study Of Biofeedback Electrical Stimulation Combined With PFMT In The Treatment Of Stress Urinary Incontinence After Total Hysterectomy

Objective:To explore the clinical efficacy of biofeedback electrical stimulation combined with pelvic floor muscle training(PFMT)in the treatment of stress urinary incontinence(SUI)after total hysterectomy.Simultaneously,the patients treated with PFMT as the control group was compared and analyzed.Methods:1.Patients who underwent hysterectomy from January 2012 to December 2016 in our hospital were selected.The patients with stress urinary incontinence after operation were divided into two groups randomly.The observation group(n=45)was treated with biofeedback electrical stimulation combined with PFMT,and the control group(n=45)was treated with PFMT alone.There was no significant difference in the average age,the history of delivery,the mode of operation,the constitution of the disease and the composition of the SUI score in the two groups(P>0.05).The main and objective therapeutic indexes of the two groups were compared before and after the treatment.2.Observation index: 1)The 1 hour urine cushion test was observed of the two groups before and after the treatment.According to the standard proposal recommended by ICS,the leakage of urine in two groups of patients before the treatment,3 months and 6 months after treatment were recorded.2)The muscle force of the pelvic floor muscle before and after the treatment of the two groups was observed.The pelvic floor muscle force of the two groups before treatment,3 months and 6 months after treatment were recorded according to the rating standard of pelvic floor muscle strength test.3)Observing the score of ICI-Q-SF questionnaire before and after the treatment in two groups of patients.The subjective conditions and recovery of symptoms in two groups were evaluated after treatment based on the ICI-Q-SF score.Result:1.There was no significant difference in the average age,the history of delivery,the mode of operation,the constitution of the disease and the composition of the SUI score in the two groups(p>0.05).2.Comparison of 1 hour urine cushion test results before and after treatment of two groups.There was no significant difference in the amount of leaked urine[(11.2±4.3)g vs(10.5±3.9)g] before treatment in two groups(P>0.05).The amount of leakage of urine in the observation group at 3 months and 6 months after treatment were less than those in the control group,the difference was statistically significant(P<0.05).3.Comparison of pelvic floor muscle strength before and after treatment of two groups.1)Before the treatment: There was no significant difference in the muscle strength of type I fibers [(2.0±1.4)grade vs(1.8±1.3)grade ] and type II fibers [(3.7±0.6)grade vs(3.1±1.2)grade] in the pelvic floor muscle of the two groups(P>0.05).2)3 months after treatment: The increase of type I fibers [(3.5±0.9)grade vs(2.9±1.1)grade] and type II fibers[(3.7±0.6)grade vs(3.1±1.2)grade] in the pelvic floor muscle of the observation group were better than those of the control group,and the difference was statistically significant(P<0.05).3)6 months after treatment: The improvement of type I fibers [(4.2±0.7)grade vs(3.5±1.0)grade] and type II fibers[(4.6±0.4)grade vs(4.0±0.9)grade] in the pelvic floor muscle of the observation group were better than those of the control group,and the difference was statistically significant(P<0.05).4.Comparison of the subjective symptoms of urinary incontinence before and after treatment by ICI-Q-SF questionnaire in two groups.1)Before the treatment: The score of ICI-Q-SF questionnaire in two groups [(12.1 ±5.5)in vs(10.4 ±4.9)] was not statistically significant(P>0.05).2)3 months after treatment: The score of ICI-Q-SF questionnaire in the observation group [(3.4 ± 2.1)vs(6.6 ±3.2)] was lower than that of the control group,and the difference was statistically significant(P<0.05).3)6 months after treatment: The score of ICI-Q-SF questionnaire in the observation group [(2.4 ±1.7),vs(4.5±2.9)] was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Biofeedback electrical stimulation combined with PFMT therapy was used for patients with stress urinary incontinence after total hysterectomy in our study.Compared with using the PFMT alone,the leakage of urine and pelvic floor muscle strength were significantly improved after 3 months and 6 months of treatment,and the subjective symptoms were better.