Long-term efficacy of the pelvic floor muscle rehabilitation for women with stress urinary incontinence.

Objectives: Stress urinary incontinence is a common disease with many therapeutic ways, but it lacks long-term follow-up. This study aims to conduct a retrospective study on the long-term efficacy of women with mild and moderate stress urinary incontinence after pelvic floor rehabilitation treatment for 3-years so as to provide a more effective treatment plan for this disease.

Methods: Data were collected from 279 female patients, who were diagnosed with stress urinary incontinence at the Pelvic Floor Rehabilitation Center of the Third Xiangya Hospital of Central South University from January 2017 to January 2019. All patients received health education and were instructed to perform Kegel exercises for 20 min daily at home. According to the treatment pattern, patients were divided into 3 groups as A, B, and C. Group A (=94) received pelvic floor biofeedback, electrical stimulation and electroacupuncture; Group B (=99) received pelvic floor biofeedback and electrical stimulation; Group C (=86) only got pelvic floor function examinations and did not receive any pelvic floor treatment. The pelvic floor functional examinations included a pelvic floor electrophysiological test, pelvic organ prolapse quantitive examination (POP-Q), and stress urinary incontinence severity assessment. All patients were followed up with questionnaire consisting of the International Committee on Urinary Incontinence Questionnaire-Short Form (ICI-Q-SF) and the Quality of Life questionnaire of Urinary Incontinence (I-QOL) before and after the treatment, as well as at 1-, 2-, and 3-years after the treatment (5 times in total). Among the patients who received the treatment, 43 returned to the hospital, including 21 in group A (Group A) and 22 in group B (Group B). Pelvic floor electrophysiological test and POP-Q were performed on the 2 groups.

Results: For the leakage rate at the end of the treatment and the following 1-, 2-, and 3-years: Group A0.05), but the I-QOL scores of Group A and Group B were much higher than that in Group C (both <0.05). On the other hand, the I-QOL scores at 1-, 2-, and 3-years after the treatment were Group A>Group B>Group C (all <0.05). In addition, the ICI-Q-SF scores at the end of the treatment and 1-, 2-, and 3-years after the treatment were Group A0.05). While the pelvic floor muscle strength in Group A was much higher than that in Group B (<0.05) after 3 years of the treatment. What's more, the pelvic floor muscle potential in Group A was much higher than that in Group B (both <0.05) at the end of the treatment and after 3 years of the treatment.

Conclusions: Compared with pelvic floor biofeedback and electrical stimulation for stress urinary incontinence, electroacupuncture combined with pelvic floor electrical stimulation and biofeedback reveal more remarkable short-term efficacy and more stable long-term efficacy, which can significantly improve the quality of life in female patients.