We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

We undertook this work to compare the treatment efficacies and the changes of quality of life after pelvic floor muscle (PFM) exercise and the functional electrical stimulation (FES)-biofeedback treatment, both of which are being widely used as conservative treatment methods for female urinary incontinence. We randomly selected 60 female incontinence patients who visited our department and divided them evenly into two groups. They were treated for a period of 6 weeks. The subjective changes in the severity of incontinence and discomfort in daily and social life were measured using a translated version of the questionnaire by Jackson. Objective changes of pelvic muscle contraction force were measured using a perineometer. Pre- and post-treatment maximal pelvic floor muscle contractile (PMC) pressure and changes in the severity of urinary incontinence and discomfort of the two groups showed statistically significant differences (p>0.001). In particular the FES-biofeedback group showed significantly increased maximal PMC pressure and a decreased severity of urinary incontinence and discomfort compared to the intensive PFM exercise group (p>0.001). In conclusion, FES-biofeedback proved more effective than simple PFM exercise.
Activities of Daily Living ; Biofeedback (Psychology)* ; Exercise Therapy*/methods ; Female ; Human ; Muscle Contraction ; Muscles ; Pelvic Floor ; Treatment Outcome ; Urinary Incontinence, Stress/therapy* ; Urinary Incontinence, Stress/psychology ; Urinary Incontinence, Stress/prevention & control ; Urinary Incontinence, Stress/physiopathology

Defective or inadequate pelvic floor function is important etiologic factor for urinary stress incontinence and uterine prolapse. Pelvic floor muscle exercise is the mainstream of the nonoperative treatment for female stress urinary incontinence. Especially Vaginal cones have been known as a simple and practical means of improving both pelvic floor muscle strength and genuine stress incontinence using biofeedback mechanism. Forty adult women suffering from mild and moderate stress incontincnce were instructed to exercise their pelvic muscles using vaginal cones. They retained cones of increasing weight in the vagina by contracting pelvic floor muscles for 15 minutes twice a day for 4 weeks. The comparison of pelvic floor muscle function before and after the exercise were assessed by the frequency of incontinence, vaginal digital palpation, vaginal pressure measurement and speculm lift test. The results were as follows; 1. The frequency of incontinence was significantly reduced after the exercise using vaginal cone (P<0.001). 2. Vaginal digital palpation score (strength of vaginal levator muscle) was significantly increased after the exercise using vaginal cone (P<0.001). 3. The vaginal pressure by perineometer was significantly increased after the exercise using vaginal cones (P<0.001). 4. The vaginal lumen during contraction was significantly narrower after the exercise using vaginal cones (P<0.001). 5. The maximal cone weight which patients could hold over 1 minute was significantly increased after the exercise using vaginal cones (P<0.001).
Adult ; Biofeedback, Psychology ; Female ; Humans ; Korea* ; Muscle Strength ; Muscles ; Palpation ; Pelvic Floor* ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Uterine Prolapse ; Vagina

OBJECTIVETo observe the effect on female stress urinary incontinence (SUI) treated with the pudendal nerve stimulation of electroacupuncture therapy at different frequencies.

METHODSSixty patients were divided into a group treated three times every week (group A) and a group treated twice every week (group B), 30 cases in each one. The pudendal nerve stimulation of electroacupuncture therapy was adopted at Disixue (four acupoints on sacral region), 60 min in each time in the two groups, treated three times a week or twice a week respectively. SUI severity and the score of life quality were observed before and after 12 treatments separately. The efficacy was evaluated in the two groups.

RESULTSAt the end of treatment, SUI severity was relieved and the score of life quality was improved in the two groups (all P<0.01). The results in group A were superior to group B [0 (0-4.3) vs 4 (0-5), P<0.01]. At the end of treatment, the total effective rate in group A was 90.0% (27/30) and was 76.7% (23/30) in group B; the efficacy in group A was better than that in group B (P<0.05).

CONCLUSIONThe pudendal nerve stimulation of electroacupuncture therapy achieves the definite efficacy on female SUI and the results in the treatment of three times a week are superior to those in the treatment of twice a week.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Middle Aged ; Quality of Life ; Treatment Outcome ; Urinary Incontinence, Stress ; psychology ; therapy

PURPOSE: Pelvic floor muscles play an important role in female sexual function. Urinary incontinence is one of the complex symptoms of pelvic floor relaxation. The purpose of the present study was to evaluate the effects of behavioral treatment on the sexual life variables and quality of life in stress urinary incontinent women. MATERIALS AND METHODS: Fifty women with clinically and urodynamically proven stress urinary incontinence were randomly selected, and treated with functional electrical stimulation (FES) -Biofeedback. The FES-Biofeedback treatment was performed for 20 min per session, 2 sessions a week, for 6 weeks. The treatment consisted of electrical stimulation (35Hz and 50Hz, simultaneously) for 24 seconds, and the biofeedback, composed of 3 phases of contraction, lasted for 32 seconds. The outcome measures on the sexual life variables and quality of life scales were assessed by the Bristol Female Lower Urinary Tract Symptoms questionnaire and a self-developed questionnaire, based on the Brief index of sexual Functioning for women (BISF-W). RESULTS: The general quality of life scores were significantly improved after 6 weeks of FES-Biofeedback (p<0.05). The quality of orgasms, sexual interest, sexual activity and sexual anxiety were significantly improved after the FES-Biofeedback (p<0.05). Changes in the scores for the degree of satisfaction in those variables also showed statistical significance (p<0.05). CONCLUSIONS: Women with incontinence were dissatisfied with their sexual life due to various symptoms associated with their urinary symptoms or symptoms that result from pelvic floor relaxation. The FES-Biofeedback therapy showed positive effects on improving, not only stress incontinence, but also sexual life variables and the life quality.
Anxiety ; Biofeedback, Psychology* ; Electric Stimulation ; Female* ; Humans ; Lower Urinary Tract Symptoms ; Muscles ; Orgasm ; Outcome Assessment (Health Care) ; Pelvic Floor ; Quality of Life* ; Surveys and Questionnaires ; Relaxation ; Sexual Behavior* ; Sexuality ; Urinary Incontinence* ; Urinary Incontinence, Stress ; Weights and Measures

Several different methods of enhancing pelvic floor functions have been developed and modified. The aim of this study was to compare the efficacy of a new vaginal cone with conventional FES-Biofeedback therapy for female urinary incontinence, with respect to pelvic floor rehabilitation. One hundred and twenty patients, who required a non-surgical treatment for urinary incontinence, were divided randomly into two groups; (1) the Functional Electrical Stimulation (FES) - Biofeedback group (or BFB group) and (2) the new vaginal cone group (or cone group). For a period of six weeks, two training sessions each week were carried out on the BFB group. The new 150-gram dumbbell-shaped vaginal cone, made of fine ceramic material, was developed domestically. A therapist instructed patients in the cone group upon its use for pelvic floor exercise, and directed the exercise to be repeated at home daily; these patients had follow-up visits every week. Objective improvements were obvious in both groups. 88.3% and 91.6% of the cone and BFB groups showed an improvement after treatment, respectively. There was no significant difference in the improvement or dissatisfaction scores of the two groups. In conclusion, no significant differences in the therapeutic effects were observed between the FES- Biofeedback and the new vaginal cone groups. Considering improvements in the quality of life and objective symptoms, the therapeutic effects of the two techniques showed no significant differences. The new vaginal cone is relatively easy to use at home and aids in pelvic floor muscle exercises. Consequently, the new vaginal cone could be used as an alternative non-surgical treatment modality in female stress urinary incontinence.
Adult ; Aged ; *Biofeedback (Psychology) ; Comparative Study ; *Electric Stimulation Therapy ; Exercise Therapy/*instrumentation ; Female ; Humans ; Middle Aged ; Pelvic Floor ; Prospective Studies ; Urinary Incontinence, Stress/*therapy

This study was undertaken to identify risk factors for postoperative voiding dysfunction and factors having impact on patient global satisfaction after a tension-free vaginal tape (TVT) procedure. Two hundred and eighty-five women who underwent the TVT procedure for stress urinary incontinence were analyzed to identify risk factors predictive of voiding dysfunction. Postoperative voiding dysfunction was defined as a peak urinary flow rate (PFR) <10 mL/sec (straining voiding, n=17) or residual urine volume >30% of bladder capacity (incomplete emptying, n=13). The global satisfaction rate was 91.6%. Voiding dysfunction developed in 29 (10.2%) patients. Among the factors, PFR was only factor of significance for voiding dysfunction. There was no significant difference between patients with and without voiding dysfunction in terms of their satisfaction. But postoperative PFR <10 mL/sec significantly compromised global satisfaction after the surgery. In those patients with a preoperative PFR <20 mL/sec, there were more patients with postoperative PFR <10 mL/sec. Peak urinary flow rate is an important factor for the postoperative voiding dysfunction. The inevitable decline in PFR can compromise patients' satisfaction with the procedure, when their postoperative PFR was <10 mL/sec.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Middle Aged ; Patient Satisfaction ; Risk Factors ; Surgical Procedures, Minimally Invasive/methods ; Urinary Incontinence, Stress/*physiopathology/psychology/*surgery ; Urologic Surgical Procedures/methods ; Vagina/surgery

PURPOSE: This study was conducted to investigate the effectiveness of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal delivery. METHODS: The subjects of this study were 49 (experimental group: 25, control group: 24) postpartum women who passed 6 weeks after normal delivery without complication of pregnancy, delivery and postpartum. The experimental group was applied to the pelvic muscle enforcement program by biofeedback and electrical stimulation for 30 minutes per session, twice a week for 6 weeks, after then self-exercise of pelvic floor muscle was done 50-60 repetition per session, 3 times a day for 6 weeks. Maximum pressure of pelvic floor muscle contraction (MPPFMC), average pressure of pelvic floor muscle contraction (APPFMC), duration time of pelvic floor muscle contraction (DTPFMC) and the subjective lower urinary symptoms were measured by digital perineometer and Bristol Female Urinary Symptom Questionnaire and compared between two groups prior to trial, at the end of treatment and 6 weeks after treatment. RESULTS: The results of this study indicated that MPPFMC, APPFMC, DTPFMC were significantly increased and subjective lower urinary symptoms were significantly decreased after treatment in the experimental group than in the control group. CONCLUSIONS: This study suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for reinforcing pelvic floor muscle after normal delivery.
Adult ; Analysis of Variance ; Biofeedback (Psychology)/*methods ; Combined Modality Therapy ; Delivery, Obstetric/adverse effects/methods ; Electric Stimulation/*methods ; Exercise Therapy/*methods ; Female ; Humans ; Korea ; Muscle Contraction ; Nursing Evaluation Research ; Parity ; *Pelvic Floor/physiopathology ; Pregnancy ; Puerperal Disorders/etiology/physiopathology/*prevention & control ; Risk Factors ; Treatment Outcome ; Urinary Incontinence, Stress/etiology/physiopathology/*prevention & control ; Urodynamics