Efficacy of pelvic floor neuromuscular stimulation combined with progesterone in the treatment of pelvic floor function recovery after hysterectomy
10.3760/cma.j.cn341190-20240524-00635
- VernacularTitle:盆底神经肌肉刺激联合普罗雌烯治疗子宫切除术后盆底功能障碍的效果研究
- Author:
Xiangyang JIANG
1
;
Shanying KE
;
Lujie XUE
Author Information
1. 陕西省人民医院检验科，西安 710068
- Publication Type:Journal Article
- Keywords:
Hysterectomy;
Pelvic floor disorders;
Electric stimulation therapy;
Myofibroblasts;
Quality of life;
Urinary incontinence, stress
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(4):487-492
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of pelvic floor neuromuscular stimulation combined with progesterone in the treatment of pelvic floor function recovery after hysterectomy.Methods:This study used a randomized controlled design, involving 108 patients with pelvic floor dysfunction who underwent hysterectomy at Shaanxi Provincial People's Hospital between January 2021 and December 2023. These patients were randomly assigned to either a control group or an observation group, with 54 patients in each group, using a random number table for allocation. Both groups received basic pelvic floor muscle training. The control group was treated solely with progesterone vaginal soft capsules, while the observation group also received neuromuscular stimulation through pelvic rehabilitation equipment. Before and after treatment, changes in muscle strength (measured by electromyography values of type I and type II muscle fibers), quality of life (assessed using the Pelvic Floor Dysfunction Index Questionnaire-7 and the Pelvic Floor Distress Inventory-Short Form 20), pelvic relaxation indicators (levels of laminin, relaxin, and transforming growth factor beta-3), and Pelvic Organ Prolapse Quantification staging were compared between the two groups. Additionally, stress urinary incontinence, lumbosacral pain, sexual satisfaction, vaginal prolapse conditions, and overall efficacy post-treatment were compared between the two groups.Results:After treatment, electromyography values for type I and type II muscle fibers in the observation group were (4.71 ± 0.61) μA and (5.63 ± 0.79) μA, respectively, which were significantly higher than those in the control group [(3.51 ± 0.53) μA, (4.53 ± 0.50) μA, t = -10.91, -8.65, both P < 0.001]. The scores for the Pelvic Floor Dysfunction Index Questionnaire-7 and Pelvic Floor Distress Inventory-Short Form 20 in the observation group were (4.56 ± 0.64) and (4.56 ± 0.64), respectively, both of which were significantly lower than those in the control group [(5.36 ± 0.70), (5.36 ± 0.70), t = 6.20, 26.74, both P < 0.001]. The levels of laminin, relaxin, and transforming growth factor beta-3 in the observation group were (27.28 ± 3.00) μg/L, (53.32 ± 6.40) μg/L, and (28.25 ± 3.67) mg/L, respectively, all of which were significantly lower than those in the control group [(32.14 ± 3.54) μg/L, (59.22 ± 6.51) μg/L, (36.25 ± 3.99) mg/L, t = 7.70, 4.75, 10.84, all P < 0.001]. The proportion of patients in the observation group with a POP-Q stage of 0 was 90.74% (49/54), which was significantly higher than that in the control group [68.52% (37/54), χ2=8.22, P < 0.05]. The proportion in the observation group with a stage of 1 was 7.41% (4/54), which was significantly lower than that in the control group [25.93% (14/54), χ2 = 6.67, P < 0.05]. The incidence rates of stress urinary incontinence, lumbosacral pain, sexual dissatisfaction, and vaginal prolapse in the observation group were all significantly lower than those in the control group ( χ2 = 4.41, 4.36, 4.70, 4.41, all P < 0.05). The overall effective rate in the observation group was 92.59% (50/54), which was significantly higher than that in the control group [74.07% (40/54), χ2 = 6.67, P < 0.05]. Conclusions:Pelvic floor neuromuscular stimulation combined with progesterone vaginal soft capsules can improve muscle strength in patients with pelvic floor dysfunction after hysterectomy, enhance life satisfaction, relieve pelvic relaxation, and promote comprehensive recovery of pelvic function.
