Эффективность физиотерапии в лечении недостаточности мышц тазового дна у женщин репродуктивного возраста

Abstract

Study Objective: To compare the efficacy of two physical therapy techniques in the treatment of pelvic floor distress (PFD). Study Design: This was a prospective, randomized, double-blind, controlled study. Materials and Methods: Health information about ninety-five women who had had vaginal delivery and suffered from PFD was reviewed in the study. In Group I (n = 50) patients were treated using high-intensity focused electromagnetic (HIFEM) technology, and in Group II (n = 45) electrical stimulation therapy was delivered via an intracavity sensor. Assessments in the study included physical examination, instrumental investigations, and a discussion with patients (completion of a questionnaire and a scale-based assessment). To establish reference values for the parameters used in the study, a control group was made up of 30 apparently healthy women who had had a vaginal delivery. Study Results: Ultrasound of the pelvic floor showed that in Groups I and II the anteroposterior diameter of the levator hiatus (LH) decreased by 3.12 mm and 1.16 mm, respectively (2.7-fold difference), and the transverse diameter of the LH decreased by 3.04 mm and 1.04 mm (2.9-fold difference). The area of the LH decreased by 1.38 cm2 in Group I and 0.08 cm2 in Group II. After treatment the mean Pelvic Floor Distress Inventory (PFDI-20) score was 1.9 times lower (p<0.001) in Group I and the number of women who reported a feeling of looseness in the vagina and urinary incontinence using a bimodal scale for complaint assessment was 1.5 and 1.9 times lower, respectively, than in Group II. Conclusion: Electromagnetic stimulation demonstrated higher efficacy than stimulation via an intracavitary sensor in the treatment of PFD. Keywords: pelvic floor distress, genital prolapse, high-intensity focused electromagnetic stimulation.