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Læknablaðið - 15.09.2009, Síða 32

Læknablaðið - 15.09.2009, Síða 32
FRÆÐIGREINAR RANNSÓKN 27. Gunnarsson M, Mattiasson A. Female stress, urge, and mixed urinary incontinence are associated with a chronic and progressive pelvic floor/vaginal neuromuscular disorder: An investigation of 317 healthy and incontinent women using vaginal surface eiectromyography. Neurourol Urodyn 1999; 18: 613-21. 28. Gunnarsson M, Mattiasson A. Circumvaginal surface electromyography in women with urinary incontinence and in healthy volunteers. Scand J Urol Nephrol 1994; 157: Suppl. 89-95. 29. Turker KS. Electromyography: some methodological problems and issues. Phys Ther 1993; 73: 698-710. 30. Wijma J, Tinga DJ, Visser GH. Perineal ultrasonography in women with stress incontinence and controls: the role of the pelvic floor muscles. Gynecol Obstet Invest 1991; 32:176-9. 31. Christensen LL, Djurhuus JC, Constantinou CE. Imaging of pelvic floor contractions using MRI. Neurourol Urodyn 1995; 14: 209-16. 32. Isherwood PJ, Rane A. Comparative assessment of pelvic floor strength using a perineometer and digital examination. BJOG 2000; 107:1007-11. 33. Wilson PD, A1 Samarrai T, Deakin M, Kolbe E, Brown AD. An objective assessment of physiotherapy for female genuine stress incontinence. Br J Obstet Gynaecol 1987; 94: 575-82. 34. Bo K, Hagen R, Dvarstein B, Jörgensen J, Larsen S. Pelvic floor muscle exercise for the treatment of stress urinary incontinence: III Effects of two different degrees of pelvic floor muscle exercises. 1990; 9:489.!!!!!!!!! 35. Hay-Smith EJ, Dumoulin C. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev 2006; (1)(1):CD005654. 36. Ashton-Miller JA, Howard D, DeLancey JO. The functional anatomy of the female pelvic floor and stress continence control system. Scand J Urol Nephrol 2001; 207: Suppl. 1-7; discussion 106-25. >- CC < 5 5 3 W X (0 o z LU Pelvic floor muscle training with and without functional electrical stimulation as treatment for stress urinary incontinence Background: Twelve to 55% of women experience stress urinary incontinence at some time during their lifetime. Objective: To compare the effectiveness of pelvic floor muscle training with and without electrical stimulation in treatment of stress urinary incontinence. Material and Methods: Participants were 24 women, 27-73 years of age, diagnosed with stress urinary incontinence. Exclusion criteria were pregnancy and urge urinary incontinence. These participants were randomly divided into group 1 and 2. Both groups trained 15 min. twice a day for 9 weeks. Group 2 used simultaneously intermittent electrical stimulation. The pelvic floor muscles were evaluated using the Oxford scale, vaginal palpation, and by electromyogram, (Myomed 930, Enraf Nonius). The quantity and frequency of urinary incontinence episodes was evaluated using a questionnaire and a VAS scale before and after the treatment. Results: The groups were demographically similar, except group 2 was significantly younger. Both groups had significantly increased pelvic floor muscle strength (p=0.007; p=0.005 respectively) after the treatment and 70% of all the women had reduced or no stress urinary incontinence. Group 2 had significantly (p=0.013) better relaxation post treatment. Conclusion: Pelvic floor muscle training is an effective treatment for stress urinary incontinence, but electrical stimulation gave no additional effect for this patient group. The significantly lower relaxation threshold in group 2 indicates that electrical stimulation could be a possible treatment for symptoms caused by hypertensive pelvic floor muscles. Eyjolfsdottir H, Ragnarsdottir M, Geirsson G. Pelvic floor muscle training with and without functional electrical stimulation as treatment for stress urinary incontinence. Icel Med J 2009; 95: 575-80. Key words: stress incontinence, pelvic fioor training, electrical stimulation. Correspondence. Halldóra Eyjólfsdóttir, halldey@landspitali.is Barst: 4. febrúar 2009, - samþykkt til birtingar: 16. júní 2009 580 LÆKNAblaðið 2009/95
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