Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial.

IF 1.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Female Pelvic Medicine and Reconstructive Surgery Pub Date : 2021-11-01 DOI:10.1097/SPV.0000000000001037
Oluwateniola Brown, Bhumy Davé Heliker, Julia Geynisman-Tan, Meera Tavathia, Margaret G Mueller, Sarah Collins, Kimberly Kenton, Christina Lewicky-Gaupp
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Abstract

Objective: The aim of this study was to compare 3-month postpartum anal incontinence symptoms in women who sustain obstetric anal sphincter injuries and begin immediate vaginal electrical stimulation versus sham therapy.

Methods: In this double-blind randomized controlled trial, women who sustained obstetric anal sphincter injuries were randomized to receive self-administered vaginal electrical stimulation using a commercial device or sham therapy with an identical device. Anal incontinence symptom severity was assessed at 1 week (baseline) and again at 13 weeks postpartum using the Fecal Incontinence Severity Index. The primary outcome was anal incontinence symptom severity measured by the total Fecal Incontinence Severity Index score at 13 weeks postpartum.

Results: Between February 2016 and September 2018, 48 women completed a 13-week follow-up. At 13 weeks postpartum, median Fecal Incontinence Severity Index scores were higher (more severe) in the vaginal electrical stimulation group (12; interquartile range, 0-23) than in the sham group (4; interquartile range, 0-10) (P = 0.04). Unlike the vaginal electrical stimulation group, the improvement in Fecal Incontinence Severity Index scores in the sham group (vaginal electrical stimulation: 12 [interquartile range, 8-22] to 12 [interquartile range, 0-23] [P = 0.12] vs sham: 12 [interquartile range, 6-18] to 4.0 [interquartile range, 0-11] [P < 0.001]) met the threshold for clinical significance based on the minimum important difference of the Fecal Incontinence Severity Index.

Conclusion: At 13 weeks postpartum, women who underwent postpartum vaginal electrical stimulation reported more anal incontinence symptoms compared with those receiving sham therapy. Vaginal electrical stimulation after obstetric anal sphincter injury was not beneficial in reducing anal incontinence symptoms and may impede recovery.

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阴道电刺激产后神经肌肉恢复:一项随机临床试验。
目的:本研究的目的是比较产科肛门括约肌损伤并立即开始阴道电刺激与假治疗的妇女产后3个月肛门失禁症状。方法:在这项双盲随机对照试验中,持续产科肛门括约肌损伤的妇女被随机分为两组,一组使用商业设备进行阴道电刺激,另一组使用相同的设备进行假治疗。在产后1周(基线)和产后13周使用大便失禁严重程度指数评估肛门失禁症状严重程度。主要结局为产后13周肛门失禁症状严重程度,以粪便失禁严重程度指数总分衡量。结果:在2016年2月至2018年9月期间,48名女性完成了为期13周的随访。产后13周,阴道电刺激组大便失禁严重程度指数中位数得分更高(更严重)(12;四分位数范围,0-23)比假手术组(4;四分位数范围,0-10)(P = 0.04)。与阴道电刺激组不同,假手术组(阴道电刺激组:12[四分位数范围,8-22]至12[四分位数范围,0-23][P = 0.12]与假手术组:12[四分位数范围,6-18]至4.0[四分位数范围,0-11][P < 0.001])在大便失禁严重程度指数的最小重要差异基础上达到临床意义阈值。结论:产后13周,与接受假治疗的妇女相比,接受产后阴道电刺激的妇女报告了更多的肛门失禁症状。产科肛门括约肌损伤后阴道电刺激不利于减轻肛门失禁症状,并可能阻碍康复。
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来源期刊
CiteScore
2.10
自引率
12.50%
发文量
228
期刊介绍: Female Pelvic Medicine & Reconstructive Surgery, official journal of the American Urogynecologic Society, is a peer-reviewed, multidisciplinary journal dedicated to specialists, physicians and allied health professionals concerned with prevention, diagnosis and treatment of female pelvic floor disorders. The journal publishes original clinical research, basic science research, education, scientific advances, case reports, scientific reviews, editorials and letters to the editor.
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