Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
Por:
Borrego-Jimenez, P, Padilla-Fernandez, B, Valverde-Martinez, S, Garcia-Sanchez, M, Rodriguez-Martin, M, Sanchez-Conde, M, Flores-Fraile, M, Marquez-Sanchez, M, Flores-Fraile, J, Peran-Teruel, M, Miron-Canelo, J, Garcia-Cenador, M and Lorenzo-Gomez, M
Publicada:
1 oct 2020
Categoría:
Medicine (miscellaneous)
Resumen:
Objectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: prospective observational study in 226 women who received complementary therapy after surgical treatment of cystocele due to persistent perineal discomfort or pain. Groups: GA (n = 78): women treated with 25 mg of oral pregabalin every 12 h plus BFB, consisting of 20 once-weekly therapy sessions, each 20 min long, with perineal pregelled surface electrodes connected to a screen which provides visual feedback; GB (n = 148): women treated with oral pregabalin 25 mg every 12 h without BFB. Variables: age, body mass index (BMI), time since onset of cystocele prior to surgery (TO), SF-36 health-related quality of life survey score, diseases and concomitant health conditions, follow-up time, success, or failure of postsurgical treatment. Results: average age 67.88 years (SD 12.33, 30-88), with no difference between GA and GB. Average body mass index (BMI) 27.08 (SD 0.45, 18.74-46.22), with no difference between GA and GB. Time since onset of cystocele prior to surgery (TO) was 6.61 years (SD 0.6), with no difference between GA and GB. Pretreatment SF-36 score was lower in GA success than GB success. Treatment was successful in 141 (63.20%) women and failed in 82 (36.80%). PT and age were the main predictors of success, and the least important were pretreatment SF-36 and the time elapsed after the intervention. In GA, 63 women (80.80%) showed improvement while 15 (19.20%) did not. Age was the main predictor of treatment success, while the least important was BMI. In GB, 78 women (53.80%) showed improvement while 67 (46.20%) did not improve. The main predictor was time since cystocele onset prior to surgery, while the least important was age. The odds ratio (OR) of improving quality of life for each unit increase in SF-36 was 11.5% (OR = 0.115) in all patients, with no difference between success and failure; in GA it was 23.80% (OR = 0.238), with a difference between success and failure; in GB it was 11.11% (OR = 0.111), with no difference between success and failure. GA and GB success had more history of eutocic delivery. GA success had more rUTI. GB success and GA failure both had more history of UI corrective surgery. The "failure" outcome had a higher number of patients with more than two concomitant pathological conditions. Conclusions: BFB as an adjunctive treatment improves quality of life in women suffering from persistent discomfort after surgery for cystocele. Young women who meet the criteria for recurrent urinary tract infection or who have a history of eutocic delivery show greater improvement. Body mass index does not influence response to treatment, while the presence of more than two concomitant conditions indicates a poor prognosis for improving quality of life.
Filiaciones:
Borrego-Jimenez, P:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
Inst Appl Technol, Physiotherapy Dept, Abu Dhabi 3798, U Arab Emirates
Padilla-Fernandez, B:
Univ La Laguna, Dept Surg, Sect Urol, San Cristobal De La Lagu 38200, Santa Cruz De T, Spain
Valverde-Martinez, S:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
Inst Biomed Res Salamanca IBSAL, Multidisciplinary Renal Res Grp, Salamanca 37007, Spain
Univ Hosp Avila, Dept Urol, Avila 05071, Spain
Garcia-Sanchez, M:
Univ Hosp Salamanca, Dept Gynecol & Obstet, Salamanca 37007, Spain
Rodriguez-Martin, M:
Univ Hosp Salamanca, Dept Gynecol & Obstet, Salamanca 37007, Spain
Sanchez-Conde, M:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
Univ Hosp Salamanca, Dept Anesthesiol, Salamanca 37007, Spain
Flores-Fraile, M:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
Marquez-Sanchez, M:
Inst Biomed Res Salamanca IBSAL, Multidisciplinary Renal Res Grp, Salamanca 37007, Spain
Flores-Fraile, J:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
:
Arnau de Vilanova Hosp, Dept Urol, Valencia 46015, Spain
Miron-Canelo, J:
Inst Biomed Res Salamanca IBSAL, Multidisciplinary Renal Res Grp, Salamanca 37007, Spain
Univ Salamanca, Dept Biomed & Diagnost Sci, Salamanca 37007, Spain
Garcia-Cenador, M:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
Lorenzo-Gomez, M:
Univ Salamanca, Dept Surg, Salamanca 37001, Spain
Inst Biomed Res Salamanca IBSAL, Multidisciplinary Renal Res Grp, Salamanca 37007, Spain
Univ Hosp Salamanca, Dept Urol, Salamanca 37007, Spain
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