The results the of the comparative study of biofeedback with test electrostimulation of the pelvic floor muscles as monotherapy and in combinationwith extra-corporeal magnetic stimulation of the pelvic floor muscles with functional infravesical obstruction in women
Introduction. The functional bladder outlet obstruction (fBOO) in women is one of the urgent and dif-ficult tasks of functional urology. As a conservative treatment, pelvic floor muscle training is widely used, including using the method of biofeedback (BFB).
Materials and methods. A comparative study of the results of mild-to-moderate fBOO treatment with the method of BFB with test electrostimulation of the pelvic floor muscles as monotherapy and in com-bination with electromagnetic stimulation of the pelvic floor muscles (EMS) was conducted. The eval-uation of results was carried out with the use of PGI-I scale and uroflowmetry (UFM). A group of 92 patients with urodynamically confirmed fBOO was formed. Before the start of treatment all patients were randomly assigned to two groups.
In group I (n = 46) the treatment was carried out using the BFB method (sessions - 2 times a week, total - 10). In group II (n = 46) in addition to the BFR all women were given EMS (sessions also 2 times a week, total - 10). In terms of basic UFM parameters patients in groups I and II were not statistically different (p> 0.05). Clinical efficacy was evaluated after treatment during 8 weeks based on the results of PGI-I questionnaire and UFM data.
Results. In Group I, 27 (58.7%) patientsreported an improvement on the PGI-Iscale, and 19 (41.3%)rated the outcome ofthe treatment as“no change”. The same women registered: an increase in Qmax from 11.4 ± 3.0 to 19.5 ± 2.5 or by 71.0%; Qave -from 7.3 ± 3.0 to 10.8 ± 2.5 or by 47.9%; a decrease in the amount of residual urine from 68.4 ± 1.1 to 26.9 ± 0.9, or 60.7%. In Group II, 35 participants in the study (76.1%) rated the result of treatment on the PGI-I scale as im-provement, and 11 (23.9%) rated it as “no change”.
The increase in Qmax - from 12.1 ± 2.7 to 23.4 ± 2.5 or 93.4%; Qave - from 8.6 ± 3.5 to 12.7 ± 2.5 or by 47.7%; a decrease in the amount of residual urine from 59.3 ± 1.6 to 21.5 ± 0.9, or by 63.7%. Statisticalsignificance was achieved, both in the number of patients with improvement in the groups, and in the dynamics of Qmax both within and between groups (p <0.05). None of the study participants noted any deterioration due to treatment. No adverse events were reported during the study.
Findings. BFB - therapy combined with test electrostimulation of the pelvic muscles, both in mono-therapy mode and in combination with EMS, are minimally invasive, safe and effective methods of treating dysfunctional urination in women. A combination of techniques can be recommended as a first-line therapy for mild to moderate fBOO.
Authors declare lack of the possible conflicts of interests