在根治性前列腺切除术后尿失禁的前列腺癌患者中使用低强度巡回脉冲磁场的首次经验

Ivan E. Musaev, T. I. Grushina, E. Gusakova, Sergey P. Darenkov, Aleksey A. Proskokov, Ilya S. Pinchuk, E. Pronkin
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引用次数: 0

摘要

背景:迄今为止,很少有文献研究单独使用体外磁刺激治疗根治性前列腺切除术后尿失禁患者的疗效。目的:本研究旨在获得低频低强度巡回脉冲磁场对根治性前列腺切除术后长期尿失禁患者的有效性和安全性的初步数据。材料和方法:观察 22 例 TI-IIIAN0M0 期前列腺癌患者(平均年龄为 66.3±6.8 岁)。为了评估尿失禁的类型和程度,对排尿日记、咳嗽测试、24 小时尿垫测试、夜间排尿次数和 OAB-q SF 问卷进行了分析。患者被分为两组:1(主要组)--盆底肌肉锻炼和局部脉冲磁场相结合;2(对照组)--盆底肌肉锻炼和为期 10 天的康复课程。结果:所有患者都出现了压力性尿失禁。第一组和第二组分别有 75% 和 70% 的患者出现轻度尿失禁;第二组和第三组分别有 25% 和 30% 的患者出现中度尿失禁。50%的患者有夜尿症。根据 OAB-q SF 问卷,两组患者之间的差异无统计学意义:分别为 8.1±1.6 分和 8.0±1.5 分(P=0.9)。康复疗程结束后,主要治疗组和对照组分别有 66.7% 和 80% 的患者咳嗽测试结果呈阳性。从这一指标来看,联合康复方法比运动疗法有效 13.3%。主要治疗组和对照组分别有一半和 10%的患者不再夜尿。主要治疗组 75% 的患者和对照组 40% 的患者尿失禁发作的总体发生率有所下降。联合康复方法的有效率为 35%。OAB-q SF 问卷显示,两组之间的差异无统计学意义:分别为 6.2+0.9 分和 6.9+1.3 分(P=0.8)。结论:局部巡回脉冲磁场可提高根治性前列腺切除术后长期尿失禁患者康复治疗运动的效果。获得的数据可作为对更多患者进行进一步有序研究的基础,从而得出明确的结论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The first experience of using a low-intensity traveling pulsed magnetic field in patients with prostate cancer with urinary incontinence after radical prostatectomy
BACKGROUND: To date, there are few studies in the literature that have examined the efficacy of extracorporeal magnetic stimulation alone for urinary incontinence in patients after radical prostatectomy. AIM: The purpose of the study is to obtain preliminary data on the effectiveness and safety of a low-frequency low-intensity traveling pulsed magnetic field in patients with long-term urinary incontinence after radical prostatectomy. MATERIALS AND METHODS: 22 patients (mean age is 66.3±6.8 years) with stage TI-IIIAN0M0 prostate cancer were observed. To assess the type and degree of urinary incontinence, urination diaries, a cough test, a 24h pad-test, the number of nocturnal mictions, and the OAB-q SF questionnaire were analyzed. Patients were divided into 2 comparable groups: 1 (main group) ― a combination of exercises for the pelvic floor muscles and a local pulsed magnetic field, 2 (control group) ― exercises for the pelvic floor muscles, a rehabilitation course of 10 days. RESULTS: All patients showed a stressful form of urinary incontinence. Mild urinary incontinence was observed in 75% of patients in group 1 and in 70% of patients in group 2; moderate urinary incontinence was observed in 25% and 30% of the group, respectively. 50% of patients suffered from nocturia. According to the OAB-q SF questionnaire, there were no statistically significant differences between patients in both groups: 8.1±1.6 points versus 8.0±1.5 points (p=0.9), respectively. As a result of the rehabilitation course, the cough test remained positive in 66.7% of patients in the main group and in 80% of patients in the control group. According to this indicator, the combined method of rehabilitation was more effective than exercise therapy by 13.3%. Nocturia stopped in half of the patients in the main group and in 10% of the patients in the control group. The overall incidence of urinary incontinence episodes decreased in 75% of patients in the main group and in 40% of patients in the control group. The effectiveness of the combined rehabilitation method was 35%. The OAB-q SF questionnaire showed no statistically significant differences between the groups: 6.2+0.9 and 6.9+1.3 points (p=0.8), respectively. CONCLUSION: Local traveling pulsed magnetic field increases the effectiveness of therapeutic exercises in rehabilitation of patients with long-standing urinary incontinence after radical prostatectomy. The obtained data can serve as a basis for further well-organized studies on a larger number of patients allowing to make unambiguous conclusions.
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