To explore the effectiveness of sling surgery followed by pelvic floor muscle exercises (PFME) or PFME alone for moderate stress urinary incontinence (SUI) in women and its influencing factors.
This is a prospective observational cohort study investigating whether sling surgery or PFME is preferred for pre-menopause women with moderate uncomplicated SUI. Those who received PFME alone or sling surgery were divided to PT or TVT group, respectively. The primary outcome was objective cure at 12 months. The secondary outcomes included Incontinence Impact Questionnaire-Short Form (IIQ-7) scores and PFME adherence.
The study sample comprised 130 and 74 patients in the PT and TVT groups, respectively. There was 38.2% of patients adhered to PFME twice weekly or more often, and the compliance varied by education level. At 12 months, the objective cure rate was significantly higher in the TVT versus PT group (75.7% vs 47.7%; adjusted OR = 4.27; 95% CI, 2.05-8.87; P < 0.001). In addition, the mean reduction in IIQ-7 scores was greater in the TVT group (16.2 vs 10.0; adjusted OR = 3.38; 95% CI, 1.93-4.82; P < 0.001). However, among patients with lower education or those without adherence to PFME at 12 months, the TVT was also favorized, and the discrepancy in cure rates was greater between the two groups.
Sling procedures followed by PFME demonstrate greater efficacy versus physiotherapy alone for moderate female SUI management. Continued adherence to PFME was important, even for patients undergoing sling procedures. Educational factors influenced patient PFME adherence and the advantage conferred by sling procedures.
Archives of gynecology and obstetrics. 2024 Aug 14 [Epub ahead of print]
Ziwen Yuan, Lulu Cao, Jing Liu, Wenying Wang, Xiaoyong Liu, Yun Li, Zhenjin Kang, Jin Qiao, Lixia Luan
Department of Rehabilitation, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, China., Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Medical University, No.48 Fenghao West Road, Xi'an, China., Department of Rehabilitation, Mian County Hospital, Hanzhong, China., Department of Obstetrics and Gynecology, Fifth Hospital of Yulin, Yulin, China., Department of Rehabilitation, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, China. ., Department of Obstetrics and Gynecology, First Affiliated Hospital of Xi'an Medical University, No.48 Fenghao West Road, Xi'an, China. .