Sains Malaysiana 50(12)(2021): 3659-3666

http://doi.org/10.17576/jsm-2021-5012-16

Low-frequency Electrical Stimulation Combined with Preventative Pelvic Floor Muscle Exercises and Knowledge-Attitude-Practice Model in Women with Urinary Retention after a Pelvic Surgery

(Rangsangan Elektrik Frekuensi Rendah yang Digabung dengan Latihan Pencegahan Otot Lantai Pelvis dan Model Pengetahuan-Sikap-Amalan pada Wanita dengan Pengekalan Air Kencing selepas Pembedahan Pelvis)

HONG LIU¹, LIXIN GUO¹, ZHICHEN KANG¹, JIANGCHUN ZHANG¹, ZHONGLIANG LIU¹, TAIYUAN LIU², WEI LIU¹ & FULING QU¹*

¹The Second Hospital, Jilin University, China

²The Second Affiliated Hospital of Dalian Medical University, China

Received: 21 December 2020/Accepted: 22 March 2021

ABSTRACT

This study was to explore the efficacy of low-frequency electrical stimulation (LFES) combined with preventative pelvic floor muscle exercises (PPFME) and knowledge-attitude-practice model (KAP model) in women with urinary retention (UR) after a pelvic surgery and the effect on quality of life (QOL). The clinical data of 153 women hospitalized with UR after a pelvic surgery from January 2015 to June 2019 were retrospectively analyzed and divided into the Control Group (CG, n=45, LFES+PPFME) and the Study Group (SG, n=108, LFES+PPFME+KAP model) according to the different treatment methods. Following indicators were compared between the two groups: clinical efficacy, time to first urination, urine output, rate of extubation in 3D, rate of repeated intubation, urodynamic indicators before and after treatment, postvoid residual (PVR), bladder compliance (BC), maximal flow rate (Q-max), pressure of detrusor at Pdet-Q-max (Pdet-Q-max), changes in QOL, incidence of urinary tract infection, and length of stay (LOS). Compared to CG, SG showed higher overall response rate (ORR) and rate of extubation in 3D, shorter time to first urination, higher urine output, lower rate of repeated intubation and incidence of urinary tract infection, and shorter LOS (P<0.05); both groups achieved improvements in urodynamic indicators and QOL score after treatment (P<0.05); the urodynamic indicators and QOL score in SG were better than the CG’s (P<0.05). LFES combined with PPFME and KAP model is effective in treating women with UR after a pelvic surgery by efficaciously improving patients’ urination and QOL.

Keywords: KAP model; LFES; pelvic cavity; PPFME; QOL; UR

ABSTRAK

Kajian ini mengkaji keberkesanan rangsangan elektrik frekuensi rendah (LFES) yang digabungkan dengan latihan pencegahan otot lantai pelvis (PPFME) dan model pengetahuan-sikap-amalan (model KAP) pada wanita dengan pengekalan kencing (UR) selepas pembedahan pelvis dan kesan terhadap kualiti hidup (QOL). Data klinikal 153 wanita yang dimasukkan ke hospital dengan UR setelah pembedahan pelvis dari Januari 2015 hingga Jun 2019 dianalisis secara retrospektif dan dibahagikan kepada Kumpulan Kawalan (CG, n = 45, LFES + PPFME) dan Kumpulan Kajian (SG, n = 108, Model LFES + PPFME + KAP) mengikut kaedah rawatan yang berbeza. Petunjuk berikut dibandingkan antara kedua-dua kumpulan: keberkesanan klinikal, masa kencing pertama, pengeluaran air kencing, kadar pemupukan dalam 3D, kadar intubasi berulang, petunjuk urodinamik sebelum dan selepas rawatan, residu pasca lompong (PVR), kepatuhan pundi kencing (BC), kadar aliran maksimum (Q-max), tekanan detrusor pada Pdet-Q-max (Pdet-Q-max)], perubahan QOL, kejadian jangkitan saluran kencing dan jangka masa tinggal (LOS). Berbanding dengan CG, SG menunjukkan kadar tindak balas keseluruhan (ORR) dan kadar pemupukan dalam 3D yang lebih tinggi, masa yang lebih pendek hingga kencing pertama, pengeluaran air kencing yang lebih tinggi, kadar intubasi berulang dan kejadian jangkitan saluran kencing dan LOS yang lebih pendek (P <0.05); kedua-dua kumpulan mencapai peningkatan dalam petunjuk urodinamik dan skor QOL selepas rawatan (P <0.05); petunjuk urodinamik dan skor QOL dalam SG lebih baik daripada CG (P <0.05). LFES yang digabungkan dengan model PPFME dan KAP berkesan untuk merawat wanita dengan UR setelah pembedahan pelvis dengan berkesan meningkatkan kencing dan QOL pesakit.

Kata kunci: LFES; model KAP; PPFME; QOL; rongga pelvis; UR

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*Corresponding author; email: linglingfu@yeah.net