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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李瑋涓 | 以「非侵入性高強度聚焦電磁刺激」治療尿失禁的成效及提升生活品質 | 2022/3/3 下午 05:54:21 | 0 |
| 原 文 | 題 目 | Safety and Efficacy of a Non‐Invasive High‐Intensity Focused Electromagnetic Field (HIFEM) Device for Treatment of Urinary Incontinence and Enhancement of Quality of Life |
| 作 者 | Julene B. Samuels, Andrea Pezzella, Joseph Berenholz, and Red Alinsod | |
| 出 處 | Lasers in Surgery and Medicine 51:760–766 (2019) | |
| 出版日期 | 2019 November | |
| 評 論 |
有尿失禁困擾的病人影響生活品質甚鉅，尤其是應力性尿失禁，口服藥物效果不佳，手術又擔心併發症，因此能增強骨盆底肌肉強度的非侵入性治療（例如：磁波椅）便能提供另一個治療選擇。
磁波椅的使用已行之有年，而目前較新的機器提高電磁強度以及強調聚焦功能，是否對於尿失禁的治療有更顯著的效果？ 此篇研究主要探討使用「非侵入性高強度聚焦電磁刺激」的安全性及成效，以及對生活品質的改善。 75位有尿失禁症狀的受試者（平均年齡約55歲）接受每週2次（總共6次）、每次28分鐘的療程。結果顯示有超過八成的受試者表示尿失禁症狀顯著改善，國際尿失禁問卷簡表(ICIQ‐SF)的分數也有明顯進步。並有近七成的受試者表示每日棉墊的使用量減少，平均下降了四至五成。 至於治療副作用的部分並無疼痛或其他不良事件的報告，反而有其他益處例如：性慾增加、更好的排尿控制⋯⋯等等。 總結來說，新型的電磁波刺激對於尿失禁是個安全、有效、並能提升生活品質的治療。 |
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| abstract |
Background and Objectives: Urinary incontinence is a common and distressing condition which interferes with everyday life. Patients frequently experience discomfort related to urine leakage and the subsequent need to use absorbent pads. Since the continence mechanism is primar- ily maintained by a proper function of pelvic floor muscles (PFM), many treatment methods focused on strengthening of the PFM have been introduced in the past. The aim of this study was to evaluate the safety and efficacy of a high‐ intensity focused electromagnetic technology (HIFEM) for treatment of urinary incontinence with emphasis on effects on prospective patients’ quality of life.
Study Design/Materials and Methods: The study followed an institutional review board approved protocol. A total of 75 women (55.45 ± 12.80 years, 1.85 ± 1.28 deliv- eries) who showed symptoms of stress, urge, or mixed urinary incontinence were enrolled. They received six HIFEM treatments (2 per week) in duration of 28 minutes. Outcomes were evaluated after the sixth treatment and at the 3‐month follow‐up. The primary outcome was to assess changes in urinary incontinence by the International Consultation on Incontinence Questionnaire‐Short Form (ICIQ‐SF) and changes in the number of absorbent pads used per day. The secondary outcome was subjective evaluation of the therapy and self‐reported changes in quality of life. The statistical analysis was conducted by paired T‐test and Pearson correlation coefficient (α = 0.05). Results: After the sixth session, 61 out of 75 patients (81.33%) reported significant reduction of their symptoms. The average improvement of 49.93% in ICIQ‐SF score was observed after the sixth treatment, which further increased to 64.42% at the follow‐up (both P < 0.001). Individually, the highest level of improvement was reached in patients suffering from mixed urinary incontinence (69.90%). The reduction of absorbent pads averaged 43.80% after the sixth treatment and 53.68% at 3 months (both P < 0.001), while almost 70% of patients (30 out of 43) reported decreased number of used pads. At the follow‐up, a highly significant medium correlation (r = 0.53, P < 0.001) was found between the ICIQ‐SF score improvement and the reduction in pad usage. A substantial decrease in the frequency of urine leakage triggers was documented. Patients reported no pain, downtime or adverse events, and also reported additional beneficial effects of the therapy such as increased sexual desire and better urination control. Conclusions: This study demonstrated that HIFEM technology is able to safely and effectively treat a wide range of patients suffering from urinary incontinence. After six treatments, an improvement in ICIQ‐SF score and reduction in absorbent pads usage was observed. Based on subjective evaluation, these changes positively influenced quality of life. |
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