Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele

Objectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: pro...

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Main Authors: Pedro-Santiago Borrego-Jimenez, Bárbara-Yolanda Padilla-Fernandez, Sebastián Valverde-Martinez, Maria-Helena Garcia-Sanchez, Maria-de-la-O Rodriguez-Martin, Maria-Pilar Sanchez-Conde, Maria-Carmen Flores-Fraile, Magaly Marquez-Sanchez, Javier Flores-Fraile, Miguel Perán-Teruel, José-Antonio Mirón-Canelo, Maria-Begoña García-Cenador, María-Fernanda Lorenzo-Gómez
Format: Article
Language:English
Published: MDPI AG 2020-10-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/9/10/3310
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author Pedro-Santiago Borrego-Jimenez
Bárbara-Yolanda Padilla-Fernandez
Sebastián Valverde-Martinez
Maria-Helena Garcia-Sanchez
Maria-de-la-O Rodriguez-Martin
Maria-Pilar Sanchez-Conde
Maria-Carmen Flores-Fraile
Magaly Marquez-Sanchez
Javier Flores-Fraile
Miguel Perán-Teruel
José-Antonio Mirón-Canelo
Maria-Begoña García-Cenador
María-Fernanda Lorenzo-Gómez
author_facet Pedro-Santiago Borrego-Jimenez
Bárbara-Yolanda Padilla-Fernandez
Sebastián Valverde-Martinez
Maria-Helena Garcia-Sanchez
Maria-de-la-O Rodriguez-Martin
Maria-Pilar Sanchez-Conde
Maria-Carmen Flores-Fraile
Magaly Marquez-Sanchez
Javier Flores-Fraile
Miguel Perán-Teruel
José-Antonio Mirón-Canelo
Maria-Begoña García-Cenador
María-Fernanda Lorenzo-Gómez
author_sort Pedro-Santiago Borrego-Jimenez
collection DOAJ
description Objectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: prospective observational study in 226 women who received complementary therapy after surgical treatment of cystocele due to persistent perineal discomfort or pain. Groups: GA (<i>n</i> = 78): women treated with 25 mg of oral pregabalin every 12 h plus BFB, consisting of 20 once-weekly therapy sessions, each 20 min long, with perineal pregelled surface electrodes connected to a screen which provides visual feedback; GB (<i>n</i> = 148): women treated with oral pregabalin 25 mg every 12 h without BFB. Variables: age, body mass index (BMI), time since onset of cystocele prior to surgery (TO), SF-36 health-related quality of life survey score, diseases and concomitant health conditions, follow-up time, success, or failure of postsurgical treatment. Results: average age 67.88 years (SD 12.33, 30–88), with no difference between GA and GB. Average body mass index (BMI) 27.08 (SD 0.45, 18.74–46.22), with no difference between GA and GB. Time since onset of cystocele prior to surgery (TO) was 6.61 years (SD 0.6), with no difference between GA and GB. Pretreatment SF-36 score was lower in GA success than GB success. Treatment was successful in 141 (63.20%) women and failed in 82 (36.80%). PT and age were the main predictors of success, and the least important were pretreatment SF-36 and the time elapsed after the intervention. In GA, 63 women (80.80%) showed improvement while 15 (19.20%) did not. Age was the main predictor of treatment success, while the least important was BMI. In GB, 78 women (53.80%) showed improvement while 67 (46.20%) did not improve. The main predictor was time since cystocele onset prior to surgery, while the least important was age. The odds ratio (OR) of improving quality of life for each unit increase in SF-36 was 11.5% (OR = 0.115) in all patients, with no difference between success and failure; in GA it was 23.80% (OR = 0.238), with a difference between success and failure; in GB it was 11.11% (OR = 0.111), with no difference between success and failure. GA and GB success had more history of eutocic delivery. GA success had more rUTI. GB success and GA failure both had more history of UI corrective surgery. The “failure” outcome had a higher number of patients with more than two concomitant pathological conditions. Conclusions: BFB as an adjunctive treatment improves quality of life in women suffering from persistent discomfort after surgery for cystocele. Young women who meet the criteria for recurrent urinary tract infection or who have a history of eutocic delivery show greater improvement. Body mass index does not influence response to treatment, while the presence of more than two concomitant conditions indicates a poor prognosis for improving quality of life.
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spelling doaj.art-a115a164d7a249fc8284bddfbe42fed92023-11-20T17:13:37ZengMDPI AGJournal of Clinical Medicine2077-03832020-10-01910331010.3390/jcm9103310Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of CystocelePedro-Santiago Borrego-Jimenez0Bárbara-Yolanda Padilla-Fernandez1Sebastián Valverde-Martinez2Maria-Helena Garcia-Sanchez3Maria-de-la-O Rodriguez-Martin4Maria-Pilar Sanchez-Conde5Maria-Carmen Flores-Fraile6Magaly Marquez-Sanchez7Javier Flores-Fraile8Miguel Perán-Teruel9José-Antonio Mirón-Canelo10Maria-Begoña García-Cenador11María-Fernanda Lorenzo-Gómez12Department of Surgery, University of Salamanca, 37001 Salamanca, SpainSection of Urology, Department of Surgery, University La Laguna, 38200 San Cristóbal de la Laguna, (Santa Cruz de Tenerife), SpainDepartment of Surgery, University of Salamanca, 37001 Salamanca, SpainDepartment of Gynecology and Obstetrics of University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Gynecology and Obstetrics of University Hospital of Salamanca, 37007 Salamanca, SpainDepartment of Surgery, University of Salamanca, 37001 Salamanca, SpainDepartment of Surgery, University of Salamanca, 37001 Salamanca, SpainMultidisciplinary Renal Research Group of the Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, SpainDepartment of Surgery, University of Salamanca, 37001 Salamanca, SpainDepartment of Urology of Arnau de Vilanova Hospital, 46015 Valencia, SpainMultidisciplinary Renal Research Group of the Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, SpainDepartment of Surgery, University of Salamanca, 37001 Salamanca, SpainDepartment of Surgery, University of Salamanca, 37001 Salamanca, SpainObjectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: prospective observational study in 226 women who received complementary therapy after surgical treatment of cystocele due to persistent perineal discomfort or pain. Groups: GA (<i>n</i> = 78): women treated with 25 mg of oral pregabalin every 12 h plus BFB, consisting of 20 once-weekly therapy sessions, each 20 min long, with perineal pregelled surface electrodes connected to a screen which provides visual feedback; GB (<i>n</i> = 148): women treated with oral pregabalin 25 mg every 12 h without BFB. Variables: age, body mass index (BMI), time since onset of cystocele prior to surgery (TO), SF-36 health-related quality of life survey score, diseases and concomitant health conditions, follow-up time, success, or failure of postsurgical treatment. Results: average age 67.88 years (SD 12.33, 30–88), with no difference between GA and GB. Average body mass index (BMI) 27.08 (SD 0.45, 18.74–46.22), with no difference between GA and GB. Time since onset of cystocele prior to surgery (TO) was 6.61 years (SD 0.6), with no difference between GA and GB. Pretreatment SF-36 score was lower in GA success than GB success. Treatment was successful in 141 (63.20%) women and failed in 82 (36.80%). PT and age were the main predictors of success, and the least important were pretreatment SF-36 and the time elapsed after the intervention. In GA, 63 women (80.80%) showed improvement while 15 (19.20%) did not. Age was the main predictor of treatment success, while the least important was BMI. In GB, 78 women (53.80%) showed improvement while 67 (46.20%) did not improve. The main predictor was time since cystocele onset prior to surgery, while the least important was age. The odds ratio (OR) of improving quality of life for each unit increase in SF-36 was 11.5% (OR = 0.115) in all patients, with no difference between success and failure; in GA it was 23.80% (OR = 0.238), with a difference between success and failure; in GB it was 11.11% (OR = 0.111), with no difference between success and failure. GA and GB success had more history of eutocic delivery. GA success had more rUTI. GB success and GA failure both had more history of UI corrective surgery. The “failure” outcome had a higher number of patients with more than two concomitant pathological conditions. Conclusions: BFB as an adjunctive treatment improves quality of life in women suffering from persistent discomfort after surgery for cystocele. Young women who meet the criteria for recurrent urinary tract infection or who have a history of eutocic delivery show greater improvement. Body mass index does not influence response to treatment, while the presence of more than two concomitant conditions indicates a poor prognosis for improving quality of life.https://www.mdpi.com/2077-0383/9/10/3310quality of lifecystocelebiofeedbackphysiotherapy
spellingShingle Pedro-Santiago Borrego-Jimenez
Bárbara-Yolanda Padilla-Fernandez
Sebastián Valverde-Martinez
Maria-Helena Garcia-Sanchez
Maria-de-la-O Rodriguez-Martin
Maria-Pilar Sanchez-Conde
Maria-Carmen Flores-Fraile
Magaly Marquez-Sanchez
Javier Flores-Fraile
Miguel Perán-Teruel
José-Antonio Mirón-Canelo
Maria-Begoña García-Cenador
María-Fernanda Lorenzo-Gómez
Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
Journal of Clinical Medicine
quality of life
cystocele
biofeedback
physiotherapy
title Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
title_full Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
title_fullStr Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
title_full_unstemmed Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
title_short Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele
title_sort effects on health related quality of life of biofeedback physiotherapy of the pelvic floor as an adjunctive treatment following surgical repair of cystocele
topic quality of life
cystocele
biofeedback
physiotherapy
url https://www.mdpi.com/2077-0383/9/10/3310
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