关键词:

三代电生理技术, 经皮低频脉冲电刺激, 盆底肌过度紧张

Abstract:

Objective　To explore the clinical efficacy of third-generation electrophysiological technique based on pelvic floor anatomy in the treatment of pelvic floor muscle hypertonicity. Methods　A retrospective analysis was performed on 36 male patients admitted to the First Affiliated Hospital of Jinan University from October 2022 to May 2023, with an age of 21-82 (48.47±19.68) years old. All of them were diagnosed as pelvic floor muscle hypertonicity. The clinical manifestations were characterized by dysuria such as urine waiting, fine urine line, urine interruption, and even urinary retention, with frequent urination, nocturnal urination, some accompanied by difficulty in defecation. Digital rectal examination showed tension of the anal sphincter. Color ultrasound indicated a prostate size of 23-43 (32.42±5.24) g. Three of 36 patients had catheters retained due to urinary retention. Each patient took tamsulosin sustained-release capsules (0.2 mg qn) or silodosin capsules (4 mg bid) for 2-4 weeks, and the clinical symptoms did not improve. Twenty-six patients with difficulty in defecation were treated with percutaneous low-frequency pulse electrical stimulation. Before treatment, infrared thermal imaging detection was provided for each patient to visualize the selection of personalized electrotherapy parameters, to perform precise treatment. After every 10 treatments, infrared thermal imaging detection was repeated to adjust electrical stimulation treatment parameters. Paired t test and χ² test were used. Results　After electrostimulation treatment, the urinary waiting time [(2.39±1.44) s] was shorter than that before treatment [(41.21±12.25) s], the maximum urinary flow rate (Q_max) [(16.06±1.90) ml/s] was higher than that before treatment [(7.46±1.39) ml/s], the frequency of urination [(6.00±0.71) times] was lower than that before treatment [(10.76±1.50) times], and the frequency of nocturnal urination [(0.45±0.50) times per night] was lower than that before treatment [(2.06±1.22) times per night], with statistically significant differences (all P<0.000 1). After treatment, the catheter was pulled out in all the patients with urinary retention and the urination was smooth. The incidence of difficulty in defecation was 72.0% (26/36) before treatment and 0 after treatment. Conclusions　In adopting α1-receptor blockers are ineffective in treating dysuria and accompanied by a history of difficulty in defecation, pelvic floor muscle hypertonicity should be considered. The third-generation electrophysiological technology has achieved satisfactory short-term clinical efficacy in the treatment of pelvic floor muscle hypertonicity. With the increase of treatment cases, the long-term clinical efficacy of the technology will be further confirmed, providing a reliable new method for the treatment of pelvic floor muscle hypertonicity.

Key words:

Third-generation electrophysiological technology, Percutaneous low-frequency pulse electrical stimulation, Pelvic floor muscle hypertonicity