关键词:

压力性尿失禁, 盆底肌训练, CO₂激光, 凯格尔运动, 焦虑

Abstract:

Objective　To explore the clinical efficacy of CO₂ laser combined with Kegel exercises in treating patients with stress urinary incontinence of different age groups and its impact on quality of life. Methods　A total of 100 female patients with stress urinary incontinence who visited the obstetrics and gynecology department of Zhuhai Doumen District Maternal and Child Health Hospital from February 2023 to October 2024 were selected as the study subjects. The patients were divided by age into the reproductive age group (<45 years old) and the perimenopausal group (≥45 years old), with 50 cases in each group. After stratification, they were randomly divided into the control group and the study group, with 25 cases in each group. Reproductive age patients: in the control group, the age was (35.72±4.82) years, the body mass index was (22.06±0.87) kg/m², and there were 8 cases of mild stress urinary incontinence and 17 cases of moderate stress urinary incontinence; in the study group, the age was (36.60±4.20) years, the body mass index was (21.72±1.04) kg/m², and there were 14 cases of mild stress urinary incontinence and 11 cases of moderate stress urinary incontinence. Perimenopausal patients: in the control group, the age was (54.88±6.19) years, the body mass index was (21.85±0.75) kg/m², and there were 9 cases of mild stress urinary incontinence and 16 cases of moderate stress urinary incontinence; in the study group, the age was (53.44±8.80) years, the body mass index was (22.09±0.73) kg/m², and there were 8 cases of mild stress urinary incontinence and 17 cases of moderate stress urinary incontinence. The control group received Kegel exercise therapy, while the study group received CO₂ laser therapy combined with Kegel exercise. All groups received a continuous treatment course (3 months). The 1-hour urine leakage volume (1-hour urine pad test) were compared before and after treatment in each group of reproductive-aged and post-menopausal patients, as well as the symptoms score of stress urinary incontinence [International Consultation on Incontinence Questionnaire - Short Form (ICI-Q-SF)], quality of life [World Health Organization Quality of Life - Brief Version (WHOQOL-BREF)], and anxiety level [Self-Rating Anxiety Scale (SAS)]. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the 1-hour urine leakage volume and ICI-Q-SF score of the reproductive age and perimenopausal patients in the study group were lower than those in the control group [(0.56±0.27) g vs. (1.26±1.24) g, (4.52±3.06) points vs. (6.40±2.94) points; (0.68±0.26) g vs. (5.46±1.02) g, (7.52±3.95) points vs. (11.24±4.53) points] (all P<0.05); the WHOQOL-BREF scores of the reproductive age and perimenopausal patients in the study group were higher than those in the control group [(86.44±4.39) points vs. (77.76±4.44) points; (86.12±5.06) points vs. (60.80±4.92) points] (both P<0.05). There was no statistically significant difference in the SAS scores between the two groups of patients of reproductive age and those in the perimenopausal (both P>0.05). Conclusions　Simple Kegel exercises are highly effective for patients in the reproductive age group, but have less effect on those in the perimenopausal. Moreover, in both the reproductive age group and the perimenopausal group, the combined treatment of CO₂ laser and Kegel exercises for stress urinary incontinence is highly effective, which can improve the quality of life of patients and alleviate their anxiety.

Key words:

Stress urinary incontinence, Pelvic floor muscle training, CO₂ , laser, Kegel exercises, Anxiety