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

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Department of Surgery, University of Salamanca, 37001 Salamanca, Spain
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Physiotherapy Department of Institute of Applied Technology, Abu Dhabi 3798, UAE
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Section of Urology, Department of Surgery, University La Laguna, 38200 San Cristóbal de la Laguna, (Santa Cruz de Tenerife), Spain
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Multidisciplinary Renal Research Group of the Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
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Department of Urology of University Hospital of Avila, 05071 Ávila, Spain
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Department of Gynecology and Obstetrics of University Hospital of Salamanca, 37007 Salamanca, Spain
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Department of Anesthesiology of University Hospital of Salamanca, 37007 Salamanca, Spain
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Department of Urology of Arnau de Vilanova Hospital, 46015 Valencia, Spain
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Department of Biomedical and Diagnostic Sciences of University of Salamanca, 37007 Salamanca, Spain
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Department of Urology of University Hospital of Salamanca, 37007 Salamanca, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(10), 3310; https://doi.org/10.3390/jcm9103310
Received: 20 September 2020 / Revised: 5 October 2020 / Accepted: 8 October 2020 / Published: 15 October 2020
(This article belongs to the Section Nephrology & Urology)
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 (n = 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 (n = 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. View Full-Text
Keywords: quality of life; cystocele; biofeedback; physiotherapy quality of life; cystocele; biofeedback; physiotherapy
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MDPI and ACS Style

Borrego-Jimenez, P.-S.; Padilla-Fernandez, B.-Y.; Valverde-Martinez, S.; Garcia-Sanchez, M.-H.; Rodriguez-Martin, M.-d.-l.-O.; Sanchez-Conde, M.-P.; Flores-Fraile, M.-C.; Marquez-Sanchez, M.; Flores-Fraile, J.; Perán-Teruel, M.; Mirón-Canelo, J.-A.; García-Cenador, M.-B.; Lorenzo-Gómez, M.-F. Effects on Health-Related Quality of Life of Biofeedback Physiotherapy of the Pelvic Floor as an Adjunctive Treatment Following Surgical Repair of Cystocele. J. Clin. Med. 2020, 9, 3310. https://doi.org/10.3390/jcm9103310

AMA Style

Borrego-Jimenez P-S, Padilla-Fernandez B-Y, Valverde-Martinez S, Garcia-Sanchez M-H, Rodriguez-Martin M-d-l-O, Sanchez-Conde M-P, Flores-Fraile M-C, Marquez-Sanchez M, Flores-Fraile J, Perán-Teruel M, Mirón-Canelo J-A, García-Cenador M-B, Lorenzo-Gómez M-F. 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. 2020; 9(10):3310. https://doi.org/10.3390/jcm9103310

Chicago/Turabian Style

Borrego-Jimenez, Pedro-Santiago, 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, and María-Fernanda Lorenzo-Gómez. 2020. "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 9, no. 10: 3310. https://doi.org/10.3390/jcm9103310

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