干旱区生态环境知识资源中心(Arid): Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial

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	Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial
	Brown, Oluwateniola; Heliker, Bhumy Dave; Geynisman-Tan, Julia; Tavathia, Meera; Mueller, Margaret G.; Collins, Sarah; Kenton, Kimberly; Lewicky-Gaupp, Christina
通讯作者	Brown, O (corresponding author)，Northwestern Univ, Dept Obstet & Gynecol, Chicago, IL 60611 USA.
来源期刊	OBSTETRICAL & GYNECOLOGICAL SURVEY
ISSN	0029-7828
EISSN	1533-9866
出版年	2022
卷号	77 期号:1
英文摘要	Obstetric anal sphincter injuries (OASIS) have been established as risk factors for anal incontinence (AI). Several studies have shown that women with OASIS were more likely to have AI than those without anal sphincter lacerations or tears. Evidence also suggests that vaginal delivery may be a cause of neuromuscular injury. Both animal and human studies suggest that ESTIMafter injury stimulates neuromuscular recovery, by promoting axonal regeneration, accelerating the reinnervation of denervated muscles and stimulating muscle contraction and muscle contractile force. The aim of this study was to determine if vaginal ESTIM improves neuromuscular recovery. This was a randomized, double-blind clinical study conducted at a single center between February 2016 and September 2018. Included were adult women with OASIS, who were invited to participate in the trial 1 week postpartum. Excluded were women with implanted electrical devices, a history of neurological disease, inflammatory bowel disease, perineal would breakdown or current infection, or mediolateral episiotomy. The women were randomized 1:1 to undergo ESTIM or sham stimulation. They were asked to record the number of stimulation sessions they performed in a weekly log that was submitted at weeks 5, 10, and 13 postpartum. At baseline and 13 weeks postpartum, the women were asked to complete a visual analog scale for pain and questionnaires that assessed the severity of their AI symptoms (Fecal Incontinence Severity Index [FISI]) and impact on their quality of life (Colorectal-Anal Distress Inventory 8 [CRADI-8] and Colorectal Anal Impact Questionnaire 7 [CRAIQ-7]). A total of 48 women were included in the analysis: 26 in the ESTIM group and 22 in the sham group. At 13 weeks postpartum, the sham group reported lower AI symptom severity than the ESTIM group (total FISI scores: 4.0 [IQR, 0-11] vs 12 [IQR, 0-23]; P = 0.04). In the sham group, a significant improvement was observed in themedian total FISI scores from baseline to 13 weeks (12 [IQR, 6-18] vs 4 [IQR, 0-11]; P < 0.001). The shamgroup also saw improvements in gas (4 [IQR, 0-12] vs 4 [IQR, 0-6]; P < 0.08), liquid stool (0 [IQR, 0-8] vs 0 [IQR, 0-0]; P < 0.04), and solid stool (0 [IQR, 0-8] vs 0 [IQR, 0-0]; P < 0.04) from baseline. In contrast, the ESTIM group saw no improvements overall from baseline to 13 weeks (12 [IQR 8-22] vs 12 [IQR 0-23]; P = 0.120). The ESTIM group only saw improvements in liquid stool (0 [IQR, 0-8] vs 0 [IQR, 0-0]; P < 0.01). For both groups, there were improvements in the quality of life questionnaires, CRADI-8 (ESTIM: 13 [IQR, 0-28] vs 6 [IQR, 0-18]; P < 0.05; sham: 8 [IQR, 0-40] vs 6 [IQR, 0-13]; P < 0.03) and CRAIQ-7 (ESTIM: 14 [IQR, 0-57] vs 0 [IQR, 0-5]; P < 0.001; sham: 2 [IQR, 0-25] vs 0 [IQR, 0-0]; P < 0.01). No differences in pain scores were observed between the ESTIM group and sham group (2 [IQR, 0-4.3] vs 3 [IQR, 2-4]; P < 0.58). In conclusion, at 3 months postpartum, vaginal ESTIM did not improve AI symptoms in women with OASIS and was instead associated with the worsening of some symptoms.
类型	Editorial Material
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000739995400010
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/376822
作者单位	[Brown, Oluwateniola; Geynisman-Tan, Julia; Tavathia, Meera; Mueller, Margaret G.; Collins, Sarah; Kenton, Kimberly; Lewicky-Gaupp, Christina] Northwestern Univ, Dept Obstet & Gynecol, Chicago, IL 60611 USA; [Heliker, Bhumy Dave] Univ Calif Irvine, Dept Obstet & Gynecol, Irvine, CA 92717 USA
推荐引用方式 GB/T 7714	Brown, Oluwateniola,Heliker, Bhumy Dave,Geynisman-Tan, Julia,et al. Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial[J],2022,77(1).
APA	Brown, Oluwateniola.,Heliker, Bhumy Dave.,Geynisman-Tan, Julia.,Tavathia, Meera.,Mueller, Margaret G..,...&Lewicky-Gaupp, Christina.(2022).Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial.OBSTETRICAL & GYNECOLOGICAL SURVEY,77(1).
MLA	Brown, Oluwateniola,et al."Vaginal Electrical Stimulation for Postpartum Neuromuscular Recovery: A Randomized Clinical Trial".OBSTETRICAL & GYNECOLOGICAL SURVEY 77.1(2022).