Comparative prospective study of biofeedback therapy and neuromuscular electrical stimulation in rehabilitation of patients with pelvic floor dysfunctions

Aim. To evaluate the effectiveness of the combined effects of biological feedback (BFB therapy) and electroimpulse stimulation (EIS) in rehabilitation of patients with pelvic floor dysfunctions. Materials and methods. A comparative prospective study included 235 women with clinical and ultrasound signs of genital prolapse stages I-IV according to POP-Q. The observation program was completed by 209 patients who were divided into group 1 with stage I-II prolapse and group 2 with stage III-IV prolapse. Vaginal extraperitoneal vaginopexy with installation of mesh implant was performed in group 2 patients before inclusion in the study. Lifestyle modification was recommended for all patients. In each group, patients were divided into subgroups of control and treatment (BOS-therapy and EIS). Group 1: subgroup A - control (n=47), subgroup B - treatment (n=56); group 2: subgroup C - control (n=49), subgroup D - treatment (n=57). Index of influence on the quality of life (IQOLI) and parameters of ultrasound were evaluated.Results. After a year of observation, in subgroup A, the IQOLI decreased by 5%, in subgroup B by 64% ( p< 0.05); in subgroup C, IQOLI decreased by 32%, in subgroup D - by 63% of the initial value ( p <0.05). In subgroup B, there was a statistically significant decrease in the size of the anterior urethro - vesical angle during the Valsalva test and in rotation of the alpha angle under load, leveling or reducing signs of genital prolapse in all patients. In subgroup A, the ultrasound parameters did not change, the dynamics of the prolapse stages were not noted. After a year of the program, the size of the anterior urethro - vesical angle at rest statistically significantly decreased in subgroups C and D. In subgroup D, the rotation of the alpha angle during loading, the size of the anterior urethro - vesical angle during the Valsalva test, and the smoothness of the beta angle at rest also decreased. In subgroup C, 4 (8%) cases of recurrence of genital prolapse were recorded; in subgroup D, no relapses were observed ( p =0.023).Conclusion. In patients with genital prolapse, both I-II stages and III-IV stages after surgical treatment, the use of biofe - edback therapy and EIS are more effective than the standard recommendations for lifestyle modification with regard to reducing IQOLI and changing ultrasound parameters. Adherence to rehabilitation program was 89%.