Issue №2-22, 2023

Original article

Biofeedback Therapy Pelvic Floor Muscle Training Program Efficacy vs. Traditional Methods of Medical Rehabilitation in Patients with Chronic Endometritis Associated with Pelvic Floor Muscle Failure: a Prospective Randomized Study



1 ORCIDNatalya V. Kotenko 1 ORCIDOlga O. Borisevich 1 ORCIDOlga O. Borisevich

1National Medical Research Center for Rehabilitation and Balneology


ABSTRACT

INTRODUCTION. Inflammatory diseases of the pelvic organs are one of the main reasons for the decline in the reproductive potential of women. In this regard, modern technologies are being developed, including non-drug methods for correcting functional disorders associated with the inflammatory process. The creation of personalized programs based on the use of natural and preformed physical factors in patients with a burdened obstetric and gynecological history is still an urgent task.

AIM. To evaluate the clinical effectiveness of the use of pelvic floor muscle training as part of a complex method for the treatment of patients with chronic endometritis, combined with pelvic floor muscle failure.

MATERIALS AND METHODS. The randomized study included 55 patients with chronic endometritis associated with pelvic floor muscle failure. 28 women of the main group received a complex of amplipulse therapy procedures (10 procedures), sodium chloride baths (8 procedures) and pelvic floor muscle training using the biofeedback method (10 sessions). In 27 patients of the comparison group, restorative treatment was used, including only amplipulse therapy and sodium chloride baths.

RESULTS AND DISCUSSION. In both groups, after treatment, there was a significantly significant increase in the uterine arterial perfusion index (p < 0.01), as well as a significant improvement in the structure and thickness of the endometrium according to transvaginal ultrasound (p < 0.001), an improvement in situational anxiety according to the Spielberger-Khanin scale (p < 0.001). In addition, in patients of the main group, restoration of normal anatomical relationships of the pelvic floor muscles was observed according to translabial ultrasound of the pelvic floor (p < 0.05).

CONCLUSION. Taking into account the high efficiency of the short-term treatment program in patients of the main group, the use of pelvic floor muscle training as part of a complex rehabilitation treatment is recommended for chronic endometritis in combination with grade I–II genital prolapse.


KEYWORDS: INTRODUCTION. Inflammatory diseases of the pelvic organs are one of the main reasons for the decline in the reproductive potential of women. In this regard, modern technologies are being developed, including non-drug methods for correcting functional disorders associated with the inflammatory process. The creation of personalized programs based on the use of natural and preformed physical factors in patients with a burdened obstetric and gynecological history is still an urgent task. AIM. To evaluate the clinical effectiveness of the use of pelvic floor muscle training as part of a complex method for the treatment of patients with chronic endometritis, combined with pelvic floor muscle failure. MATERIALS AND METHODS. The randomized study included 55 patients with chronic endometritis associated with pelvic floor muscle failure. 28 women of the main group received a complex of amplipulse therapy procedures (10 procedures), sodium chloride baths (8 procedures) and pelvic floor muscle training using the biofeedback method (10 sessions). In 27 patients of the comparison group, restorative treatment was used, including only amplipulse therapy and sodium chloride baths. RESULTS AND DISCUSSION. In both groups, after treatment, there was a significantly significant increase in the uterine arterial perfusion index (p < 0.01), as well as a significant improvement in the structure and thickness of the endometrium according to transvaginal ultrasound (p < 0.001), an improvement in situational anxiety according to the Spielberger-Khanin scale (p < 0.001). In addition, in patients of the main group, restoration of normal anatomical relationships of the pelvic floor muscles was observed according to translabial ultrasound of the pelvic floor (p < 0.05). CONCLUSION. Taking into account the high efficiency of the short-term treatment program in patients of the main group, the use of pelvic floor muscle training as part of a complex rehabilitation treatment is recommended for chronic endometritis in combination with grade I–II genital prolapse.

Acknowledgments: The study had no sponsorship.

Conflict of interest:: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

For citation:

Kotenko N.V., Borisevich O.O., Romanova N.A. Biofeedback Therapy Pelvic Floor Muscle Training Program Efficacy vs. Traditional Methods of Medical Rehabilitation in Patients with Chronic Endometritis Associated with Pelvic Floor Muscle Failure: a Prospective Randomized Study. Bulletin of Rehabilitation Medicine. 2023; 22(2): 129-135. https://doi.org/10.38025/2078-1962-2023-22-2-129-135 (In Russ.)



References:

  1. Park H. J., Kim Y. S., Yoon T. K. Lee W. S. Chronic endometritis and infertility. Clinical and Experimental Reproductive Medicine. 2016; 43(4): 185–192. https://doi.org/10.5653/cerm.2016.43.4.185
  2. Kasius J.C., Fatemi H.M., Bourgain C., Sie-Go D.M., Eijkemans R.J., Fauser B.C., Devroey P., Broekmans F.J. The impact of chronic endometritis on reproductive outcome. Fertility and Sterility. 2011; 96(6): 1451–1456. https://doi.org/10.1016/j.fertnstert.2011.09.039
  3. Di Tucci C., Di Mascio D., Schiavi M. C., Perniola G., Muzii L., Benedetti Panici P. Pelvic Inflammatory Disease: Possible Catches and Correct Management in Young Women. Case Reports in Obstetrics and Gynecology. 2018; (5831029). https://doi.org/10.1155/2018/5831029
  4. Kimura F., Takebayashi A., Ishida M., Nakamura A., Kitazawa J., Morimune A., Hirata K., Takahashi A., Tsuji S., Takashima A., Amano T., Tsuji S., Ono T., Kaku S., Kasahara K., Moritani S., Kushima R., Murakami T. Review: Chronic endometritis and its effect on reproduction. The Journal of Obstetrics and Gynaecology Research. 2019; 45(5): 951–960. https://doi.org/10.1111/jog.13937
  5. Jennings L. K., Krywko D. M. Pelvic Inflammatory Disease. StatPearls Publishing. 2023.
  6. Wang J., Li Z., Ma X., Du L., Jia Z., Cui X., Yu L., Yang J., Xiao L., Zhang B., Fan H., Zhao F. Translocation of vaginal microbiota is involved in impairment and protection of uterine health. Nature Communications. 2021; 12(1): 4191. https://doi.org/10.1038/s41467-021-24516-8
  7. Lozano F. M., Bernabeu A., Lledo B. et al. Characterization of the vaginal and endometrial microbiome in patients with chronic endometritis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2021; (263): 25–32. https://doi.org/10.1016/j.ejogrb.2021.05.045
  8. Borodulina I. V., Mukhina A. A., Chesnikova E. I. Features of the Application of Instrumental Methods for Lumbosacral Muscle Groups Functional State Assessing. Bulletin of Rehabilitation Medicine. 2021; 20 (5): 65–72. https://doi.org/10.38025/2078-1962-2021-20-5-65-72 (In Russ.).
  9. Zhang Y., Yang H., Lin L., Yang W., Xiong G., Gao G. The relationship between pelvic floor functions and vaginal microbiota in 6–8 weeks postpartum women. Frontiers in Microbiology. 2022; (13): 975406. https://doi.org/10.3389/fmicb.2022.975406
  10. Nygaard I. E., Wolpern A., Bardsley T., Egger M. J., Shaw J. M. Early postpartum physical activity and pelvic floor support and symptoms 1 year postpartum. American Journal of Obstetrics and Gynecology. 2021; 224(2): 193.e1–193.e19. https://doi.org/10.1016/j.ajog.2020.08.033



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