بررسی ارتباط قدرت عضلات کف لگن و شدت بیاختیاری ادراری بر کیفیت زندگی زنان مبتلا به بیاختیاری استرسی ادراری

نوع مقاله: اصیل پژوهشی

نویسندگان

1 استادیار گروه فیزیوتراپی، مرکز تحقیقات توانبخشی عضلانی - اسکلتی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

2 دانشجوی کارشناسی ارشد فیزیوتراپی، مرکز تحقیقات توانبخشی عضلانی - اسکلتی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

3 استادیار گروه مامایی، مرکز تحقیقات ارتقای سلامت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی جندی شاپور اهواز، اهواز، ایران.

چکیده

مقدمه: بی­اختیاری استرسی ادرار یکی از مشکلات شایع در میان زنان است که جنبه­های مختلف زندگی افراد را به طور منفی تحت تأثیر قرار می­دهد. مطالعه حاضر با هدف بررسی ارتباط قدرت عضلات کف لگن و شدت بی­اختیاری ادراری با میزان کیفیت زندگی زنان مبتلا به بی­اختیاری استرسی ادرار انجام شد.
روش‌کار: این مطالعه مقطعی در سال 95-1394 بر روی 126 زن مبتلا به بی­اختیاری استرسی ادرار در شهر اهواز انجام شد. جهت تعیین نوع بی­اختیاری و شدت آن از پرسشنامه­های تشخیص بی­اختیاری ادراری (QUID) و شاخص شدت بی­اختیاری ادراری استفاده شد. ارزیابی قدرت عضلات کف لگن به صورت دستی انجام گرفت. سنجش کیفیت زندگی با استفاده از پرسشنامه سنجش کیفیت زندگی در زنان مبتلا به بی اختیاری ادراری (IQOL) صورت گرفت. تجزیه و تحلیل داده­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 22) و آزمون کای دو انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته‌ها: در مطالعه حاضر بین شدت بی­اختیاری ادراری و قدرت عضلات با کیفیت زندگی ارتباط معنا‌داری وجود داشت (0001/0>p)؛ بدین معنا که افرادی که قدرت عضلات کف لگن آن­ها کمتر بود و فرم شدید بی‌اختیاری ادراری استرسی داشتند، کیفیت زندگی پایین‌تری داشتند.
نتیجه‌گیری: زنان مبتلا به بی­اختیاری ادراری شدیدتر و عضلات کف لگن ضعیف‌تر، کیفیت زندگی پایین‌تری دارند، لذا ضروری است تدابیری جهت افزایش قدرت عضلات کف لگن و ارتقاء سلامت دستگاه ادراری اندیشیده شود.

کلیدواژه‌ها


عنوان مقاله [English]

The relationship between pelvic floor muscle’s strength and severity of urinary incontinence with quality of life in women with stress urinary incontinence

نویسندگان [English]

  • Gholamhosein Nassaj 1
  • Parvin Amirpour 2
  • Shadab Shahali 3
  • Zahra Sarikhani 2
1 Assistant Professor, Department of Physiotherapy, Musculoskeletal Rehabilitation Research Center, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
2 M.Sc. student of Physiotherapy, Musculoskeletal Rehabilitation Research Center, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
3 Assistant Professor, Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing & Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
چکیده [English]

Introduction: Stress urinary incontinence is a common problem among women, which negatively affects all aspects of a woman's life. This study was performed with aim to investigate the relationship between pelvic floor muscles’ strength and severity of urinary incontinence with quality of life in women with stress urinary incontinence.
Methods: This cross-sectional study was performed on 126 women with stress urinary incontinence in Ahvaz in 2015-2016. To determine the type of incontinence and its severity, the questionnaires of urinary incontinence (QUID) and urinary incontinence severity index were used. Pelvic floor muscle's strength was evaluated manually. The quality of life was measured using a questionnaire of measuring quality of life in women with urinary incontinence (IQOL). Data were analyzed using SPSS statistical software (version 22) and Chi-square test. P Results: In this study, there is a significant relationship between the severity of urinary incontinence and muscles' strength with quality of life (p <0.0001). It means that women with severe urinary incontinence and lower pelvic floor muscles’ strength had lower quality of life.
Conclusion: Women with more severe form of urinary incontinence and weaker pelvic floor muscles have lower quality of life, thus it is essential to consider the strategies to strengthen pelvic floor muscles and improve urinary tract health.

کلیدواژه‌ها [English]

  • Pelvic Floor muscles
  • Quality of life
  • Stress Urinary Incontinence
  1. Wood LN, Anger JT. Urinary incontinence in women. BMJ 2014; 349:4531.
  2. Dehghan-Manshadi F, Bazaz-Behbahani R, Khademi K, Rahmani M, Eftekhar T. Ultrasonic thickness of lateral abdominal wall muscles in response to pelvic floor muscle contraction in women with stress incontinency with and without chronic low back pain. Arch Rehabilit 2014; 14(4):50-7. (Persian).
  3. Berek JS, Berek NS. Berek and Novak's gynecology. 15th ed. Philadelphia: Lippincott Williams & Wilkins; 2012.
  4. McGuire EJ. Pathophysiology of stress urinary incontinence. Rev Urol 2004; 6(Suppl 5):S11-7.
  5. Farzinmehr A, Moezzi A, Koohpayezadeh J. A combination training of pelvic floor muscles and core muscles in improvement of stress urinary incontinence. Razi J Med Sci 2013; 20(109):30-40. (Persian).
  6. Gasquet I, Tcherny-Lessenot S, Gaudebout P, Le Goux BB, Klein P, Haab F. Influence of the severity of stress urinary incontinence on quality of life, health care seeking, and treatment: a national cross-sectional survey. Eur Urol 2006; 50(4):818-25.
  7. Howard F, Steggall M. Urinary incontinence in women: quality of life and help-seeking. Br J Nurs 2010; 19(12):742, 744, 746, 748-9.
  8. Kwon BE, Kim GY, Son YJ, Roh YS, You MA. Quality of life of women with urinary incontinence: a systematic literature review. Int Neurourol J 2010; 14(3):133-8.
  9. Papanicolaou S, Hunskaar S, Lose G, Sykes D. Assessment of bothersomeness and impact on quality of life of urinary incontinence in women in France, Germany, Spain and the UK. BJU Int 2005; 96(6):831-8.
  10. Stach-Lempinen B, Hakala AL, Laippala P, Lehtinen K, Metsänoja R, Kujansuu E. Severe depression determines quality of life in urinary incontinent women. Neurourol Urodyn 2003; 22(6):563-8.
  11. Shahali S, Kashanian M, Azari A, Salehi R. Effects of pelvic floor muscle exercises on quality of life outcomes in women with stress urinary incontinence. Med J Islamic Republic Iran 2010; 24(3):159-62.
  12. Bø K. Pelvic floor muscle strength and response to pelvic floor muscle training for stress urinary incontinence. Neurourol Urodyn 2003; 22(7):654-8.
  13. Mokhlesi SS, Kariman N, Ebadi A, Khoshnejad F, Dabiri F. Psychometric properties of the questionnaire for urinary incontinence diagnosis of married women of Qom city in 2015. J Rafsanjan Univ Med Sci Health Serv 2016; 15(10):955-66. (Persian).
  14. Nojomi M, Baharvand P, Patric DL. Incontinence quality of life questionnaire (I-QOL) translation and validation study of Iranian version. Int Urol J 2009; 20(5):575-9.
  15. Liebergall‐Wischnitzer M, Paltiel O, Hochner‐Celnikier D, Lavy Y, Manor O, Woloski Wruble AC. Sexual function and quality of life for women with mild‐to‐moderate stress urinary incontinence. J Midwifery Womens Health 2011; 56(5):461-7.
  16. Ozkan S, Ogce F, Cakir D. Quality of life and sexual function of women with urinary incontinence. Jpn J Nurs Sci 2011; 8(1):11-9.
  17. Pakgohar M, Sabetghadam S, Vaseg RS, Kazemnejad A. Quality of life in postmenopausal women with urinary incontinence: a cross sectional study. Payesh 2014; 13(1):73-81. (Persian).
  18. Rangraz Jeddi M, Momenyan S, Rasouli A, Seyfzade Z, Hedayatizadeh A. Study of the relationship between the severity of postpartum urinary incontinence and parity and the quality of life in multiparous women. Iran J Obstet Gynecol Infertil 2014; 17(105):18-23. (Persian).
  19. Melville JL, Delaney K, Newton K, Katon W. Incontinence severity and major depression in incontinent women. Obstet Gynecol 2005; 106(3):585-92.
  20. Barentsen JA, Visser E, Hofstetter H, Maris AM, Dekker JH, de Bock GH. Severity, not type, is the main predictor of decreased quality of life in elderly women with urinary incontinence: a population-based study as part of a randomized controlled trial in primary care. Health Qual Life Outcomes 2012; 10:153.
  21. Oh SJ, Hong SK, Son H, Paick JS, Ku JH. Quality of life and disease severity in Korean women with stress urinary incontinence. Urology 2005; 66(1):69-73.
  22. Monz B, Chartier-Kastler E, Hampel C, Samsioe G, Hunskaar S, Espuna-Pons M, et al. Patient characteristics associated with quality of life in European women seeking treatment for urinary incontinence: results from PURE. Eur Urol 2007; 51(4):1073-81.
  23. Paick JS, Cho MC, Oh SJ, Kim SW, Ku JH. Influence of self‐perceived incontinence severity on quality of life and sexual function in women with urinary incontinence. Neurourol Urodyn 2007; 26(6):828-35.
  24. Minassian VA, Devore E, Hagan K, Grodstein F. Severity of urinary incontinence and effect on quality of life in women, by incontinence type. Obstet Gynecol 2013; 121(5):1083-90.
  25. Shahali S, Kashanian M, Azari A, Salehi R. Effects of pelvic floor muscle exercises on quality of life outcomes in women with stress urinary incontinence. Med J Islamic Republic Iran 2010; 24(3):159-62. (Persian).
  26. Bø K, Talseth T, Vinsnes A. Randomized controlled trial on the effect of pelvic floor muscle training on quality of life and sexual problems in genuine stress incontinent women. Acta Obstet Gynecol Scand 2000; 79(7):598-603.
  27. Sar D, Khorshid L. The effects of pelvic floor muscle training on stress and mixed urinary incontinence and quality of life. J Wound Ostomy Continence Nurs 2009; 36(4):429-35.