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Vaginal cones for perineal strengthening and treatment of stress urinary incontinence in women
IUGA Academy. BEZERRA L. Jun 30, 2018; 213034
Topic: Stress Incontinence
Prof. Dr. LEONARDO BEZERRA
Prof. Dr. LEONARDO BEZERRA

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Vaginal cones for perineal strengthening and treatment of stress urinary incontinence in women

Bezerra, L1; Carvalho, K2; Monteiro Bilhar, AP1

1: FEDERAL UNIVERSITY OF CEARÁ; 2: Hospital Getúlio Vargas-Teresina

Kinesiotherapy using vaginal cones is a simple and accessible modalitie of physical therapy treatment for stress urinary incontinence. The study aimed to evaluate pelvic muscle strength (Oxford Grading System) and objective involuntary loss of urine (Pad-test) in the context of intervention with vaginal cones (Hotflowers (R)) in women with stress urinary incontinence. Method: Analytical and interventional longitudinal design with a convenience sample composed of 58 women with a medical diagnosis of stress urinary incontinence evaluated in the urodynamic study. The women underwent a program of kinesiotherapy treatment with vaginal cones (Hotflowers (R)) at the patient's home, 3 times a week, 2 times a day. We proceeded with guidance through explanatory leaflets and anatomical maps and fundamentals of Haddad (1999) for cones use. Pad Test of 1 (one) hour or test of the absorbent were collected in three moments: in the first care, 30 days after the start of the home program and 60 days after the intervention, and evaluation of the pelvic muscle strength through the Modified Oxford Grading System. Univariate and bivariate statistics were calculated: Wilcoxon's test for comparison of the values ??of the Oxford Grading System, Student's t test for Pad test measures and Spearman's correlation test to measure differences between means of muscle strength versus loss of urine between the first and third evaluation. The study was approved by a research ethics committee, the participants signed the consent form and the Declaration of Helsinki was followed. Results: The mean age of the women was 45.8 (± 16.3) years. At the first visit, most of the women presented a sketch of non-sustained contraction (72.4%) or no contraction (17.3%). In the evaluation performed 30 days after the beginning of the intervention, the number of women with low intensity contraction increased to 53.5% and 24.1% had moderate contraction. In the 60-day interval, 44.8% of the women presented moderate contraction and 36.3% had a satisfactory contraction. The median measures of the distributions of the Modified Oxford Grading System scores had a statistically significant increase from the first to the second evaluation (p <0.001), and from this to the third evaluation (p <0.001). There was also a significant reduction in urinary losses measured by the Pad-test at the three moments of evaluation: average before treatmente: 24g; and after treatment:3,6g (p <0.001) Conclusion: The strengthening of the pelvic floor muscles through kinesiotherapy exercises using vaginal cones is a low-cost and low-invasive option for stress urinary incontinence. According to our data its efficacy with home use is simple and already demonstrates objective effects (Pad-test) in 3 weeks.


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