Clinical Study on Warming-Needle Moxibustion Combined with Pelvic Floor Muscle Training and Electrical Pudendal Nerve Stimulation for Urinary Incontinence After Radical Prostatectomy
Abstract: Objective: To observe the curative effect of warming-needle moxibustion combined with pelvic floor muscle training (PFMT) and electrical pudendal nerve stimulation (EPNS) on patients with postprostatectomy incontinence (PPI) after radical prostatectomy (RP). Methods: A total of 93 cases of PPI patients of kidney yang deficiency type with RP treatment were randomly divided into the control group and the trial group,with 46 and 47 cases in each group respectively. The control group was treated with PFMT combined with EPNS of the pudendal nerve, and the trial group was additionally treated with warmingneedle moxibustion at Baliao points, Shenshu point (BL 23), and Mingmen point (Du 4) based on the treatment of the control group. After 12 weeks of treatment,the scores of the International Consultation on Incontinence Questionnaire Incontinence short form (ICI-Q-SF) , Incontinence Quality of Life Scale (I-QOL), PPI Rehabilitation Trend Scoring Scale, and the pelvic floor muscle (Glazer Protocol), urine leakage measured by 1-hour pad test, and clinical effects were compared between the two groups. Results:After treatment,the cure rate was 93.62% in the trial group and 78.26% in the control group, the difference being significant (P<0.05). After treatment for 4, 8, and 12 weeks,ICI-Q-SF scores in the two groups were decreased when compared with those before treatment (P<0.05) and showed a gradual downward trend (P<0.05);ICI-Q-SF scores in the trial group were lower than those in the control group at the same time point (P<0.05). After treatment for 4,8,and 12 weeks,I-QOL scores in the two groups were increased when compared with those before treatment (P<0.05) and showed a gradual rising trend (P<0.05); I-QOL scores in the trial group were higher than those in the control group at the same time point (P<0.05). After treatment for 4,8,and 12 weeks,the scores of the PPI Rehabilitation Trend Scoring Scale in the two groups were increased when compared with those before treatment (P<0.05) and showed a gradual rising trend (P<0.05);the scores of the PPI Rehabilitation Trend Scoring Scale in the trial group were higher than those in the control group at the same time point (P<0.05). After treatment for 4, 8, and 12 weeks, Glazer scores in the two groups were increased when compared with those before treatment (P<0.05) and showed a gradual rising trend (P<0.05); Glazer scores in the trial group were higher than those in the control group at the same time point (P<0.05). After treatment for 4, 8, and 12 weeks,urine leakage measured by 1-hour pad test in the two groups were decreased when compared with those before treatment (P<0.05) and showed a gradual downward trend (P<0.05); urine leakage measured by 1-hour pad test in the trial group was less than that in the control group at the same time point (P<0.05). During the 3-month follow-up, the ICI-Q-SF scores and urine leakage measured by 1-hour pad test in the two groups were increased when compared with those after treatment (P<0.05),and the scores of I-QOL , the scores of the PPI Rehabilitation Trend Scoring Scale and Glazer were decreased when compared with those after treatment (P<0.05); ICI-Q-SF scores and urine leakage measured by 1-hour pad test in the trial group were lower than those in the control group (P<0.05), and the scores of I-QOL,the scores of the PPI Rehabilitation Trend Scoring Scale in the trial group were higher than those in the control group (P<0.05),but there was not much difference in Glazer scores between the two groups (P>0.05). Conclusion:Warming-needle moxibustion has significant curative effects in the treatment of PPI based on PFMT combined with EPNS of the pudendal nerve,which can improve the symptoms of urinary incontinence and pelvic floor muscle function in patients, improve quality of life, promote disease recovery,and have relatively good long-term curative effects.