Top

International Urogynecology Journal

Published in:

Open Access 18-01-2024 | Original Article

Efficacy of Warm Acupuncture Therapy Combined with Kegel Exercise on Postpartum Pelvic Floor Dysfunction in Women

Authors: Jinling Dai, Zhu Jin, Xiaojin Zhang, Feng Lian, Jie Tu

Published in: International Urogynecology Journal | Issue 3/2024

Abstract

Introduction and hypothesis

The objective was to observe the clinical efficacy of warm acupuncture combined with Kegel exercise in treating postpartum pelvic floor dysfunction in women.

Methods

A total of 70 primiparous women with postpartum pelvic floor muscle (PFM) injury were randomly divided into a combination group (n = 35, receiving warm acupuncture at Zhibian (BL54) acupoint and Kegel exercise) and a sham control group (n = 35, receiving sham warm acupuncture and Kegel exercise). Both groups were treated three times a week for 4 consecutive weeks. The recovery of PFM strength and changes in Urethral Rotation Angle (URA), Bladder Neck Descent (BND), and Retrovesical Angle (RVA) in pelvic floor ultrasound reports, the scores of pelvic floor dysfunction-related questionnaires, and the efficacy of urinary incontinence treatment of the two groups were compared before and after treatment.

Results

After treatment, the recovery rates of type I and II PFM strength, pelvic floor ultrasound parameters, pelvic floor dysfunction-related scale scores, and urinary incontinence treatment efficacy in the combination group were significantly better than those in the sham control group (p < 0.05).

Conclusion

Warm acupuncture combined with Kegel exercise can significantly improve PFM strength and promote the recovery of postpartum pelvic floor function in women.

Yun Z, Li Z, Mei X, et al. Effect of different delivery modes on the short-term strength of the pelvic floor muscle in Chinese primipara. BMC Pregnancy Childbirth. 2018;18(1):275.CrossRef

Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EJC. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2017;12(12):CD007471. https://doi.org/10.1002/14651858.CD007471.pub3.CrossRefPubMed

Sigurdardottir T, Steingrimsdottir T, Geirsson RT, et al. Can postpartum pelvic floor muscle training reduce urinary and anal incontinence?: an assessor-blinded randomized controlled trial. Am J Obstet Gynecol. 2020;222(3):247.e1–247.e8. https://doi.org/10.1016/j.ajog.2019.09.011.CrossRefPubMed

Blomquist JL, Carroll M, Muñoz A, et al. Pelvic floor muscle strength and the incidence of pelvic floor disorders after vaginal and cesarean delivery. Am J Obstet Gynecol. 2020;222(1):62.e1–62.e8. https://doi.org/10.1016/j.ajog.2019.08.003.CrossRefPubMed

Cho ST, Kim KH. Pelvic floor muscle exercise and training for coping with urinary incontinence. J Exerc Rehabil. 2021;17(6):379–87. https://doi.org/10.12965/jer.214266

Wang X, Xu X, Luo J, et al. Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas: a randomized controlled trial. Int J Nurs Stud. 2020;104:103527. https://doi.org/10.1016/j.ijnurstu.2020.103527.CrossRefPubMed

Chu L, Jin X, Wu S, et al. Effect of pelvic floor muscle training with smartphone reminders on women in the postpartum period: a randomized controlled trial. Urogynecology (Phila). 2023. https://doi.org/10.1097/SPV.0000000000001401.CrossRefPubMed

Zhang Y, Wang H, Gong YN, et al. Pathological pathway analysis in an experimental rheumatoid arthritis model and the tissue repair effect of acupuncture at ST36. Front Immunol. 2023;14:1164157. https://doi.org/10.3389/fimmu.2023.1164157.CrossRefPubMedPubMedCentral

Liu Y, Dong X, Huo H, et al. Effects of programmed flexor-extensor alternating electrical acupoint stimulation on upper limb motor functional reconstruction after stroke: study protocol for a double-blind, randomized controlled trial. Trials. 2023;24(1):324. https://doi.org/10.1186/s13063-023-07283-3.CrossRefPubMedPubMedCentral

10.

Gao Y, Sun J, Fu Z, et al. Treatment of postsurgical trigeminal neuralgia with Fu’s subcutaneous needling therapy resulted in prompt complete relief: two case reports. Medicine. 2023;102(9):e33126. https://doi.org/10.1097/md.0000000000033126.CrossRefPubMedPubMedCentral

11.

World Health Organization. WHO international standard terminologies on traditional medicine in the Western Pacific region. 2007.

12.

Chen S, Wang S, Liu S, et al. Efficacy of electrical pudendal nerve stimulation versus pelvic floor muscle training in treating postradical prostatectomy urinary incontinence: study protocol for a randomised controlled trial. BMJ Open. 2023;13(1):e062323.CrossRefPubMedPubMedCentral

13.

Wang Q, Yu X, Sun X, et al. Does epidural anesthesia influence pelvic floor muscle endurance and strength and the prevalence of urinary incontinence 6 weeks postpartum? Int Urogynecol J. 2020;31(3):577–82. https://doi.org/10.1007/s00192-019-04176-5.CrossRefPubMed

14.

Zhu H, Zhang D, Gao L, et al. Effect of pelvic floor workout on pelvic floor muscle function recovery of postpartum women: protocol for a randomized controlled trial. Int J Environ Res Public Health. 2022;19(17):11073. https://doi.org/10.3390/ijerph191711073.CrossRefPubMedPubMedCentral

15.

Krhut J, Zachoval R, Smith PP, et al. Pad weight testing in the evaluation of urinary incontinence. Neurourol Urodyn. 2014;33(5):507–10. https://doi.org/10.1002/nau.22436.CrossRefPubMed

16.

Rada MP, Ciortea R, Măluțan AM, et al. Transperineal ultrasound assessment of a cystocele’s impact on the bladder neck mobility in women with stress urinary incontinence. Medicina (Kaunas). 2019;55(9):562. https://doi.org/10.3390/medicina55090562.CrossRefPubMed

17.

Liu W, Qian L. Establishment and validation of a risk prediction model for postpartum stress urinary incontinence based on pelvic floor ultrasound and clinical data. Int Urogynecol J. 2022;33(12):3491–7. https://doi.org/10.1007/s00192-022-05395-z.CrossRefPubMedPubMedCentral

18.

Mao YJ, Zheng ZJ, et al. Pelvic floor biometry in asymptomatic primiparous women compared with nulliparous women: a single-center study in Southern China. J Int Med Res. 2020;48(4):300060520920393. https://doi.org/10.1177/0300060520920393.CrossRefPubMed

19.

Yin W, Ma Q, Xie W, et al. Three-dimensional ultrasound assessment of risk factors for cystocele and Green classification in primipara. Front Med (Lausanne). 2022;30(9):979989. https://doi.org/10.3389/fmed.2022.979989.CrossRef

20.

Viereck V, Pauer H-U, Bader W, Oppermann M, Hilgers R, Gauruder-Burmester A, Lange R, Emons G, Hackenberg R, Krauss T. Introital ultrasound of the lower genital tract before and after colposuspension: a 4-year objective follow-up. Ultrasound Obstet Gynecol. 2004;23(3):277–83. https://doi.org/10.1002/uog.982.

21.

Viereck V, Pauer HU, Hesse O, et al. Urethral hypermobility after anti-incontinence surgery—a prognostic indicator? Int Urogynecol J Pelvic Floor Dysfunct. 2006;17(6):586–92. https://doi.org/10.1007/s00192-006-0071-4.CrossRefPubMed

22.

De Arruda GT, de Andrade DF, Virtuoso JF. Internal structure and classification of pelvic floor dysfunction distress by PFDI-20 total score. J Patient Rep Outcomes. 2022;6(1):51.CrossRefPubMedPubMedCentral

23.

Skorupska K, Grzybowska ME, Kubik-Komar A, et al. Identification of the Urogenital Distress Inventory-6 and the Incontinence Impact Questionnaire-7 cutoff scores in urinary incontinent women. Health Qual Life Outcomes. 2021;19(1):87.CrossRefPubMedPubMedCentral

24.

Aksac B, Aki S, Karan A, et al. Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence. Gynecol Obstet Invest. 2003;56(1):23–7. https://doi.org/10.1159/000072327.CrossRefPubMed

25.

Chen H, Yang N, Yang H, et al. Efficacy of Kegel exercises combined with electrical stimulation on the restoration of postpartum pelvic floor muscle function. Am J Transl Res. 2023;15(1):622–9.PubMedPubMedCentral

26.

De Araujo CC, Coelho SA, Stahlschmidt P, et al. Does vaginal delivery cause more damage to the pelvic floor than cesarean section as determined by 3D ultrasound evaluation? A systematic review. Int Urogynecol J. 2018;29(5):639–45. https://doi.org/10.1007/s00192-018-3609-3.CrossRefPubMed

27.

Soave I, Scarani S, Mallozzi M, et al. Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Arch Gynecol Obstet. 2019;299(3):609–23. https://doi.org/10.1007/s00404-018-5036-6.CrossRefPubMed

28.

Woodley SJ, Hay-Smith EJC. Narrative review of pelvic floor muscle training for childbearing women—why, when, what, and how. Int Urogynecol J. 2021;32(7):1977–88. https://doi.org/10.1007/s00192-021-04804-z.CrossRefPubMed

29.

Terry R, Jarvie R, Hay-Smith J, et al. “Are you doing your pelvic floor?” An ethnographic exploration of the interaction between women and midwives about pelvic floor muscle exercises (PFME) during pregnancy. Midwifery. 2020;83:102647.CrossRefPubMed

30.

31.

Sugaya K, Nishijima S, Miyazato M, Ogawa Y. Central nervous control of micturition and urine storage. J Smooth Muscle Res. 2005;41(3):117–32. https://doi.org/10.1540/jsmr.41.117.CrossRefPubMed

32.

Lee TC, Cheng TL, Chen WJ, et al. On the hazard caused by the heat of acupuncture needles in warm needling (wēn zhēn). J Tradit Complement Med. 2013;3(2):119–25.CrossRefPubMedPubMedCentral

33.

Myoung HS, Park JS, Cho SP, et al. A design of RF stimulator which is similar to temperature distribution by moxibustion (preliminary study). Annu Int Conf IEEE Eng Med Biol Soc. 2010;2010:1238–41. https://doi.org/10.1109/iembs.2010.5626434.CrossRefPubMed

34.

Hsieh CH, Tseng ST, Hung YC, et al. Effect of moxibustion on meridian in a warm needling model: a protocol for a prospective observational study. Medicine. 2022;101(47):e31492. https://doi.org/10.1097/md.0000000000031492.CrossRefPubMedPubMedCentral

35.

Wen L, Zhao B, Chen W, et al. Real-time assessment of the behaviour of the bladder neck and proximal urethra during urine leaking in the cough stress test (CST) in supine and standing positions using transperineal ultrasound. Int Urogynecol J. 2020;31(12):2515–9. https://doi.org/10.1007/s00192-020-04273-w.CrossRefPubMedPubMedCentral

36.

Zheng Y, Yang H, Yin X, et al. Acupoint injection combined with pelvic floor rehabilitation in the treatment of postpartum pelvic floor disorders: a protocol of randomized controlled trial. Medicine (Baltimore). 2021;100(23):e25511. https://doi.org/10.1097/MD.0000000000025511.CrossRefPubMed

37.

Yao L, Li F, Wang D, et al. Evaluation of acupuncture treatments of postpartum female pelvic floor dysfunction by four-dimensional transperineal pelvic floor ultrasound. Medicine (Baltimore). 2021;100(42):e27236. https://doi.org/10.1097/MD.0000000000027236.CrossRefPubMed

Title: Efficacy of Warm Acupuncture Therapy Combined with Kegel Exercise on Postpartum Pelvic Floor Dysfunction in Women
Authors: Jinling Dai
Zhu Jin
Xiaojin Zhang
Feng Lian
Jie Tu
Publication date: 18-01-2024
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 3/2024
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-023-05698-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of Warm Acupuncture Therapy Combined with Kegel Exercise on Postpartum Pelvic Floor Dysfunction in Women

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2024

Autologous Fascial Slings for Stress Urinary Incontinence: a 17-year Follow-up of a Randomised Controlled Study

Use of Methenamine for Urinary Tract Infection Prophylaxis: Systematic Review of Recent Evidence

Impact of Mannitol Bladder Distension in the Intraoperative Detection of Ureteral Kinking During Pelvic Floor Surgery

Correlation Between Mobile-Application Electronic Bowel Diary and Validated Questionnaires in Women with Fecal Incontinence

Comment on “Iliac Vein Variation in the Sacral Promontory on Three-dimensional Computed Tomography Angiography: A Prospective Observational Study Before Laparoscopic Sacrocolpopexy”

Effect of Dietary Choline Consumption on the Development of Urinary Urgency Incontinence in a Longitudinal Cohort of Women