Aşırı Aktif Mesane Sendromu Olan Hastalarda Mesane Eğitimi ve Pelvik Taban Egzersiz Eğitiminin Üriner Semptomlar ve Yaşam Kalitesi Üzerine Etkisi

Abstract

The aim of this study was to investigate the effects of "Bladder Training" and "Pelvic Floor Muscle Training (PFMT)" on urinary symptoms and quality of life in patients diagnosed with Overactive Bladder (OAB) following routine botox application, compared to "Standard Patient Recommendations." 46 patients who received routine botox were included in the study and assigned to either the Pelvic Physiotherapy group (Group 1, n=23) or the Control group (Group 2, n=23). Two weeks after botox, Group 1 received bladder training and PFMT, while Group 2 received standard recommendations. The first bladder training and PFMT session in Group 1 lasted 45-60 minutes, with online sessions every two weeks for 10 weeks. Group 2's standard recommendations lasted 15-20 minutes. The primary outcome measure, subjective urinary symptom severity, was assessed using the International Consultation on Incontinence Questionnaire – Female Lower Urinary Tract Symptoms. Secondary outcome measures included objective urinary symptom severity, assessed using a 1-hour pad test and ICIQ-Bladder Diary, quality of life, evaluated with the International Consultation on Incontinence – Lower Urinary Tract Symptoms Quality of Life Scale (ICIQ-LUTSqol), and subjective perception of improvement, assessed with the Patient Global Impression of Change Scale. Patients were evaluated three times: at week 0 (before routine botox), week 2 (before training/recommendations), and week 12 (after training/recommendations). Both groups showed improvements in urinary symptom severity and quality of life over time (p<0.05). Interaction effects (group x time) on subjective urinary symptom severity, objective urinary symptom severity (pad test), and quality of life were found to be significant in favor of the pelvic physiotherapy group (p<0.05). Bladder training and PFMT after botox improve symptoms and quality of life more than standard recommendations. Bladder training and PFMT should be recommended for OAB patients after botox.