[Effect of conservative treatment in the management of low-degree urogenital prolapse].
OBJECTIVE
The objective of our study was to determine the respective effects of conservative treatment (pelvic muscle exercises plus advice on healthy living) and the absence of treatment in the management of urogenital prolapse.


METHODS
Forty-seven women (mean+/-S.D. age: 53.42+/-11.01 years) consulting for genital prolapse (grade I or II cystocele) were randomized into two groups: a conservative treatment group (CTG) and a nontreated group (NTG). The patients' outcomes were rated according to several parameters; a clinical examination, the "Measurement of Urinary Handicap" (MUH) scale, urodynamic tests, the Ditrovie quality of life scale and patient satisfaction on a visual analogue scale (VAS).


RESULTS
The immediate post-treatment results showed that pelvic heaviness persisted in only five patients (18.51%) in the CTG compared with fourteen (70%) in the NTG (p<0.001). Furthermore, a significant improvement in the MUH scale score was noted in the CTG compared with the NTG. The Ditrovie score also improved. The maximum urethral closure pressure (MUCP) ranged from 54.4+/-13.23 to 57.81+/-12.8 cm H(2)O in the CTG versus 54.05+/-12.18 to 52.95+/-12.18 cm H(2)O in the NTG. Uroflowmetry revealed a significant improvement in the maximum flow rate. These benefits were maintained two years after cessation of the conservative treatment in 20 of the CTG patients.


CONCLUSIONS
Conservative treatment can be effective in the treatment of low-degree urogenital prolapse and enables the improvement of clinical symptoms and urodynamic parameters. The benefits were maintained two years after treatment cessation.
Ghroubi
S
S
Service de médecine physique, rééducation et réadaptation fonctionnelle, CHU Habib Bourguiba, université du Sud, 3029 Sfax, Tunisie. habib.eleuch@rns.fr
Kharrat
O
O
Chaari
M
M
Ben Ayed
B
B
Guermazi
M
M
Elleuch
M H
MH
D000328:Adult; D052858:Cystocele / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010298:Parity; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000502:physiology; D010502:Perineum / Q000502:physiology; D026741:Physical Therapy Modalities; D011247:Pregnancy; D011446:Prospective Studies; D011788:Quality of Life; D020047:Rectocele / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014555:Urination Disorders / Q000209:etiology; D014563:Urodynamics