title: Impact of at-home self-rehabilitation of the perineum on pelvic floor function in patients with stress urinary incontinence: Results from a prospective study using three-dimensional ultrasound.
abstract: OBJECTIVE
  Pelvic floor muscle training (PFMT) is the first step of treatment for stress urinary incontinence (SUI). Patients must perform self-retraining exercises of the perineal muscles at home in order to maintain the benefit of the physiotherapy. The aim of this study is to assess the benefit of a perineal electro-stimulator, using three-dimensional ultrasound, during this home-care phase.
  
  
  METHODS
  A longitudinal prospective study was conducted between May 2012 and May 2013. All patients with de novo SUI benefited from PFMT followed by a self-maintenance of perineal rehabilitation at home with the Keat(®) Pro system. The primary endpoint was the biometric of the levator ani and it was assessed by three-dimensional perineal ultrasound at inclusion, after conventional rehabilitation and at the end of the study after self-rehabilitation.
  
  
  RESULTS
  Ten patients were included. All patients (100%) showed a clinical improvement of SUI. The quality of life was significantly improved after PFMT vs. inclusion (P=0.014) and after self-rehabilitation vs. after PFMT (P=0.033). Levator ani muscles were significantly thicker after conventional rehabilitation than at baseline (P=0.004) and significantly thicker after self-rehabilitation than after PFMT (P=0.009).
  
  
  CONCLUSIONS
  Conducting self-rehabilitation in addition to conventional PFMT objectively improves the perineal muscle building achieved after conventional rehabilitation.
authors: Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France; Service de gynécologie-obstétrique, CHU d'Angers, 49933 Angers cedex, France. Electronic address: g_legendre@hotmail.com.
authors: G
authors: G
authors: Legendre
authors: Service de gynécologie-obstétrique, CHU d'Angers, 49933 Angers cedex, France.
authors: A
authors: A
authors: Gonzalves
authors: Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France.
authors: J-M
authors: JM
authors: Levaillant
authors: Cabinet de sage-femmes, 47, avenue Aristide-Briand, 92350 Le Plessis-Robinson, France.
authors: D
authors: D
authors: Fernandez
authors: Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France.
authors: F
authors: F
authors: Fuchs
authors: Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France.
authors: H
authors: H
authors: Fernandez
mesh_terms: D000328:Adult; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods; D005260:Female; D006699:Home Care Services; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D017773:Pelvic Floor / Q000000981:diagnostic imaging / Q000502:physiology; D010502:Perineum / Q000000981:diagnostic imaging / Q000502:physiology; D011788:Quality of Life; D012648:Self Care / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography; D014550:Urinary Incontinence, Stress / Q000000981:diagnostic imaging / Q000534:rehabilitation*
keywords: Auto-réeducation; Incontinence urinaire d’effort; Levator ani; Muscle levator ani; Pelvic floor muscle training; Rééducation périnéale; Self-rehabilitation; Stress urinary incontinence; Three-dimensional ultrasonography; Échographie 3D; Électrostimulation