Objective To evaluate the role of different rehabilitation programs in the treatment of lower urinary tract dysfunction (LUTD) in women with multiple sclerosis (MS).Methods From June 2015 to June 2018, 81 MS female patients in the Second Affiliated Hospital of Xi'an Medical College were selected as the study subjects and divided into three groups according to the random number table method, with 21 cases in each group. Pelvic floor muscle training (PFMT) and electromyography (EMG) biofeedback and virtual neuromuscular stimulation (VNES) were used in group I, PFMT and EMG biofeedback and vaginal VNES were used in group Ⅱ, and PFMT and EMG biofeedback and transcutaneous tibial nerve stimulation (TTNS) were used in group Ⅲ. All patients were treated for 12 weeks. The 24-hour urinary pad test, 3-day bladder diary and urodynamic study were evaluated before and after treatment. The self-recognition of urinary dysfunction and the impact on quality of life were assessed by questionnaires[OABSS, ICIQ-SF].Results Compared with before intervention, 24-hour pad weight, urinary urgency, dysuria, urgent incontinence and residual urine volume decreased significantly, and maximum urine flow increased significantly in three groups after 12 weeks (P<0.05). Compared with before treatment, the number of nocturnal urine and urine in group Ⅱ and group Ⅲ were not significantly reduced, and the difference was statistically significant (P<0.05). Compared with the difference before and after intervention, the reduction level of 24h pad weight, residual urine volume and urgent urinary incontinence and the improvement level of maximum urine flow in group Ⅱ were significantly better than those in other two groups with statistical significance (P<0.05). Compared with before intervention, the OABSS score and ICIQ-SF score of three groups were significantly improved (P<0.05); after intervention, the ICIQ-SF score of three groups changed more significantly (P<0.05), and there was a significant difference between the two groups.Conclusions Vaginal VNES or TTNS combined with PFMT can effectively improve lower urinary tract dysfunction in MS patients. The combination of PFMT and VNES has some advantages in reducing overactive bladder. |