不同年龄女性中盆底肌高强度聚焦电磁刺激与射频治疗性功能障碍的疗效比较评价
- 作者: Zhumanova E.N.1, Kolgaeva D.I.1, Korchazhkina N.B.2, Koneva E.S.1,3
-
隶属关系:
- Center of gynecology, oncology, reproductive and aesthetic medicine, Clinical Hospital “MEDSI”
- Russian Scientific Center of Surgery named after academician B.V. Petrovsky
- Sechenov First Moscow State Medical University
- 期: 卷 24, 编号 6 (2025)
- 页面: 445-460
- 栏目: Original studies
- URL: https://journals.rcsi.science/1681-3456/article/view/364043
- DOI: https://doi.org/10.17816/rjpbr690257
- EDN: https://elibrary.ru/VYTBXF
- ID: 364043
如何引用文章
详细
论证。女性性功能障碍会显著影响患者的生活质量。其发生具有多因素特征,包括年龄、生理及心理方面的因素。
目的。评估非药物治疗在不同年龄段女性性功能障碍中的应用效果。
方法。本前瞻性观察研究共纳入90例≥18岁、主诉性功能障碍的女性患者。受试者按年龄分为三组:生育年龄组(21–46岁)、围绝经期组(47–53岁)与绝经后组(54–72岁),各组人数相同。在每个年龄组中,患者均接受非药物治疗,包括:盆底肌高强度聚焦电磁刺激(high-intensity focused electromagnetic, HIFEM-疗法),使用BTL Emsella设备(BTL,英国);射频治疗,使用BTL EXILIS设备(BTL,英国);或上述两种方法的联合干预。收集病史、临床及仪器检查数据,并于治疗前、治疗后1个月与3个月采用女性性功能指数(Female Sexual Function Index, FSFI)及女性性生活质量量表(Sexual Quality of Life-Female, SQOL-F)进行评估。
结果。所有受试女性均出现性功能改善。HIFEM治疗在生育年龄组疗效最显著。射频治疗对围绝经期及绝经后女性效果更佳。联合方案的效果优于任一单一治疗方式。治疗后1个月FSFI>26.55分者:生育年龄组18例(60%)、围绝经期组12例(40%)、绝经后组5例(17%), 差异具有统计学意义,p=0.003。治疗后3个月SQOL-F>65分者:生育年龄组28例(93%)、围绝经期组15例(50%)、绝经后组12例(40%),p=0.0001。预测良好结局的因素包括:年龄<57岁,治疗1个月FSFI>13.5分,会阴测压1个月>10.5 mmHg、3个月>12.5 mmHg。
结论。HIFEM治疗对女性性功能具有积极影响,且疗效可维持3个月。该治疗方案尤其适用于生育年龄患者。射频治疗对围绝经期与绝经后患者最为有效。联合方案的效果优于任一单一治疗方式。疗效判定标准可包括:年龄<57岁,以及治疗1个月后FSFI评分≥13.5分。
作者简介
Ekaterina N. Zhumanova
Center of gynecology, oncology, reproductive and aesthetic medicine, Clinical Hospital “MEDSI”
编辑信件的主要联系方式.
Email: ekaterinazhumanova@yandex.ru
ORCID iD: 0000-0003-3016-4172
SPIN 代码: 3437-7865
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, OtradnoeDagmara I. Kolgaeva
Center of gynecology, oncology, reproductive and aesthetic medicine, Clinical Hospital “MEDSI”
Email: dagmusya@mail.ru
ORCID iD: 0000-0001-5068-5325
SPIN 代码: 3915-1427
MD, Cand. Sci. (Medicine)
俄罗斯联邦, OtradnoeNatalia B. Korchazhkina
Russian Scientific Center of Surgery named after academician B.V. Petrovsky
Email: n9867678103@gmail.com
ORCID iD: 0000-0001-6913-8778
SPIN 代码: 9733-7646
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, MoscowElisaveta S. Koneva
Center of gynecology, oncology, reproductive and aesthetic medicine, Clinical Hospital “MEDSI”; Sechenov First Moscow State Medical University
Email: elizaveta.coneva@yandex.ru
ORCID iD: 0000-0002-9859-194X
SPIN 代码: 8200-2155
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, Otradnoe; Moscow参考
- Pushkar DYu, Gumin LM. Pelvic Disorders in Women. Moscow; 2006. 256 p. (In Russ.)
- Azar M, Sima Noohi S, Radfar S. Sexual function in women after surgery for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(1):53–7. doi: 10.1007/s00192-007-0399-4
- WHOQOL Group. The world health organization quality of life assessment (WHOQOL): position paper from the world health organization. Soc Sci Med. 1995;41(10):1403–9. doi: 10.1016/0277-9536(95)00112-k
- McCabe MP, Sharlip ID, Atalla E, et al. Definitions of sexual dysfunctions in women and men: a consensus statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med. 2016;13(2):135–43. doi: 10.1016/j.jsxm.2015.12.019
- Pereverzev AS. Sexual Function Disorders in Women with Urological Diseases. Medical Aspects of Women's Health. 2009;(5):22–25. (In Russ.)
- Zhumanova EN, Muravlev AI, Savelyeva YaS, et al. Assessment of sexual function in women of different age groups after a course of bos-therapy in the early postoperative period of surgical treatment of rectocele. Physiotherapist. 2018;(4):64–68. EDN: XZDICL
- Kuzmin IV, Ignashov YuA, Slesarevskaya MN, Al-Shukri SKh. Assessment of sexual function in women with primary painful bladder syndrome. Experimental and Clinical Urology. 2021;14(3):164–169. doi: 10.29188/2222-8543-2021-14-3-164-169 EDN: JFQHLA
- Silantyeva E, Zarkovic D, Astafeva E, et al. A Comparative Study on the Effects of High-Intensity Focused Electromagnetic Technology and Electrostimulation for the Treatment of Pelvic Floor Muscles and Urinary Incontinence in Parous Women: Analysis of Posttreatment Data. Female Pelvic Med Reconstr Surg. 2021;27(4):269–273. doi: 10.1097/SPV.0000000000000807
- Arab M, Vasef M, Talayeh M, et al. The Effect of Radiofrequency Therapy on Sexual Function in Female Cancer Survivors (Gynecologic and Breast) and Non-cancer Menopausal Women: A Single-Arm Trial. J Lasers Med Sci. 2023;14:e32. doi: 10.34172/jlms.2023.32
- Stenyaeva NN, Khritinin DF, Chausov AA, Sukhikh GT. Prevalence and structure of sexual dysfunctions in women visiting a gynecological clinic. Akusherstvo i ginekologija. 2017;(3):101–7. doi: 10.18565/aig.2017.3.101-7 EDN: YHSRET
- Hevesi K, Mészáros V, Kövi Z, et al. Different Characteristics of the Female Sexual Function Index in a Sample of Sexually Active and Inactive Women. J Sex Med. 2017;14(9):1133–1141. doi: 10.1016/j.jsxm.2017.07.008
- Meston CM, Freihart BK, Handy AB, et al. Scoring and Interpretation of the FSFI: What can be Learned From 20 Years of use? J Sex Med. 2020;17(1):17–25. doi: 10.1016/j.jsxm.2019.10.007
- Symonds T, Boolell M, Quirk F. Development of a questionnaire on sexual quality of life in women. J Sex Marital Ther. 2005;31(5):385–397. doi: 10.1080/00926230591006502
- Jarząbek-Bielecka G, Plagens-Rotman K, Mizgier M, et al. The importance of use of the FSFI questionnaire in gynecology and venerology: a pilot study. Postepy Dermatol Alergol. 2021;38(3):480–485. doi: 10.5114/ada.2021.107934
- Stachowicz AM, Hoover ML, Karram MM. Clinical utility of radiofrequency energy for female genitourinary dysfunction: past, present, and future. Int Urogynecol J. 2021;32(6):1345–1350. doi: 10.1007/s00192-021-04735-9
- Golbasi Z, Erenel AS. The quality of sexual life in women with gynaecological cancers. Arch Gynecol Obstet. 2012;285(6):1713–1717. doi: 10.1007/s00404-011-2210-5
- Janik MR, Bielecka I, Kwiatkowski A, et al. Cross-sectional study of male sexual function in bariatric patients. Wideochir Inne Tech Maloinwazyjne. 2016;11(3):171–177. doi: 10.5114/wiitm.2016.62135
- Wang N, Li H. Therapeutic effect of the temperature-controlled radio frequency technology in female sexual dysfunction. Ginekol Pol. 2023. doi: 10.5603/gpl.94788
- Sarmento ACA, Fernandes FS, Maia RR, et al. Microablative fractional radiofrequency for sexual dysfunction and vaginal Trophism: A randomized clinical trial. Clinics (Sao Paulo). 2023;78:100293. doi: 10.1016/j.clinsp.2023.100293
- Yaylali GF, Tekekoglu S, Akin F. Sexual dysfunction in obese and overweight women. Int J Impot Res. 2010;22(4):220–6. doi: 10.1038/ijir.2010.7
- Elgayar SL. Combined effects of high-intensity focused electromagnetic therapy and pelvic floor exercises on pelvic floor muscles and sexual function in postmenopausal women. Obstet Gynecol Sci. 2024;67(6):574–585. doi: 10.5468/ogs.24103
- Evans K. HIFEM procedure for Treatment of Urinary Incontinence Accompanied with Female Sexual Dysfunction: 1-year Follow-up Data. The Journal of Sexual Medicine. 2022;19(Suppl_3):S34. doi: 10.1016/j.jsxm.2022.05.118
- Certificate of state registration of database No. 2024626138 RU. Database of scientific studies on the application of valid methods and protocols for pre-clinical diagnostics of age-associated diseases for monitoring individual health: No. 2024625794: declared 04.12.2024: published 18.12.2024. Kotenko KV, Korchazhkina NB, Mikhailova AA, et al.; applicant Federal State Budgetary Scientific Institution "Russian Scientific Center of Surgery named after Academician B.V. Petrovsky". (In Russ.) EDN: VZKYCT
- Kotenko KV, Korchazhkina NB, Mikhailova AA, et al. Predictors of premature aging and the effectiveness of combined physiotherapy. Issues of balneology, physiotherapy and therapeutic physical culture. 2024;101(6–2):50–59. doi: 10.17116/kurort202410106250 EDN: HQWNYV
- Korchazhkina NB, Mikhailova AA, Kotenko KV, et al. Systemic mechanisms of premature aging and their correction by the use of complex physiotherapy. Issues of balneology, physiotherapy and therapeutic physical culture. 2024;101(6–2):60–70. doi: 10.17116/kurort202410106260 EDN: NUVVIR
- Mikhailova AA, Kotenko KV, Nagornev SN, et al. Identification of prognostically significant markers for early diagnosis of obesity and metabolic disorders. Issues of balneology, physiotherapy and therapeutic physical culture. 2024;101(6–2):71–79. doi: 10.17116/kurort202410106271 EDN: XZNYYG
- Kotenko KV, Nagornev SN, Mikhailova AA, et al. Efficiency of using preventive and personalized technologies for obesity correction. Issues of balneology, physiotherapy and therapeutic physical culture. 2024;101(6–2):80-90. doi: 10.17116/kurort202410106280 EDN: JXJBYE
- Tkhakushinov IA, Lysenkov SP, Korchazhkina NB, et al. Gender and age features of autophagy in men and women under the conditions of a comprehensive health program: a prospective observational study. Kuban Scientific Medical Bulletin. 2024;31(2):95–106. doi: 10.25207/1608-6228-2024-31-2-95-106 EDN: CHMRAK
- Pogonchenkova IV, Khan MA, Korchazhkina NB, et al. Physical factors in the medical rehabilitation of children with neurogenic bladder dysfunction. Issues of balneology, physiotherapy and therapeutic physical culture. 2017;94(6):53–58. doi: 10.17116/kurort201794653-58 EDN: YMOYAK
- Karpukhin IV, Li AA, Korchazhkina NB, Kiyatkin VA. Physical factors in the treatment of patients with chronic bacterial prostatitis. Issues of Balneology, Physiotherapy, and Therapeutic Physical Culture. 2011;(1):39–43. EDN: NDHJPH
- Markosyan TG, Korchazhkina NB, Nikitin SS, Bodrov AV. Training of perineal muscles in the rehabilitation treatment of patients with chronic prostatitis with latent neurogenic disorders of urination. Sports Medicine: Science and Practice. 2013;(2):36–40. EDN: RTOAHH
- Korchazhkina NB, Mikhailova AA, Reshetova IV, et al. Modern approaches to the development of a system of valid methods for monitoring individual health and maintaining active longevity. Issues of Balneology, Physiotherapy, and Therapeutic Physical Culture. 2023;100(6):6–13. doi: 10.17116/kurort20231000616 EDN: EVOLOQ
- Korchazhkina NB, Markosyan TG, Nikitin SS. Modern Diagnostics, Restorative Treatment, and Rehabilitation of Patients with Neurogenic Disorders of Urination and Erection. Bulletin of Restorative Medicine. 2012;(1):30–36. EDN: OZEKPB
补充文件
