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Corrélation entre l’activité électromyographique du plancher pelvien à la toux et les symptômes d’incontinence urinaire à l’effort

Correlation between pelvic floor muscle activity during coughing and symptoms of stress urinary incontinence

  • Article Original / Original Article
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Pelvi-périnéologie

Résumé

Objectif

L’objectif de cette étude est d’étudier s’il existe une corrélation entre la modulation de la réponse musculaire périnéale lors de la toux et différents questionnaires de symptômes et de qualité de vie relatifs à l’incontinence urinaire à l’effort.

Matériel et méthode

La population d’étude était constituée de 20 femmes présentant une incontinence urinaire à l’effort et de six femmes continentes. Après avoir été informées et avoir signé un consentement écrit, elles ont rempli les questionnaires de symptômes et de qualité de vie suivants: une version traduite du bristol female LUTS questionnaire (BFLUTS), incontinence impact questionnaire (IIQ) et urogenital distress inventory (UDI), l’échelle de mesure du handicap urinaire (MHU), et le ICIQ-SF (international consultation on incontinence questionnaire short form). Nous avons enregistré de façon concomitante la pression intravésicale et l’activité e’lectromyographique du sphincter anal externe lors d’efforts de toux d’intensité croissante.

Résultat

Il ne semblait pas exister de corrélation entre la valeur de la PCUM (p = 0,91) et la modulation de la réponse réflexe périnéale. II existait une corrélation dans le même sens entre la modulation de la réponse réflexe périnéale et la fréquence des fuites à l’effort (ICIQ-SF q#1 et score total, BFLUTS q#6 et q#7; p = 0,015, 0,048, 0,033 et 0,013 respectivement). Plus la réponse traduisait une sévérité ou une fréquence importante des fuites, plus la modulation s’altérait (affaissement de la sigmoïde). En revanche, on n’a pas observé de corrélation entre les questions portant sur l’impact général des symptômes sur la qualité de vie et la modulation de la réponse réflexe périnéale (BFLUTS q#31 et q#33, p = 0,39 et 0,72 respectivement).

Conclusion

Cette étude montre qu’il existe une bonne corrélation entre l’existence d’une anomalie de la modulation de la réponse réflexe périnéale et les symptômes d’incontinence urinaire à l’effort évalués par des questionnaires spécifiques.

Abstract

Objectives

To assess the association between the modulations of pelvic contraction during increased coughing and the responses to questionnaires related to stress urinary incontinence (SUI).

Methods

Informed consent was obtained from 20 women presenting with SUI and 6 healthy women. They all completed the following questionnaires: the BFLUTS (Bristol Female Lower Urinary Tract Symptoms) questionnaire, the 6-item, short-form Urogenital Distress Inventory (UDI), the ICIQ-SF (International Consultation on Incontinence Questionnaire Short Form), the Incontinence Impact Questionnaire (IIQ) and the urinary handicap scale (MHU). Bladder pressure (BP) and external anal sphincter electromyographic activity (EAS EMGi) were recorded simultaneously during increased coughing.

Results

There was no correlation between maximum urethral closure pressure (MUCP) and the modulation of pelvic contraction during increased coughing (P = 0.91). The responses to the BFLUTS and ICIQ-SF questionnaires correlated closely with the modulation of pelvic contractions during increased coughing (ICIQ-SF q#1 and total score, BFLUTS q#6 and q#7; P = 0.015, 0.048, 0.033 and 0.013, respectively). The more severe the SUI (based on questionnaire responses), the more the modulation of pelvic contraction during increased coughing was altered. However, there was no correlation between the impact of urinary incontinence on quality of life and the presence or absence of an altered modulation of pelvic contraction during increased coughing (BFLUTS q#31 and q#33; P = 0.39 and 0.72, respectively).

Conclusions

As SUI increases in severity; the modulation of pelvic contraction during increased coughing becomes altered.

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Authors and Affiliations

  1. UMR-S 731, université Pierre-et-Marie-Curie-Paris-VI, F-75005, Paris, France

    X. Deffieux, K. Hubeaux & G. Amarenco

  2. Inserm U731, F-75651, Paris, France

    X. Deffieux, K. Hubeaux & G. Amarenco

  3. Service de rééducation neurologique et d’explorations périnéales, hôpital Rothschild, F-75012, Paris, France

    X. Deffieux, K. Hubeaux, S. Sheikh Ismael, P. Raibaut & G. Amarenco

  4. AP-HP, service de gynécologie-obstétrique et médecine de la reproduction, hôpital Antoine-Béclère, Clamart, F-92141, France

    X. Deffieux

  5. Département de biostatistiques et d’informatique médicale, hôpital Saint-Louis, F-75010, Paris, France

    R. Porcher

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  1. X. Deffieux
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  2. K. Hubeaux
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  3. R. Porcher
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  4. S. Sheikh Ismael
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  5. P. Raibaut
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  6. G. Amarenco
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Correspondence to X. Deffieux.

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Deffieux, X., Hubeaux, K., Porcher, R. et al. Corrélation entre l’activité électromyographique du plancher pelvien à la toux et les symptômes d’incontinence urinaire à l’effort. Pelv Perineol 2, 221–226 (2007). https://doi.org/10.1007/s11608-007-0147-8

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  • DOI: https://doi.org/10.1007/s11608-007-0147-8

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