En la Incontinencia Urinaria tratada en Rehabilitación hay mejoría clínica y descenso de valores electromiográficos con la edad

Introduction. The pelvic floor (SP) is formed by a set of muscular structures, which together with the  fascias and ligaments make up the pelvic diaphragm. The function of the SP is the support of the pelvic  organs and maintain a correct position of these, influencing urination, intercourse, childbirth and  defecation. A weakness or injury of these structures predisposes to the appearance of a  symptomatology that can occur in isolation or in combination, one of the main problems being UI  urinary incontinence and pelvic organ prolapse POP(1). It is estimated a prevalence of UI in adults  between 15 and 30%, presenting in all ages, detecting a progressive increase as age advances and POP  in 50% of women who have had at least one vaginal delivery.(2-4) Objectives. Evaluate both clinically and electromyographically a group of women diagnosed with UI and / or POP, after performing a rehabilitative treatment and one year of follow-up.  Material and methods. This is a longitudinal, analytical observational study of a prospective cohort  type, where women aged between 18 and 85 years were evaluated in a period of time between January  2008 and January 2012. The variables used In the present study, they differed in clinical and  electromyographic variables. For the evaluation of the MSP an intravaginal surface EMG was performed,  which consisted in a quantitative muscular diagnostic evaluation and in which some known muscle  parameters were obtained. A rehabilitation treatment protocol was designed, following the guidelines  established according to scientific evidence. Results. In the present study a total of 241 women were included, whose average age was 50.4 years  (SD = 12.3), the mean BMI was 27.7 kg / m2, the average duration of symptoms was 6.9 years (SD =  8.9). 88% of women consulted by IU and 29% by POP. The most frequent diagnosis was that of IUM in  118 women (49.0%), followed by SUI in 65 women (27.0%). 49.4% were menopausal, 85.1% had  vaginal delivery, only 2.9% were nulliparous. The mean number of deliveries was 2.4 (SD = 1.1) and in  89% of the cases they suffered episiotomy. 92.1% of the women in the sample had urine leaks, 96.4%  of them related to the effort. Of the total sample, 189 patients (78.4%) performed treatment in the SP  Unit. The average number of sessions was 14.2 (SD = 7.8). At the end of the rehabilitation treatment,  92.3% of the patients reported finding themselves better, 42% of the women presented voiding  urgencies, and 47.6% suffered from UUI. The analysis of repeated measures of the electromyographic  variables before and after the rehabilitation treatment and during the year of follow-up, statistically  significant increases were observed in the maximum values of the phasic contractions, the average  values of the tonic contractions, the duration of the tonic contraction selected and the total power of the ttonic contraction. When the means of the maximum values of the phasic contractions were compared,  the maximum values of the tonic contractions and the average values of the tonic contractions with the  degrees of the modified Oxford scale obtained statistically significant results. Conclusions. The rehabilitation treatment has achieved an improvement perceived by the patients in  92% of them after finishing the treatment and an improvement in 75% at one year of follow-up. There  is a decrease in the maximum values recorded in the EMG by age, decade by decade, experiencing a  significant drop in the group of women ≥70 years.