Efficacy of Yun-type pelvic floor optimal training therapy and PFMT on middle aged women with mild to moderate overactive bladder: a randomized controlled trial

BACKGROUND: The symptoms of overactive bladder (OAB) are highly bothersome to patients. In behavioral therapy, traditional pelvic floor muscle training (PFMT) can be boring and monotonous, which can cause poor compliance. It’s important to establish a new safe and effective crotch-pelvic floor functional reconstruction training method [Yun-type pelvic floor optimal training (Yun-type training)] for OAB patients. METHODS: This randomized, double-blind, crossover trial recruited a total of 150 women with mild to moderate OAB. Patients were randomly assigned to receive Yun-type training (n=83) or PFMT (n=67). The intervention group was first given Yun-type training for 6 weeks, then switched to PFMT for 6 weeks after 2 weeks of elution. Patients in the control group were first treated with PFMT for 6 weeks, and changed to the use of Yun-type training for 6 weeks after 2 weeks of elution. The primary endpoint was overactive bladder symptom scores (OABSS) after 6 and 14 weeks of Yun-type training and PFMT. RESULTS: Yun-type training could significantly improve OABSS compared with PFMT after 6 and 14 weeks (P<0.001). Yun-type training was associated with an improvement in urine, urgency, urge urinary incontinence (UUI), urogenital distress inventory-6 (UDI-6), patient’s perception of bladder condition (PPBC), voiding volume (VV), incontinence impact questionnaire-7 (IIQ-7), female sexual function index (FSFI), sexual desire, arousal, pain, satisfaction, pelvic floor muscle tone, type I muscle strength, type II muscle strength, and sex partner satisfaction as compared with PFMT after 6 and 14 weeks. Moreover, nocturia, maximum flow rate (Q(max)), and climax in the Yun-type training group were significantly improved after 6 weeks, and the average flow rate (Q(ave)) was improved after 14 weeks in the Yun-type training group. CONCLUSIONS: Yun-type training could yield additional benefits on OAB symptoms, sexual function, and sex partner satisfaction as compared with PFMT. The superior sexual function resulting from Yun-type training can be explained by the fact that it can contract deep and superficial muscle layers, resulting in increased vaginal wall pressure and blood flow, which further improves FSFI and sex partner satisfaction. It could lead to a new non-invasive treatment for OAB patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR-INR-17012192.