关键词: 夜尿症, 电子生物反馈治疗, 盆底脉冲磁刺激, 倾向评分匹配

Abstract:

Objective To investigate the efficacy of combined electromyographic biofeedback and pelvic floor pulsed magnetic stimulation in elderly women with nocturia and to evaluate its impact on sleep quality. Methods A retrospective study was conducted involving 328 elderly women with nocturia who received treatment in the First Affiliated Hospital of Xi′an Medical University between January 2021 and February 2026. According to the treatment modality， patients were assigned to either the intervention group （combined electromyographic biofeedback and pelvic floor pulsed magnetic stimulation） or the control group （conventional behavioral intervention combined with pelvic floor muscle training）. Propensity score matching （PSM） was performed to balance baseline characteristics between the two groups. Changes in nocturnal voiding frequency， the Pittsburgh Sleep Quality Index （PSQI）， the Overactive Bladder Symptom Score （OABSS）， and pelvic floor functional parameters were compared before and after treatment. Multivariable logistic regression analysis was performed to identify factors associated with treatment efficacy in patients with nocturia. Results After propensity score matching， 86 patients were included in the final analysis. No significant differences were observed between the two groups regarding age， body mass index （BMI）， years since menopause， duration of nocturia， comorbidities， nocturnal voiding frequency， PSQI score， OABSS score， or pelvic floor functional parameters at baseline （all P > 0.05）. Following treatment， both groups showed significant improvements in nocturnal voiding frequency， PSQI score， and OABSS score compared with baseline （all P < 0.05）. Compared with the control group， the intervention group demonstrated significantly greater reductions in nocturnal voiding frequency and PSQI score， as well as significantly better pelvic floor functional outcomes （all P < 0.05）. Multivariable logistic regression analysis identified combined electromyographic biofeedback and pelvic floor pulsed magnetic stimulation as an independent factor associated with favorable clinical efficacy in patients with nocturia （OR = 7.245， 95%CI： 1.785 - 29.404， P = 0.006）. Conclusions Combined electromyographic biofeedback and pelvic floor pulsed magnetic stimulation effectively reduced nocturnal voiding frequency， nocturnal urine volume， the number of nocturnal awakenings， PSQI scores， and OABSS scores in elderly women with nocturia， thereby alleviating clinical symptoms and improving sleep quality. As a non-invasive， repeatable， and comprehensive rehabilitation approach， this combined therapy represents a promising treatment option for elderly women with nocturia.

Key words: nocturia, electromyographic biofeedback, pelvic floor pulsed magnetic stimulation, propensity score matching