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The treatment of women with SUI through techniques that aim to strengthen this musculature, with the exception of patients with genital prolapse, must be recommended before indicating any surgical procedure 9. KEGEL4 compared the results obtained through recommended exercises and the results after surgery, in 50 patients with SUI. The authors noted that despite the better results observed in patients that were submitted to surgery, this procedure was avoided in 42% of the women that did the exercises. Besides this, the patients that used this technique to strengthen the musculature of the pelvic floor, previous to surgery, presented better results in the post-operative.
PEATTIE 9 reported a study where 30 patients used a vaginal cone in the passive phase and then, exercises recommended by KEGEL4, each phase lasting one month. At the end of the use of the vaginal cones, they observed 70% of cure or improvement of urinary loss. The authors did not obtain a clinical improvement in the second phase. The patients that worsened in the clinical picture probably did not do the exercises of the pelvic floor musculature adequately.
In our study we observed a diminished intensity of urinary loss referred by the patient, also in the active phase, raising the percentage of cured patients from 9,5%, at the end of the passive phase, to 57,1% at the end of the treatment. Probably this occurred due to the use of the cone, which made possible an adequate contraction of the pelvic floor muscles.
We believe that this is an important method for the patient to learn to contract the adequate musculature, diminishing the simultaneous use of other muscles. This way, it makes it easier to maintain improvement of the contractile activity of the musculature, because the patients must introduce these exercises in their daily routine, so the effect may be maintained after ending the therapeutic 2.
The only patient that did not show any improvement presented a functional evaluation of the pelvic floor equal to zero 2. She was submitted to surgical treatment, having a biopsy of the pubococcigeus muscle, this histomorphologic study showed an important degeneration of the muscular fibers 2 .
The parity, weight and the index of corporeal mass did not interfere with our results.
Collateral effects with the use of the vaginal cones were shown in 10% of the cases2 . The patients said they felt pain in their vagina and increase in vaginal flux, but treatment was not necessary or any therapeutic interruption. In our study there was no collateral effect.
So, the treatment of women with SUI through vaginal cones in the passive and active phase is effective and should be considered as an excellent therapeutical alternative.