Enhanced postpartum pelvic floor rehabilitation with triple therapy: Effects of acupuncture, biofeedback electrical stimulation, and pelvic floor muscle training on urinary incontinence and sexual function.

OBJECTIVE: This study compared the efficacy of three combined treatment regimens (biofeedback electrical stimulation [BES] combined with pelvic floor muscle training [PFMT], acupuncture combined with PFMT, and a triple therapy regimen of acupuncture, BES, and PFMT) in addressing urinary incontinence (UI) and sexual dysfunction in patients with postpartum pelvic floor dysfunction (PFD), with the aim of exploring the clinical advantages of the triple therapy regimen. METHODS: This study was designed as a randomized controlled trial, with blinding applied to both the evaluators and the data analysts. A total of 203 postpartum women with PFD were enrolled and randomly assigned to Group A (BES+ PFMT, n = 65), Group B (acupuncture + PFMT, n = 68), and Group C (acupuncture + BES + PFMT, n = 64). Pelvic floor EMG, muscle strength, MUCP, and MFR were measured at baseline and 6 months post-treatment. Leakage volume was assessed by 1-hour pad test. UI was evaluated using ICI-Q-SF and IIQ-7, and sexual function using FSFI and PISQ-31. Adverse events were recorded throughout treatment. RESULTS: All groups showed significant improvement in EMG, muscle strength, MUCP, MFR, FSFI, and PISQ-31 scores, alongside reductions in leakage volume, ICI-Q-SF, and IIQ-7 scores. Improvements were most significant in Group C. No significant difference was found between Groups A and B after treatment. Adverse event rates did not differ significantly among groups. CONCLUSION: Compared to dual-therapy approaches, triple-therapy (acupuncture + BES + PFMT) enhances postpartum pelvic floor rehabilitation, effectively improving UI and sexual function in patients with PFD.