2015 Dec 2;197:103-110. doi: 10.1016/j.ejogrb.2015.11.039.

[Epub ahead of print]

Is a 6-week supervised pelvic floor muscle exercise program

effective in preventing stress urinary incontinencein late
pregnancy in primigravid women?: a randomized controlled trial.
Sangsawang B1, Sangsawang N2.

Author information


 1
Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Srinakharinwirot University,
Nakhonnayok, Thailand. Electronic address: twinnui@hotmail.com.
 2
Department of Obstetrics and Gynecological Nursing, Faculty of Nursing, Srinakharinwirot University,
Nakhonnayok, Thailand.

Abstract
OBJECTIVE:
The study investigated the effect of a 6-week supervised pelvic floor muscle exercise (PFME) program to
prevent stress urinary incontinence (SUI) at 38 weeks' gestation.
STUDY DESIGN:
We conducted a randomized controlled trial into two arms design: one intervention group and one control
group, using the randomly computer-generated numbers. A research assistant, who was not involved with
care of the participants, randomly drawn up and opened the envelope for each participant to allocate into
the intervention group and the control group. The investigators could not be blinded to allocation. Seventy
primigravid women who had continent with gestational ages of 20-30 weeks were randomly assigned to
participate in the intervention (n=35) and control groups (n=35). The intervention was a supervised 6-
week PFME program with verbal instruction and a handbook, three training sessions of 45min with the
main researcher (at 1st, 3rd and 5th week of the program) and self-daily training at home for an overall
period of 6 weeks. The control condition was the PFME and the stop test had been trained by the main
researcher to all of the participants in the intervention group.
OUTCOMES:
The primary outcome was self-reported of SUI, and the secondary outcome was the severity of SUI in
pregnant women which comprises of frequency, volume of urine leakage and score of perceived severity
of SUI in late pregnancy at 38th weeks of pregnancy. Statistical analysis was performed using Chi-square
test, Independent-sample t-test, and Mann-Whitney U-test. Significance P-value was <0.05.
RESULTS:
At the end of the intervention, 2 of 35 women in the intervention group and 5 of 35 women in the control
group dropped out of the study. Therefore, the total of the study participants consisted of 63 pregnant
women (33 in the intervention group and 30 in the control group). Fewer women in the intervention group
reported SUI than the control group: 9 of 33 (27.3%) versus 16 of 30 (53.3%) at 38 weeks' gestational
age (OR 3.05, 95% CI 1.07-8.70, P=0.018).
CONCLUSIONS:
The 6-week supervised PFME program was effective in preventing SUI and decreasing the SUI severity
in pregnant women who reported SUI at late pregnancy. The women who performed PFME program
under the training sessions once every two weeks found that the program demands less time, incurs
lower costs and possibly offers more motivation to exercise. This 6-week supervised PFME program may
be suitable in real clinical situation.

2015 Nov 21. pii: S0210-4806(15)00240-5. doi: 10.1016/j.acuro.2015.09.001. [Epub ahead of print]

Effectiveness of pelvic floor muscle training in

treating urinary incontinence in women: A current review.
[Article in English, Spanish]

García-Sánchez E1, Rubio-Arias JA2, Ávila-Gandía V3, Ramos-Campo DJ2, López-Román J4.

Author information
Abstract
OBJECTIVE:
To analyse the content of various published studies related to physical exercise and its effects
on urinary incontinence and to determine the effectiveness of pelvic floor training programmes.
METHOD:
We conducted a search in the databases of PubMed, CINAHL, the Cochrane Plus Library, The Cochrane
Library, WOS and SPORTDiscus and a manual search in the Google Scholar metasearcher using the
search descriptors for documents published in the last 10 years in Spanish or English. The documents
needed to have an abstract or complete text on the treatment of urinary incontinence in female athletes
and in women in general.
RESULTS:
We selected 3 full-text articles on treating urinary incontinence in female athletes and 6 full-text articles
and 1 abstract on treating urinaryincontinence in women in general. The 9 studies included in the review
achieved positive results, i.e., there was improvement in the disease in all of the studies.
CONCLUSIONS:
Physical exercise, specifically pelvic floor muscle training programmes, has positive effects
on urinary incontinence. This type of training has been shown to be an effective programme for
treating urinary incontinence, especially stress urinary incontinence.
Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

2015 Nov 21. [Epub ahead of print]

Pelvic floor muscle training for female urinary incontinence:

Does it work?
Singh N1, Rashid M2, Bayliss L3, Graham P4.

Author information
Abstract
PURPOSE:
Supervised pelvic floor muscle training in patients of stress and mixed urinary incontinence has been
recommended. Our aim was to assess the utilisation and effectiveness of our supervised pelvic
floor muscle training service and assess the impact of incontinence scores before physiotherapy on the
subsequent results of physiotherapy.
METHODS:
All 271 patients referred to physiotherapy for symptoms of incontinence filled out the International
Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms before
starting treatment. Depending on pelvic floor muscle assessment, plans for exercises and follow up were
made. If the strength of pelvic floor muscles was poor, electrical stimulation was offered. If awareness of
the pelvic floor muscle contraction was poor, bio feedback was offered. Group sessions and vaginal
cones were also used. Depending on the response to the treatment; patients were either discharged,
referred to Urogynaecology clinic or continued physiotherapy. All patients who were discharged or
referred for surgery were given a post treatment questionnaire to fill out.
RESULTS:
79 (56 %) of 132 women with stress, 49 (51 %) of 98 with mixed and 27 (66 %) of 41 with
urge incontinence reported successful control of symptoms (overall success 54 %). However, 65 % of
women with incontinence scores of 0-5 before physiotherapy, 64 % with 6-10, 42 % with 11-15 and mere
28 % with 16-20 achieved success with physiotherapy. 27 (10 %) were lost to follow up.
CONCLUSION:
1 in 2 women referred to physiotherapy for incontinence, achieved successful control of symptoms
without the need for invasive investigations or surgery. However, poor incontinence scores before the
start of physiotherapy is a poor prognostic indicator for success. 90 % women utilised the service.

2015 Sep 23. doi: 10.1002/nau.22888. [Epub ahead of print]

Pelvic floor muscle training for female stress urinary

incontinence: Five years outcomes.
Beyar N1, Groutz A2.

Author information
Abstract
AIM:
To evaluate the clinical status, lower urinary tract symptoms (LUTS) and quality of life (QOL) 5 years after
completion of a pelvic floor muscle training (PFMT) program for female stress urinary incontinence (SUI).
METHODS:
Two hundred and eight consecutive women who underwent a guided PFMT program as first-line
management of SUI were invited to participate in a questionnaire-based outcome study 5 years after
treatment. Primary outcome measures comprised of adherence to PFMT, interim surgery for SUI, and
patients' self-assessment of LUTS and QOL.
RESULTS:
One hundred and thirty-two (63%) women completed all questionnaires, 55 of whom (41.7%, mean age
52.1 ± 10.8) reported adherence to PFMT, 75 (56.8%, mean age 49.8 ± 10.8) discontinued training, and
two (1.5%) underwent surgery. Further analysis of the 76 non-responders revealed six more patients who
underwent surgery. Thus, overall, eight patients (3.8% of the original cohort) underwent surgery within 5
years after completion of the training program. Except for those who underwent surgery, almost all
women reported SUI, however their ICIQ-UI scores for frequency and amount of leakage were low
(2.2 ± 0.9, 1.18 ± 1.04, respectively) and I-QOL score was high (96.2 ± 13.6). All investigated parameters
and domains, in each of the three questionnaires and among all women, consistently demonstrated low
severity of LUTS and relatively high continence-associated QOL. There were no statistically significant
differences in favor of adherence to PFMT.
CONCLUSIONS:
Although relatively high rates of 5-year adherence to training were demonstrated among our patients, this
adherence was not associated with superior treatment outcomes. Further studies are needed to establish
the long-term efficacy of PFMT for SUI. Neurourol. Urodynam. © 2015 Wiley Periodicals, Inc.
© 2015 Wiley Periodicals, Inc.