Pelvic Floor Exercise for Urinary Incontinence: A Systematic Literature Review

Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford, UK.
Maturitas (Impact Factor: 2.94). 12/2010; 67(4):309-15. DOI: 10.1016/j.maturitas.2010.08.004
Source: PubMed


Urinary incontinence is a common problem among adults and conservative management is recommended as the first-line treatment. Physical therapies, particularly pelvic floor muscle exercise, are the mainstay of such conservative management. The purpose of this review is to summarise current literature and describe trends in the use of pelvic floor muscle exercise in the management of urinary incontinence in women. Our review confirms that pelvic floor muscle exercise is particularly beneficial in the treatment of urinary stress incontinence in females. Studies have shown up to 70% improvement in symptoms of stress incontinence following appropriately performed pelvic floor exercise. This improvement is evident across all age groups. There is evidence that women perform better with exercise regimes supervised by specialist physiotherapists or continence nurses, as opposed to unsupervised or leaflet-based care. There is evidence for the widespread recommendation that pelvic floor muscle exercise helps women with all types of urinary incontinence. However, the treatment is most beneficial in women with stress urinary incontinence alone, and who participate in a supervised pelvic floor muscle training programme for at least three months.

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Available from: Natalia Price, Dec 30, 2013
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    • "Both unsupervised and supervised PFMT produced similar results. [39] In agreement with the findings of Price et al. [40] and Dumoulin and Hay-Smith, [35] the current study results revealed that after 3 months 34.3% of women in the intervention group had become continent. In this context, Pires [41] and Burgio et al. [42] reported significant cure rates, and reduction of incontinence episodes in patients who received behavioral interventions. "

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    • "Management options include absorbent products, behavioral modification, medical management, and surgery. Behavioral therapy (such as lifestyle modification, bladder training and pelvic floor muscle training (PFMT)) should be considered as a first-line option for all women with MUI [5, 6]. Although recommended for MUI, PFMT is the most commonly recommended physical therapy for women with SUI [7]. "
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    ABSTRACT: Background In women with mixed urinary incontinence, pelvic floor muscle training and solifenacin is the recommended conservative treatment, while electroacupuncture is a safe, economical and effective option. Methods/Design In this prospective, multi-center, randomized controlled trial, five hundred women with mixed urinary incontinence, from 10 centers will be randomized to receive either electroacupuncture or pelvic floor muscle training plus solifenacin. Women in the acupuncture group will receive electroacupuncture for 3 sessions per week, over 12 weeks, while women in the control group will receive pelvic floor muscle training plus solifenacin (5 mg once daily) for 36 weeks. The primary outcome measure is the proportion of change in 72-hour incontinence episode frequency from baseline to week 12. The secondary outcome measures include eleven items, including proportion of participants with ≥50% decrease in average 72-h incontinence episode frequency, change from baseline in the amount of urine leakage and proportion of change from baseline in 72-h incontinence episode frequency in week 25–36, and so forth. Statistical analysis will include covariance analysis, nonparametric tests and t tests. Discussion The objective of this trial is to compare the efficacy and safety of electroacupuncture versus pelvic floor muscle training plus solifenacin in women with moderate and severe mixed urinary incontinence. Trial registration Identifier: NCT02047032
    Full-text · Article · Aug 2014 · BMC Complementary and Alternative Medicine
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    • "To reduce the occurrence of the UI and in particular the incidence of SUI, some form of effective therapy should be applied. It is well known that a form of conservative treatment is recommended as the first-line procedure but such still needs to be improved [19] [20] [21] [22] [23] [24] [25] [26]. The physiotherapeutic treatment of SUI is mainly focused on achieving increased resting and functional activity of the pelvic floor muscles (PFM) [21, 27–33]. "
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    ABSTRACT: Objectives. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles (PFM) and the synergistic muscles, depending on the orientation of the pelvis, in anterior (P1) and posterior (P2) pelvic tilt. Design. Preliminary, prospective observational study. Setting. Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Participants. Thirty-two menopausal and postmenopausal women with stress urinary incontinence were recruited. Based on inclusion and exclusion criteria, sixteen women aged 55 to 70 years were enrolled in the study. Primary Outcome Measures. Evaluation of resting and functional bioelectrical activity of the pelvic floor muscles by electromyography (sEMG) and vaginal probe. Secondary Outcome Measures. Evaluation of activity of the synergistic muscles by sEMG and surface electrodes. Results. No significant differences between orientations P1 and P2 were found in functional and resting sEMG activity of the PFM. During resting and functional PFM activity, higher electrical activity in P2 than in P1 has been recorded in some of the synergistic muscles. Conclusions. This preliminary study does not provide initial evidence that pelvic tilt influences PFM activation. Although different activity of synergistic muscles occurs in various orientations of the pelvic tilt, it does not have to affect the sEMG activity of the PFM.
    Full-text · Article · Feb 2014 · BioMed Research International
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