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Bathing provided no objective pain relief. It had, however, a temporal pain stabilizing effect possibly mediated through the improved ability to relax in between contractions. No side effects were found. It gives great satisfaction to users. Bathing, in conjunction with other forms of analgesia, is recommended.

Even when managed in a single center, IVF pregnancies carry a greater antenatal risk than matched controls. Once in labor, and managed in a similar fashion, the outcome does not differ from that of controls.

Objective To determine the outcome 10 years after an individual course of pelvic¯oor muscle (PFM) exercises for genuine stress incontinence. Patients and methods Postal questionnaires were sent to 52 women who had undergone PFM training 10 years earlier, and their medical ®les were reviewed. The main outcome measures were the patients' selfassessment of therapy outcome, the frequency of PFM exercises at home, and the demand for surgery after physiotherapy. Results Forty-®ve women (87%; mean age 61 years) were suitable for analysis. On completing the course of PFM exercises, physiotherapy had been apparently successful in 24 (53%), and considered to have failed in 21 women (47%). Sixteen of the 24 successful patients remained satis®ed with their urinary continence when reassessed 10 years later; two women had undergone surgery (8%). In the group where physiotherapy initially failed, ®ve women (24%) who had not had surgery claimed to be much improved; 13 women (62%) had undergone surgery. Overall, women in whom the conservative treatment of stress incontinence had produced an improvement over the 10 years had practised PFM exercises more regularly (76%) than the others (55%; not signi®cant). However, an active voluntary PFM contraction before a sudden intra-abdominal pressure rise (`perineal lock') appeared to be responsible for most of the success. Conclusions When PFM training is initially successful, there is a 66% chance that the favourable results will persist for at least 10 years.

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