An objective assessment of physiotherapy for female genuine stress incontinence

Abstract

Summary Sixty women with genuine stress incontinence were consecutively assigned to one of four physiotherapy groups who were treated for 6 weeks by either (1) pelvic floor exercises (PFE) in hospital; (2) PFE and faradism; (3) PFE and interferential therapy; (4) PFE at home. Assessment before and after treatment was by 7‐day bladder charts, urethral pressure profiles and perineometry. Approximately two‐thirds of the hospital‐treated patients (groups 1, 2 and 3) experienced marked or moderate subjective improvement and at 6 months, 27% were dry or almost dry. There was little difference in outcome between groups 1, 2 and 3 but hospital‐based therapy was more effective than home treatment. Statistical analyses showed that there were significant improvements in the objective indices measured in the 45 hospital‐treated patients. Successful treatment was more likely in younger patients, in those with lesser degrees of genuine stress incontinence and those who had had no previous pelvic floor surgery.

Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

“…Supervision was required because many patients give up exercising when not supervised by a qualifi ed professional. 10,16 Bo et al 10 divided 52 patients presenting SUI into two random groups: one group underwent intensive perineal exercises and the other exercised at home, both for six months. For the fi rst group, the pad test gave a weight of 27 grams before treatment and 7.1 grams after it, while for the at-home exercise group, the weight only decreased from 29.3 to 22 grams.…”

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence

“…In two studies by Glavind and colleagues 150 and Wilson and colleagues, 157 the women randomised to use BF had more clinic visits than the PFMT group. There was also a potential difference in supervisory intensity in a further study by Pages and colleagues, 154 in which the PFMT group had group therapy for 60 minutes, five times a week, whereas the BF group had individual therapy for 15 minutes, five times a week.…”

“…57 157,162,190 assignment based on hospital casenote number 116 or assignment based on time of arrival at the clinic and severity of incontinence. 127 Allocation concealment was also considered to be suboptimal (sealed envelopes with no indication of third party involvement) in a further five studies.…”

“…Fifteen studies 120,122,[146][147][148][149][150][151][152][153][154][155][156][157][158] evaluated the effect of adding BF to PFMT (Table 16). In two studies by Glavind and colleagues 150 and Wilson and colleagues, 157 the women randomised to use BF had more clinic visits than the PFMT group.…”

Contração muscular do assoalho pélvico de mulheres com incontinência urinária de esforço submetidas a exercícios e eletroterapia: um estudo randomizado

“…Análise sistemática sobre a eficácia do treinamento da MAP na IUE feminina, isolada ou associada a outras terapias, como a EE, biofeedback e cones vaginais, concluiu que a fisioterapia pode ter resultados positivos nesta disfunção, mas recomenda novas pesquisas 16 . Por outro lado, recomenda-se associação da terapia comportamental para melhores resultados 14 , além da conjugação dos EP com a EE 17 , em especial nos casos de IUE, hiperatividade detrusora e IU mista 18 .…”