Comparison of the efficacy of perineal and intravaginal biofeedback assisted pelvic floor muscle exercises in women with urodynamic stress urinary incontinence

Özlü, Aysun; Yıldız, Necmettin; Öztekin, Özer

doi:10.1002/nau.23257

Cited by 24 publications

(54 citation statements)

References 23 publications

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“… 27 In a three arm trial in women with stress urinary incontinence (n=53), the addition of electromyographic perineal biofeedback or intravaginal pressure biofeedback to home PFMT were both superior to home PFMT alone for outcomes relating to severity of urinary incontinence, cure or improvement, and pelvic floor muscle strength. 28 …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial

Hagen

Elders

Stratton

et al. 2020

BMJ

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ObjectiveTo assess the effectiveness of pelvic floor muscle training (PFMT) plus electromyographic biofeedback or PFMT alone for stress or mixed urinary incontinence in women.DesignParallel group randomised controlled trial.Setting23 community and secondary care centres providing continence care in Scotland and England.Participants600 women aged 18 and older, newly presenting with stress or mixed urinary incontinence between February 2014 and July 2016: 300 were randomised to PFMT plus electromyographic biofeedback and 300 to PFMT alone.InterventionsParticipants in both groups were offered six appointments with a continence therapist over 16 weeks. Participants in the biofeedback PFMT group received supervised PFMT and a home PFMT programme, incorporating electromyographic biofeedback during clinic appointments and at home. The PFMT group received supervised PFMT and a home PFMT programme. PFMT programmes were progressed over the appointments.Main outcome measuresThe primary outcome was self-reported severity of urinary incontinence (International Consultation on Incontinence Questionnaire-urinary incontinence short form (ICIQ-UI SF), range 0 to 21, higher scores indicating greater severity) at 24 months. Secondary outcomes were cure or improvement, other pelvic floor symptoms, condition specific quality of life, women’s perception of improvement, pelvic floor muscle function, uptake of other urinary incontinence treatment, PFMT self-efficacy, adherence, intervention costs, and quality adjusted life years.ResultsMean ICIQ-UI SF scores at 24 months were 8.2 (SD 5.1, n=225) in the biofeedback PFMT group and 8.5 (SD 4.9, n=235) in the PFMT group (mean difference −0.09, 95% confidence interval −0.92 to 0.75, P=0.84). Biofeedback PFMT had similar costs (mean difference £121 ($154; €133), −£409 to £651, P=0.64) and quality adjusted life years (−0.04, −0.12 to 0.04, P=0.28) to PFMT. 48 participants reported an adverse event: for 23 this was related or possibly related to the interventions.ConclusionsAt 24 months no evidence was found of any important difference in severity of urinary incontinence between PFMT plus electromyographic biofeedback and PFMT alone groups. Routine use of electromyographic biofeedback with PFMT should not be recommended. Other ways of maximising the effects of PFMT should be investigated.Trial registrationISRCTN57756448.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial

Hagen

Elders

Stratton

et al. 2020

BMJ

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“…The vaginal probe was used with condom cover for each woman. When the treatment session finished, the vaginal probe was sterilized by the hypochlorite sterilization method 16 …”

Section: Methodsmentioning

confidence: 99%

Which combination is most effective in women with idiopathic overactive bladder, including bladder training, biofeedback, and electrical stimulation? A prospective randomized controlled trial

Firinci

Yıldız

Alkan

et al. 2020

Neurourology and Urodynamics

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Objective: To evaluate the efficacy of single and combined use of biofeedback (BF) and electrical stimulation (ES) added to bladder training (BT) on incontinence-related quality of life (QoL) and clinical parameters in women with idiopathic overactive bladder (OAB). Material and Methods: Seventy women were randomized into four groups as follows: Group 1 received BT alone (n = 18), Group 2 received BT + BF (n = 17), Group 3 received BT + ES (n = 18), and Group 4 received BT + BF + ES (n = 17). BF and ES were performed 3 days a week, 20 min a day, a total of 24 sessions for 8 weeks. All women were evaluated in terms of incontinence severity (pad test), pelvic floor muscles strength (perineometer), 3-day voiding diary (frequency of voiding, nocturia, incontinence episodes, and number of pads), QoL (incontinence impact questionnaire), treatment success (positive response rate), cure/improvement rate, treatment satisfaction (Likert scale), and discomfort level (visual analog scale). Results: At the end of the treatment, severity of incontinence, frequency of voiding, incontinence episodes, and treatment satisfaction significantly improved in Group 3 and Group 4 compared with the other two groups. In Group 3 and Group 4, high statistically significant values were found in cure/improvement and positive response rates as opposed to Group 1 and Group 2. In Group 2 and Group 3, statistically significant improvements were seen in nocturia and QoL compared with Group 1. Moreover, statistically significant improvements in nocturia and QoL were found in Group 4 compared with the other three groups. There was no difference in the discomfort level of application between the groups. Conclusion: We conclude that in the first-line conservative treatment of women with idiopathic OAB: (i) adding BF and/or ES to BT increases treatment effectiveness, (ii) clinical efficiency is greater when the combination

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“…One common problem that affects postmenopausal women is incontinence. Awareness of women regarding this disease increases from year to year [6]. Nevertheless, many patients still considers incontinence as a natural symptom of aging.…”

Section: Introductionmentioning

confidence: 99%

Urinary incontinence in postmenopausal women – causes, symptoms, treatment

Kołodyńska¹,

Zalewski²,

Rożek-Piechura³

2019

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Urinary incontinence (UI) is an important social problem that affects more than 50% of postmenopausal women. The number of patients increases from year to year. According to recent data, UI affects women twice as often as men. This condition occurs in about 20-30% of young women, 30-40% in middle age and up to 50% of women in old age. There are five types of urinary incontinence. The etiology of the problem of incontinence is not fully understood, because the problem can affect men and women of all ages and can be due to many changes in the human body. International Continence Society Guidelines indicate that treatment of urinary incontinence should begin with conservative treatment. Surgical treatment should be used when conservative treatment will not bring positive results. According to guidelines, conservative treatment should include pharmacotherapy, physiotherapy, and behavioral therapy. Numerous scientific reports indicate efficacy of physiotherapy in the treatment of urinary incontinence. Most recent reports indicate that physiotherapy gives a positive result in up to 80% of patients with stage I or stress urinary incontinence (SUI) and mixed form, and in 50% of patients with stage II SUI. Urinary incontinence is an interdisciplinary problem because in addition to the sphere directly related to medicine, it also concerns the economic and social spheres. The latest data show that incontinence in postmenopausal women occurs more often than other civilization diseases such as diabetes, hypertension or depression.

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Comparison of the efficacy of perineal and intravaginal biofeedback assisted pelvic floor muscle exercises in women with urodynamic stress urinary incontinence

Abstract: We conclude that both the home exercises plus intravaginal P-BF and home exercises plus perineal EMG-BF are superior to home exercises in women with SUI. Intravaginal P-BF and perineal EMG-BF were similarly effective and they can be used as their alternatives.

Cited by 24 publications

References 23 publications

Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial

Effectiveness of pelvic floor muscle training with and without electromyographic biofeedback for urinary incontinence in women: multicentre randomised controlled trial

Which combination is most effective in women with idiopathic overactive bladder, including bladder training, biofeedback, and electrical stimulation? A prospective randomized controlled trial

Urinary incontinence in postmenopausal women – causes, symptoms, treatment

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