Pelvic floor muscle exercise and training for coping with urinary incontinence

Abstract

The pelvic floor consists of levator ani muscles including puborectalis, pubococcygeus and iliococcygeus muscles, and coccygeus muscles. Pelvic floor muscle exercise (PFME) is defined as exercise to improve pelvic floor muscle strength, power, endurance, relaxation, or a combination of these parameters. PFME strengthens the pelvic floor muscles to provide urethral support to prevent urine leakage and suppress urgency. This exercise has been recommended for urinary incontinence since first described by Kegel. When treating urinary incontinence, particularly stress urinary incontinence, PFME has been recommended as first-line treatment. This article provides clinical application of PFME as a behavioral therapy for urinary incontinence. Clinicians and physical therapist should understand pelvic floor muscle anatomy, evaluation, regimen, and instruct patients how to train the muscles properly.

Pelvic Floor Muscle Training for Urinary Incontinence with or without Biofeedback or Electrostimulation in Women: A Systematic Review

“…In almost every study, by increasing the pelvic muscle strength in women, it improved the quality of life index as well. Hence, it could be hypothesized that PFMT is a successful method for the treatment of incontinence and is recommended as first-line treatment [ 31 ].…”

The Perception of Pelvic Floor Muscle Function amongst Exercising Women Who Are Repeatedly Instructed to Contract Their Pelvic Floor Muscles

“…Practicing and strengthening PFM is the first line of treatment and a major part of the treatment offered for PFM disorders, such as stress urinary incontinence and pelvic organ prolapse [ 4 , 5 , 7 , 9 ]. These conditions are common in women, and their incidence increases as age increases [ 26 ].…”

“…The recommended treatments for these disorders resulting from pelvic floor defects in women are divided into two treatment modalities: conservative and surgical [ 4 ]. As one of the main reasons for these disorders and symptoms is weakness of the pelvic floor muscles (PFM), the proposed treatment is the strengthening of these muscles [ 5 , 6 ]. Conservative treatment also includes recommendations for lifestyle changes, the use of pelvic floor support accessories, and the use of electrical stimuli [ 4 , 5 , 7 ].…”

“…As one of the main reasons for these disorders and symptoms is weakness of the pelvic floor muscles (PFM), the proposed treatment is the strengthening of these muscles [ 5 , 6 ]. Conservative treatment also includes recommendations for lifestyle changes, the use of pelvic floor support accessories, and the use of electrical stimuli [ 4 , 5 , 7 ]. PFM practice has been found to be effective in treating stress urinary incontinence and pelvic prolapse [ 8 , 9 , 10 , 11 , 12 ], with no side effects or risk [ 1 , 11 ], and was also found to be an effective program for treating urinary incontinence during pregnancy and/or the postpartum period [ 13 , 14 , 15 ].…”

Urology and Geriatrics in Korea: Present Status and Future Directions

“…These are common and complex morbidities in older persons; therefore, specialized consideration for older patients is required [ 23 , 24 ]. In particular, urinary incontinence and voiding dysfunction are the most prevalent major urologic problems in older patients [ 24 , 25 ]. These conditions cause significant health and quality of life problems in older adults, including restricted activity, poor self-esteem, social isolation, and depression, and result in early institutionalization in long-term care facilities [ 26 ].…”