Pelvic floor muscle training for female stress urinary incontinence: Five years outcomes

Beyar, N.; Groutz, Asnat

doi:10.1002/nau.22888

Cited by 25 publications

(22 citation statements)

References 22 publications

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“…The 12‐month adherence rates reported by women who had been in the CRT were midrange for those included in the 2013 review 7 and comparable with the rates (in younger women) reported for 5‐year adherence in Israel 13 and for older women in Quebec 14 …”

Section: Discussionsupporting

confidence: 64%

Promoting and maintaining urinary continence: Follow‐up from a cluster‐randomized trial of elderly village women in Bangladesh

Haque

Kabir

Naher

et al. 2020

Neurourology and Urodynamics

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Aims: Pelvic floor and mobility exercises were shown to be effective in managing incontinence in a cluster-randomized trial (CRT) of village women aged 60 to 75 years in Bangladesh. The present analysis examines continence 12 months after the CRT and exercise program implementation with village paramedics as preceptors.Methods: Women from nine villages in the exercise arm of the CRT were followed-up 12 months after the 6-month intervention. They provided information about exercise since the CRT and a 3-day continence record (3DCR). Posttrial, a further 6-month exercise intervention led by village paramedics was initiated in 20 villages. Women completed the two-item Sandvik severity questionnaire before and after the intervention. Paramedics kept a record of each woman's attendance at the 48 exercise sessions Results: A total of 130 of 150 women from the CRT completed the 12-month follow-up; 61.5% were dry on the 3DCR at follow-up. Total continence was related to the continuation of exercises carried out in the home and absence of urinary tract infection at follow-up. Those exercising at follow-up had an odds ratio (OR) of 3.49 (95% confidence interval [CI], 1.86-6.58) of being continent at follow-up. Higher end-of-CRT body mass index was associated with greater follow-up leakage. In the 20-village roll-out, with 316 incontinent women, improvement in both severity and total continence on the Sandvik questionnaire were related to a total number of sessions attended (OR = 1.09; 95% CI, 1.05-1.13). At roll-out, 38.6% achieved continence, comparable to 43.0% in the CRT using physiotherapy preceptors Conclusions: Group exercise classes led by paramedics resulted in a marked improvement in continence but maintenance requires exercise postintervention. K E Y W O R D Sadherence, Bangladesh, group exercises, paramedics, PFMT, rural health, urinary incontinence

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Section: Discussionsupporting

confidence: 64%

Promoting and maintaining urinary continence: Follow‐up from a cluster‐randomized trial of elderly village women in Bangladesh

Haque

Kabir

Naher

et al. 2020

Neurourology and Urodynamics

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Section: Non-surgical Interventionsmentioning

confidence: 99%

“…In those who are unable to contract the pelvic floor, biofeedback techniques might be useful 90 . Although short-term efficacy is good, with no harmful effects, evidence of long-term benefit is lacking [117][118][119] .Incontinence pessaries and intravaginal devices-Women seeking further treatment for stress urinary incontinence who wish to avoid or defer surgery, and are unable to adhere to behavioural therapy, can use vaginal continence pessaries 120 , which aim to compress the urethra. These treatments show the greatest benefit in those with severe stress urinary incontinence 121 .…”

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confidence: 99%

Urinary incontinence in women

Rm²

2017

Nat Rev Dis Primers

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Urinary incontinence symptoms are highly prevalent among women, have a substantial effect on health-related quality of life and are associated with considerable personal and societal expenditure. Two main types are described: stress urinary incontinence, in which urine leaks in association with physical exertion, and urgency urinary incontinence, in which urine leaks in association with a sudden compelling desire to void. Women who experience both symptoms are considered as having mixed urinary incontinence. Research has revealed overlapping potential causes of incontinence, including dysfunction of the detrusor muscle or muscles of the pelvic floor, dysfunction of the neural controls of storage and voiding, and perturbation of the local environment within the bladder. A full diagnostic evaluation of urinary incontinence requires a medical history, physical examination, urinalysis, assessment of quality of life and, when initial treatments fail, invasive urodynamics. Interventions can include non-surgical options (such as lifestyle modifications, pelvic floor muscle training and drugs) and surgical options to support the urethra or increase bladder capacity. Future directions in research may increasingly target primary prevention through understanding of environmental and genetic risks for incontinence.Correspondence to R.C. Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London W2 1PG, UK. r.cartwright@imperial.ac.uk. Author contributions Competing interestsThe authors declare no competing interests. Publisher's noteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. HHS Public AccessAuthor manuscript Nat Rev Dis Primers. Author manuscript; available in PMC 2018 April 01. Published in final edited form as:Nat Rev Dis Primers. ; 3: 17042. doi:10.1038/nrdp.2017.42. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptUrinary incontinence is the complaint of involuntary loss (leakage) of urine 1 . The condition occurs in both sexes, but is much more frequent in women. Although some overlap in pathophysiology is evident between sexes, incontinence in men is often a consequence of prostatic enlargement or from damage to continence mechanisms during surgery or radiotherapy for prostate cancer. By contrast, incontinence in women is typically related to dysfunction of the bladder or pelvic floor muscles, with such dysfunction often arising during pregnancy or childbirth, or at the time of menopause. This Primer focuses on female urinary incontinence because of its higher prevalence and unique pathophysiology.There are two main subtypes of urinary incontinence: stress incontinence and urgency incontinence. According to the International Urogynecological Association (IUGA) and the International Continence Society (ICS) standard definition, stress incontinence is the complaint of urine leakage in association with coughing, sneezing or physical exertion, whereas urgency incontinence is the comp...

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“…Pelvic floor muscle training (PFMT) is effective and the recommended first-line treatment for women suffering from SUI. [40][41][42] The success rate varies according to the study; selfmotivation is a major dependent factor. 43 The optimal training program is not yet known (frequency, dosage, exercises).…”

Section: Figurementioning

confidence: 99%

Pelvic floor muscle activation in stress urinary incontinent women: Impact of a distraction task

Dewaele

Deffieux

Villot

et al. 2019

Neurourology and Urodynamics

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Aims Our purpose was to explore the involvement of cognition in voluntary and involuntary pelvic floor muscle (PFM) contraction in stress urinary incontinent women. Methods PFM contraction monitored by surface electromyography (EMG) was measured without a mental distraction task (DT), and with a DT called “paced auditory serial additional test” (PASAT). Forty stress incontinent women performed voluntary contractions of the external anal sphincter (EAS), and reflex EAS contractions induced by means of coughing were studied using the external intercostal muscle (EIC) EMG pattern. Results A DT altered PFM pre‐activation when coughing: the reaction time between EIC muscle contraction and EAS contraction (called RT3) was respectively −54.94 ms (IQR −87.12; 3.12) without the PASAT and −3.99 ms (IQR: −47.92; 18.69) with a DT (P = 0.02, Wilcoxon's test). Concerning voluntary contraction, women activated their PFM sooner without than with a DT. Conclusion The PASAT altered voluntary and reflex contractions of the PFM in stress urinary incontinent women. Our study suggests that cognition plays a role in urinary pathophysiology. Future studies should investigate rehabilitation programs that consider the role of cognition in stress urinary incontinent women.

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Pelvic floor muscle training for female stress urinary incontinence: Five years outcomes

Cited by 25 publications

References 22 publications

Promoting and maintaining urinary continence: Follow‐up from a cluster‐randomized trial of elderly village women in Bangladesh

Promoting and maintaining urinary continence: Follow‐up from a cluster‐randomized trial of elderly village women in Bangladesh

Urinary incontinence in women

Pelvic floor muscle activation in stress urinary incontinent women: Impact of a distraction task

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