Single-Blind, Randomized, Controlled Trial of Pelvic Floor Muscle Training, Electrical Stimulation, Vaginal Cones, and No Active Treatment in the Management of Stress Urinary Incontinence

Abstract

PURPOSETo compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence.PATIENTS AND METHODSOne hundred eighteen subjects were randomly selected to recieve pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response.RESULTSIn the objective evaluation, we observed a statistically significant reduction in the pad test (p=0.003), in the number of stress urinary episodes (p<0.001), and a significant improvement in the quality of life (p<0.001) in subjects who used pelvic floor exercises, electrical stimulation, and vaginal cones compared to the control group. No significant difference was found between groups in the urodynamic parameters. In the subjective evaluation, 58%, 55%, and 54% of women who had used pelvic floor exercises, electrical stimulation, and vaginal cones, respectively, reported being satisfied after treatment. In the control group, only 21% patients were satisfied with the treatment.CONCLUSIONBased on this study, pelvic floor exercises, electrical stimulation, and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence.

Correlation between maximum voluntary contraction and endurance measured by digital palpation and manometry: An observational study

“…1 PFM training should be recommended as a first-line conservative management in the treatment of urinary incontinence, 2,3 as demonstrated by numerous randomized controlled trials. [4][5][6][7] The success of treatment with exercises is dependent on the achievement of strength and endurance, which consequently leads to improvement of the PFM function. Evaluation of PFM function is a difficult task, as there is no consensus regarding the best method to evaluate or control the effects of PFM training.…”

Intervenção fisioterapêutica em mulheres com incontinência urinária associada ao prolapso de órgão pélvico

“…In contrast, Castro et al 27 claim that these three different modes of therapy are equally effective for UUI and SUI. In the present study, the combination of exercise and electrical stimulation was shown to be effective as most of the participants reported being continent at the end of the treatment.…”

Perineal Muscle Strength During Pregnancy and Postpartum: the Correlation Between Perineometry and Digital Vaginal Palpation

“…It is also essential that the professional caring for these women value not only the identification of factors related to reduced PFMS but also encourage them to practice exercises to strengthen the PF muscles and also to report complains related the genitourinary tract (6,9,(14)(15)17) . Performing perineometry is more important in the realization of pelvic floor exercises with biofeedback for treating these disorders (2)(3)5,(9)(10)(11)(12)(13)15) .…”

“…About one third of adult women have Urinary Incontinence (1)(2) (UI), which can impair a woman's physical, sexual, domestic, and professional and leisure activities (2)(3)(4) . Pregnancy, vaginal delivery, parity, duration of the second stage of labor, difficulty in fetal extraction during a cesarean section, newborn's weight, perineal trauma and other mechanical, endocrinal and neural factors can lead to reduction or loss of the pelvic floor muscle tone causing genitourinary disorders (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) . Altered PFMS has been the focus of studies and research due to the evolution of equipment and exams that make its evaluation and prognosis more precise (10) .…”