Original Article

International Urogynecology Journal

, Volume 24, Issue 11, pp 1947-1951

Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting?

  • M. VellaAffiliated withDepartment of Urogynaecology, Kings College Hospital NHS Foundation TrustKing’s College Hospital Email author 
  • , E. NellistAffiliated withDepartment of Urogynaecology, Kings College Hospital NHS Foundation Trust
  • , L. CardozoAffiliated withDepartment of Urogynaecology, Kings College Hospital NHS Foundation Trust
  • , H. MastoroudesAffiliated withDepartment of Urogynaecology, Kings College Hospital NHS Foundation Trust
  • , I. GiarenisAffiliated withDepartment of Urogynaecology, Kings College Hospital NHS Foundation Trust
  • , J. DuckettAffiliated withDepartment of Obstetrics and Gynaecology, Medway NHS Foundation Trust

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Abstract

Introduction and hypothesis

Pelvic floor muscle training (PFMT) is the recommended first-line treatment for women with urinary incontinence (UI). Success rates are variable and dependent on a number of factors. The development of an incontinence treatment motivation questionnaire (ITMQ) provides us with a tool to assess patient self-motivation with respect to PFMT and UI. The aim of this study was to determine the effect of women’s self-motivation to perform PFMT on outcome.

Methods

Women with stress predominant UI completed an ITMQ and a 24-h pad test and then underwent a 12-week course of supervised PFMT. At the end of their treatment they completed a patient global impression of improvement questionnaire (PGI-I) and a second 24-h pad test. The PGI-I scores and the difference in pad test weight correlated with the ITMQ according to Spearman’s correlation coefficient.

Results

Sixty-five women were recruited. Thirty-two (49 %) patients perceived themselves as having improved, 28 women (43 %) did not experience any change in symptoms and 5 women (8 %) felt that their symptoms deteriorated following treatment. When correlating the PGI-I with the ITMQ, 3 of the 5 domains: MQS1 (positive attitude for treatment; p = 0.003), MQS3 (frustration of living with incontinence; p = 0.002) and MQS4 (desire for treatment; p = 0.002) correlated significantly with outcome. Desire for treatment was the only domain to correlate with change in pad weight (p = 0.001).

Conclusion

Self-motivation is essential in order to determine improved success rates with PFMT.

Keywords

Pelvic floor muscle training Incontinence treatment motivation questionnaire