Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence: a randomized controlled trial
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Introduction and hypothesis
The aim of this study was to assess whether bladder training (BT) combined with high-intensity pelvic floor muscle training (BT + PFMT) results in better outcomes in the short term than BT alone on female urinary incontinence (UI).
We randomly assigned 108 women with diagnoses of stress UI (SUI, n = 50), urgency UI (UUI, n = 16), or mixed UI (MUI, n = 42) to 6 weeks of BT + PFMT or BT alone (control group). The primary outcome measure was self-reported improvement. Secondary outcome measures were UI severity, symptom distress, quality of life (QOL), mean number of UI episodes and micturitions per day, and pelvic floor muscle strength and endurance (PFME).
Overall and in the SUI and MUI subgroups, significantly more patients in the BT + PFMT group reported cured and improved symptoms. Overall and in SUI patients, the BT + PFMT group also improved to significantly greater degree in UI severity, symptom distress, QOL, daily UI episodes, and PFME. The only parameter showing more improvement in patients with UUI was QOL, and UI severity in patients with MUI (p < 0.05). There were no other significant differences between the two study groups in overall and subgroup analysis (p > 0.05).
High-intensity PFMT combined with BT is more effective than BT alone in the short term for treating UI or SUI. It appears that the combination therapy may also lead to greater benefits for patients with UUI and MUI. Based on the results of this study, further studies with larger sample sizes (for UUI) and long-term follow-ups are warranted.
KeywordsIncontinence Bladder training Pelvic floor muscle training Pelvic floor exercise Urinary incontinence
We express our sincere thanks to Nejat Ozgul, MD, for his support in patient recruitment, and Anıl Barak Dolgun (from Department of Biostatistics, Hacettepe University), for her assistance with statistical analyses.
Conflicts of interest
The first author received a scholarship from The Scientific and Technological Research Council of Turkey during her PhD education. Financial support was obtained from Hacettepe University, Scientific Research Projects Coordination Unit for project materials (project no.: 012 T06102008).
- 1.Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN, International Urogynecological A, International Continence S (2010) An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and urodynamics 29(1):4–20. doi: 10.1002/nau.20798 PubMedGoogle Scholar
- 9.Uebersax JS, Wyman JF, Shumaker SA, McClish DK, Fantl JA (1995) Short forms to assess life quality and symptom distress for urinary incontinence in women: the Incontinence Impact Questionnaire and the Urogenital Distress Inventory. Continence Program for Women Research Group. Neurourol Urodyn 14(2):131–139PubMedCrossRefGoogle Scholar
- 11.Shamliyan T, Wyman J, Kane RL (2012) In: Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness. AHRQ Comparative Effectiveness Reviews, Rockville (MD)Google Scholar
- 16.Elser DM, Wyman JF, McClish DK, Robinson D, Fantl JA, Bump RC (1999) The effect of bladder training, pelvic floor muscle training, or combination training on urodynamic parameters in women with urinary incontinence. Continence Program for Women Research Group. Neurourol Urodyn 18(5):427–436PubMedCrossRefGoogle Scholar