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Postpartum pelvic floor conditioning using vaginal cones: Not only for prophylaxis against urinary incontinence and descensus

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Abstract

Seventy-one women were examined 6–8 weeks after spontaneous delivery by pelvic floor (PF) palpation, inspection, manometry and gravimetry. Re-examination was performed in the same way after 4–6 weeks of daily cone training. Control groups included 20 women prior to and after conventional puerperal exercises, and 8 nulliparae prior to and after the same cone training, using a five-cone set. The number of puerperae not capable of voluntary PF contraction declined from 34% before to 6% after training. Optimum initial and post-training responses were exhibited by all nulliparae. Differences between cone and conventional exercise groups were of minor importance. Contractility increased from 5 to 10 mmHg on average in puerperae and from 15 mmHg to 21 mmHg in nulliparae. Cone nos. 1–3 were most frequently required at the beginning of training, and nos. 3–5 towards the end. Cone training works well as an alternative or complement to conventional postpartum exercises, and may therefore be recommended especially to puerperae who are not capable of holding vaginal cones of 20–70 g 6 weeks after delivery.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics at Charité, Charité Frauenklinik, Schumannstrasse 20/21, 10098, Berlin, Germany

    W. Fischer & K. Baessler

Authors
  1. W. Fischer
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  2. K. Baessler
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Editorial comment

The investigators set out to show that vaginal cones can be used for postpartum pelvic floor conditioning, and their results do indeed indicate an improvement in pelvic floor strength based on the speculum lift test, manometry and cone holding. Unfortunately, the study does not answer, and was not designed to answer, whether the use of vaginal cones is better than, equal to or worse than pelvic floor exercises for reconditioning the pelvic floor after vaginal delivery. To answer this question requires randomization, blinding and appropriate control groups (i.e. postpartum patients who do not perform any type of exercise of the pelvic floor).

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Fischer, W., Baessler, K. Postpartum pelvic floor conditioning using vaginal cones: Not only for prophylaxis against urinary incontinence and descensus. Int Urogynecol J 7, 208–214 (1996). https://doi.org/10.1007/BF01907074

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