Skip to main content

A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence

International Urogynecology Journal volume 22, pages 17–22 (2011)Cite this article

Abstract

Introduction and hypothesis

The aim of the study was to evaluate the effect of antenatal pelvic floor muscle exercise (PFME) in the prevention and treatment of urinary incontinence during pregnancy and postpartum period.

Methods

Three hundred women were randomly assigned to the PFME group and control group. Urinary symptoms were measured by Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and question of self-reported urinary incontinence. Questionnaire scores of the PFME and the control groups were compared and analyzed.

Results

During late pregnancy and the postpartum period, the PFME group had significantly lower total UDI-6 and IIQ-7 scores; their self-report rate of urinary incontinence was also less than the control group. Additionally, we found whether in PFME or control, women who delivered vaginally were more likely to develop postpartum urinary leakage than women who delivered by cesarean section.

Conclusions

PFME applied in pregnancy is effective in the treatment and prevention of urinary incontinence during pregnancy, and this effect may persist to postpartum period.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

Abbreviations

SUI:

Stress urinary incontinence

PFME:

Pelvic floor muscle exercise

IIQ-7:

Incontinence Impact Questionnaire

UDI-6:

Urogenital Distress Inventory

References

  1. Hvidman L, Foldspang A, Mommsen S, Bugge Neilsen J (2002) Correlates of urinary incontinence in pregnancy. Int Urogynecol J 13:278–283

    Article  CAS  Google Scholar 

  2. Raza-Khan F, Graziano S, Kenton K, Shott S, Brubaker L (2006) Peripartum urinary incontinence in a racially diverse obstetrical population. Int Urogynecol J 17:525–530

    Article  Google Scholar 

  3. Brown SJ, Donath S, MacArthur C, McDonald EA, Krastev AH (2010) Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors. Int Urogynecol J 21:193–202

    Article  Google Scholar 

  4. Viktrup L, Lose G, Rolf M, Barfoed K (1993) The frequency of urinary symptoms during pregnancy and puerperium in the primipara. Int Urogynecol J 4:27–30

    Article  Google Scholar 

  5. Morkved S, Bo K (1999) Prevalence of urinary incontinence during pregnancy and post partum. Int Urogynecol J 10:394–398

    Article  CAS  Google Scholar 

  6. Sampselle CM, Miller JM, Mims BL, Delancy JO, Ashton-Miller JA, Antonakos CL (1998) Effects of pelvic muscle exercise on transient incontinence during pregnancy and after birth. Obstet Gynecol 91:406–412

    Article  CAS  PubMed  Google Scholar 

  7. Morkved S, Bo K, Schei B, Salvesen KA (2003) Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial. Obstet Gynecol 101:313–319

    Article  PubMed  Google Scholar 

  8. Rortveit G, Hannestad YS, Daltveit AK, Hunskaar S (2001) Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol 98:1004–1010

    Article  CAS  PubMed  Google Scholar 

  9. Ismail SIMF (2009) An audit of NICE guidelines on antenatal pelvic floor exercises. Int Urogynecol J 20:1417–1422

    Article  Google Scholar 

  10. Reilly ETC, Freeman RM, Waterfield MR, Waterfield AE, Steggles P, Pedlar F (2002) Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. Br J Obstet Gynaecol 109:68–76

    Article  CAS  Google Scholar 

  11. 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 14:131–139

    Article  CAS  PubMed  Google Scholar 

  12. Liang CC, Lee CL, Chang TC, Chang YL, Wang CJ, Soong YK (2009) Postoperative urinary outcomes in catheterized and non-catheterized patients undergoing laparoscopic assisted vaginal hysterectomy—a randomized controlled trial. Int Urogynecol J 20:295–300

    Article  Google Scholar 

  13. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardization of terminology of lower urinary tract function: report from the Standardization Sub-committee of the International Continence Society. Neurourol Urodyn 21:167–178

    Article  PubMed  Google Scholar 

  14. Shumaker SA, Wyman JF, Uebersax JS, McClish D, Fantl JA (1994) Health-related quality of life measures for women with urinary incontinence: the incontinence impact questionnaire and the urogenital distress inventory. Continence Program in Women (CPW) research group. Qual Life Res 3:291–306

    Article  CAS  PubMed  Google Scholar 

  15. Woldringh C, van den Wijngaart M, Albers-Heitner P, Lycklama À, Nijeholt AAB, Lagro-Janssen T (2007) Pelvic floor muscle training is not effective in women with UI in pregnancy: a randomized controlled trial. Int Urogynecol J 18:383–390

    Article  Google Scholar 

  16. Dinc A, Kizilkaya Beji N, Yalcin O (2009) Effect of pelvic floor muscle exercises in the treatment of urinary incontinence during pregnancy and the postpartum period. Int Urogynecol J 20:1223–1231

    Article  Google Scholar 

  17. Allen RE, Hosker GL, Smith ARB, Warell DW (1990) Pelvic floor damage and childbirth: a neurophysiological study. Br J Obstet Gynaecol 97:770–779

    Article  CAS  PubMed  Google Scholar 

  18. Arya LA, Jackson ND, Myers DL, Verma A (2001) Risk of new-onset urinary incontinence after forceps and vacuum delivery in primiparous. Am J Obstet Gynecol 185:1318–1324

    Article  CAS  PubMed  Google Scholar 

  19. Viktrup L, Lose G, Rolf M, Barfoed K (1992) The symptom of stress incontinence caused by pregnancy or delivery in primiparas. Obstet Gynecol 79:945–949

    CAS  PubMed  Google Scholar 

  20. Rortveit G, Daltveit AK, Hannestad YS, Hunskaar S (2003) Urinary incontinence after vaginal delivery or cesarean section. N Engl J Med 348:900–907

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This work was supported by the Medical Research Project, Chang Gung Memorial Hospital (CMRPG370321 and BMRP412). The authors would like to thank Drs. Yao-Lung Chang, Chao-Nin Wang, and Ho-Yen Chueh, and physiotherapists of our urogynecological division for their assistance to accomplish this study.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou, 5, Fu-Shin Street, Kweishan, Taoyuan, Taiwan, Republic of China, 333

    Po-Chun Ko, Ching-Chung Liang, Shuenn-Dhy Chang, An-Shine Chao & Po-Jen Cheng

  2. College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Ching-Chung Liang, Shuenn-Dhy Chang, An-Shine Chao & Po-Jen Cheng

  3. School of Nursing, Chang Gung University, Taoyuan, Taiwan, Republic of China

    Jian-Tao Lee

Authors
  1. Po-Chun Ko
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ching-Chung Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shuenn-Dhy Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jian-Tao Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. An-Shine Chao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Po-Jen Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ching-Chung Liang.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Ko, PC., Liang, CC., Chang, SD. et al. A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence. Int Urogynecol J 22, 17–22 (2011). https://doi.org/10.1007/s00192-010-1248-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-010-1248-4

Keywords

  • Pelvic floor muscle exercise
  • Pregnancy
  • Postpartum
  • Urinary incontinence