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Adherence to pelvic floor muscle training with or without vaginal spheres in women with urinary incontinence: a secondary analysis from a randomized trial

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Abstract

Introduction and hypothesis

Pelvic floor muscle training (PFMT) is widely recommended as first-line therapy for women with urinary incontinence. However, adherence to PFMT decreases over time, and information regarding barriers to PFMT is scarce. The primary aim of our study was to investigate whether a vaginal spheres device helped improve adherence to PFMT. The secondary aim was to assess determinants of adherence and the association with treatment outcome.

Methods

This was a secondary analysis of a randomized trial with a 6-month follow-up in women with urinary incontinence (UI) in whom we evaluated adherence to PFMT, performed either with (spheres group) or without (control group) vaginal spheres. The Morisky-Green Questionnaire (MGQ) was used to assess adherence, defined as the extent to which participants corresponded to the agreed recommendations; participants were classified as adherent or nonadherent according to their responses. Efficacy of PFMT was assessed using the International Consultation on Incontinence Questionnaire Short Form scale (ICIQ-SF).

Results

Seventy women were enrolled and data from 65 (35 treated and 30 controls) were suitable for analysis. There were no significant differences in adherence to treatment between groups at the end of follow-up (33.3 % in controls and 42.9 % in spheres). The largest group of nonadherent women in both arms were those who mainly forgot to do the exercises. ICIQ-SF results between adherent and nonadherent women did not differ significantly [mean 0.55, 95 % confidence interval (CI) 1.13–2.25]. No significant difference was observed between women who attained greater and lesser improvement in UI after treatment (4.5 %; 95 % CI −11.7 to 20.6).

Conclusions

In patients with UI, vaginal spheres as an adjunct to PFMT did not increase adherence to pelvic muscle exercises. Lack of persistence appeared to be due to forgetfulness and did not seem to be influenced by the efficacy of PFMT.

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Acknowledgments

The authors thank Anna Delgado García and Luisa Varela Sende for data analysis, writing and editing assistance; Carolyn Newey for help with language revision; Ignasi Gich for help with statistical analysis; and Ricard Figueras for help with figures. Funding was received from OPKO Health Spain S.L.U., which also provided the medical device used in the study.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Mas Casanovas, 90, 08025, Barcelona, Spain

    Oriol Porta Roda, Marta Simó González & Juan J. Espinós Gómez

  2. Department of Gynecology and Obstetrics, Hospital Universitario Virgen de las Nieves, Granada, Spain

    Miguel A. Díaz López & Paloma Díaz Bellido

  3. Department of Physical Medicine and Rehabilitation, Pelvic Floor Unit, Hospital Universitario 12 de Octubre, Madrid, Spain

    Jesús Vara Paniagua

Authors
  1. Oriol Porta Roda
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  2. Miguel A. Díaz López
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  3. Jesús Vara Paniagua
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  4. Marta Simó González
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  5. Paloma Díaz Bellido
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  6. Juan J. Espinós Gómez
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Corresponding author

Correspondence to Oriol Porta Roda.

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The authors declare that they have no conflict of interest.

Additional information

This study was selected by the 2015 IUGA Scientific Committee for Oral Poster Presentation (Presentation # OP 110, Control/Tracking Number: 2015-A-781-IUGA) at the 2015 IUGA Meeting in Nice, France (9–13 June 2015).

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Porta Roda, O., Díaz López, M.A., Vara Paniagua, J. et al. Adherence to pelvic floor muscle training with or without vaginal spheres in women with urinary incontinence: a secondary analysis from a randomized trial. Int Urogynecol J 27, 1185–1191 (2016). https://doi.org/10.1007/s00192-015-2941-0

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  • DOI: https://doi.org/10.1007/s00192-015-2941-0

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