Pelvic floor training may yield long-term relief from stress incontinence

Pelvic floor muscle training is a safe, noninvasive method to significantly improve the symptoms of stress urinary incontinence. Just 8 weeks of training can provide relief to some patients that lasts for years, Japanese researchers reported on Thursday.

Emoto Atsuko, a nurse at Ishikawa Prefectural Nursing University, and her colleagues enrolled 150 women with stress incontinence in their study. Between 1990 and 1996, these women participated in a pelvic floor muscle training program consisting of one weekly 60-minute group session for 8 weeks. At an average of 7.8 years later, 118 of these women were asked to complete questionnaires regarding their current incontinence symptoms.

A total of 79 women completed questionnaires that were available for analysis. Of these 79 women, 15 (19%) reported that they continued to perform pelvic floor exercises from time to time. In addition, 44 (37%) reported treatment success, defined as an absence of or significant improvement in urinary leakage immediately after completing training, and 31 (39%) reported that the training remained a successful treatment for their incontinence an average of 7.8 years later. Women who reported treatment success immediately after training were more likely to report long-term treatment success.

Atsuko told Urology Times that she studied several factors that may predict which patients with stress incontinence will benefit from pelvic floor training long-term, and the one that stood out was the difference in vaginal pressure before and after training. The bigger the change, the better the long-term outcomes.

According to Atsuko, patients with stress incontinence should be taught to perceive fine movements of their pelvic floor muscles at an early stage of the training session because this can contribute to more powerful muscle contractions. Also, the perineal lock maneuver, consisting of active contraction before a sudden abdominal pressure increase, is particularly effective at preventing stress incontinence because it also helps increase muscle contractions.