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  • Cochrane Researchers 'Confident' in Pelvic Floor Muscle Therapy as Effective UI Treatment

    Pelvic floor muscle therapy (PFMT) "could be included in first‐line conservative management programs" for women with urinary incontinence (UI), according to the authors of a recently updated Cochrane systematic review. While the conclusion itself isn't new, the revision includes more evidence that makes the case for PFMT even stronger.

    Authors analyzed data from 31 trials including a total of 1,817 women. The studies examined whether women were "cured" or "cured or improved" as a result of treatment for stress urinary incontinence (SUI), urgency urinary incontinence (UUI), or mixed urinary incontinence (MUI). Researchers also looked at the effects of PFMT on quality of life.

    The results were clear, according to authors: women with all types of UI experienced greater benefit from PFMT than from no treatment or control interventions, which included sham electrical stimulation, placebo drug, or other inactive treatments such as educational pamphlets.

    Other findings from the review:

    • In terms of cure, women with SUI in the PFMT groups were 8 times more likely than women who received no treatment or control interventions to a complete cessation of symptoms. Women with any type of UI in PFMT groups were 5 times more likely to report an end to symptoms.
    • Women with SUI in the PFMT groups were more likely to report improvement in symptoms and significant improvement in quality of life. Women with any type of UI reported that they experienced significant improvements in symptoms and quality of life if they received PFMT.
    • Women with any type of UI in the PFMT groups experienced fewer leakage episodes in a 24-hour period, as well as less urine leaked
    • Patient satisfaction was higher in the PFMT groups, and one study reported that women who received PFMT experienced better sexual outcomes.

    Authors’ conclusions have not changed since the 2014 version of the review, but the update contains 10 new studies, as well as an analysis of risk of bias in the included studies.

    Due the large variation the type and duration of the PFMT programs, authors were unable to assess their relative effectiveness. However, the quality of the evidence was of moderate quality, authors write, meaning that "we can be confident that PFMT can cure or improve symptoms of SUI and all other types of UI."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Comments

    • Thank you for the science-based affirmation that pelvic floor exercises lead to reduction and cessation of UI in women. I would hasten to point out that the above outcomes are evident in men after radical prostatectomy and other post-surgical interventions involving the pelvic floor and/or urinary apparatus. A similar study in men is thus imperative and will further strengthen the body of knowledge available in UI management vis a vis pelvic floor muscle exercises. Thank you.

      Posted by Dr. M. Okome. PT, PhD on 12/13/2018 6:39 AM

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