Pelvic muscle training may relieve SUI long term

Montreal-Pelvic floor muscle (PFM) training can significantly improve the symptoms of stress urinary incontinence. Just 8 weeks of training can provide relief to some patients that lasts for years, results of a Japanese study show.

In a study presented at the International Continence Society annual meeting here, Emoto and her colleagues enrolled 150 women diagnosed with stress urinary incontinence in their study. Between 1990 and 1996, these women participated in a PFM training program consisting of weekly 60-minute group sessions for 8 weeks.

Overall, 91 completed questionnaires were recovered, but 12 of these were excluded because the women were either not ambulatory or had undergone surgery for their incontinence.

Of the 79 remaining respondents, 15 (19%) reported that they continued to perform PFM 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 PFM training. Treatment failure was defined as slight or no improvement of leakage after the training.

Thirty-one women (39%) reported that PFM training remained a successful treatment for stress incontinence an average of 7.8 years later. Seventeen women (21.5%) reported treatment success immediately after training and at the mid- and endpoint assessments, while 29 women (36.7%) reported treatment failure at these points. The remaining 33 women (41.8%) reported fluctuating between treatment success and failure.

Women who reported treatment success immediately after the training program were more likely to also report long-term treatment success.

Emoto told Urology Times that she studied several factors capable of predicting which patients with incontinence would benefit from PFM training long-term, the predominant one being the difference in vaginal pressures before and after training. The bigger the change, she said, the better the long-term outcome. In addition, researchers found at the interim assessment that the smaller the pad test loss, the greater the improvement in continence, and that pad test loss after training was age-linked: older women had smaller losses.

According to Emoto, training patients with stress incontinence to perceive fine movements of their pelvic floor muscles early in the sessions contributes 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 incontinence because it also helps increase muscle contractions.

Eight weeks of group pelvic floor muscle training can be a very effective treatment, Emoto concluded. As a result, she recommends that this safe, noninvasive approach be considered in patients with stress incontinence.