Standardized pelvic floor exercises improve stress urinary incontinence in women with intrinsic sphincter deficiency

Effectiveness of pelvic floor muscle and abdominal training in women with stress urinary incontinence

The aim of this study was to investigate the effectiveness of pelvic floor muscle training and abdominal training in women with stress urinary incontinence. The study included 64 female patients (aged 18 to 49 years) with stress urinary incontinence. Patients were randomly allocated into the pelvic floor muscle training (PFMT) or pelvic floor muscle plus abdominal training (PFMT+AT) groups. Clinical data included stress test results, pelvic floor activity measurements, and Urinary Distress Inventory, and Incontinence Impact Questionnaire responses. The increase in the pelvic floor muscle activity (from the 0th to the 4th week, from the 4th to the 8th week, and from the 0th to the 8th week) was significantly greater for the PFMT+AT group than for the PFMT group (p < 0.05). The negativity rate of the stress test at the 4th week was significantly higher for the PFMT+AT group (93.7%) than for the PFMT group (53.1%) (p < 0.001). Women with stress urinary incontinence benefit more from pelvic floor muscle training plus abdominal training than from pelvic floor muscle training alone in terms of increasing their pelvic floor muscle activity and quality of life, and they also experience an earlier recovery.

The Role of Pelvic Floor Muscle Training in the Conservative and Surgical Management of Female Stress Urinary Incontinence: Does the Strength of the Pelvic Floor Muscles Matter?

The purpose of this review is to provide an in-depth overview of the role of pelvic floor muscle (PFM) training in the management of stress urinary incontinence (SUI). The definition, epidemiology, and pathogenesis of SUI are described. We review the anatomy of the PFM and the importance of PFM strength in maintaining urinary continence and establishing normal voiding function. A brief description of the surgical options currently available for SUI and the existing data regarding the role of perioperative PFM training for SUI are included. Critical research questions to better evaluate and assess PFM training during the perioperative period are proposed. Promising novel approaches in the treatment of SUI are also presented. This review is useful for physiatrists, urogynecologists, female urologists, and nurse practitioners who specialize in the management and treatment of women with SUI. LEVEL OF EVIDENCE: IV.

A study of transobturator tape in stress urinary incontinence

BACKGROUND

Stress urinary incontinence (SUI) is commonly encountered in gynecological practice. Nowadays, midurethral sling surgeries in the form of transobturator tape (TOT) surgery are recommended in its treatment.

AIMS AND OBJECTIVES

To assess the outcome and patient satisfaction of TOT surgery in the treatment of SUI.

MATERIALS AND METHODS

A prospective study was undertaken for patients of SUI who underwent TOT surgery by the outside in method and followed up for 5 years. The patients were assessed clinically and by the Patient Global Impression of Improvement (PGI-I) preoperatively and at postoperative day 3, discharge and 3 months follow-up.

RESULTS

Successful surgical treatment with TOT was seen in all patients at the time of discharge. There was no recurrence of SUI seen up to 1 year, but at 5-year follow-up two patients had a recurrence of SUI on examination though they did not complain of SUI. Urinary retention, tape extrusion, and groin stitch infection were the commonly seen complications following surgery. On subjective assessment, 61 patients were completely satisfied at day 3, and all patients were completely satisfied at discharge and 3 months follow-up as per the PGI-I score.

CONCLUSION

TOT gives an excellent outcome in the treatment of SUI.