Contacts with Health Professionals for Pelvic Floor Muscle Training in Urinary Incontinence in Women

Summary

A Cochrane review [Abstract] 1 included 21 studies with a total of 1490 women addressing several comparisons of approaches to pelvic floor muscle training (PFMT). Differences were in training supervision (amount, individual versus group), in approach (one versus another, the effect of an additional component) and the exercise training (type of contraction, frequency of training). In women with stress urinary incontinence, 10% of those who received weekly or twice-weekly group supervision in addition to individual appointments with the therapist did not report improvement post-treatment compared to 43% of the group who had individual appointments only (RR for no improvement 0.29, 95% CI 0.15 to 0.55; 4 trials, n=177). This finding, of subjective improvement in both active treatment groups, with more improvement reported by those receiving more health professional contact, was consistent throughout the review.

Another Cochrane review [Abstract] 2 included 24 trials involving 1583 participants. Women who received biofeedback were significantly more likely to report that their urinary incontinence was cured or improved compared to those who received PFMT alone (RR 0.75, 95% CI 0.66 to 0.86; 7 trials, n=520). However, it was common for women in the biofeedback arms to have more contact with the health professional than those in the non-biofeedback arms. There was much variety in the regimens proposed for adding feedback or biofeedback to PFMT alone, and it was often not clear what the actual intervention comprised or what the purpose of the intervention was.