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Evidence summaries

Pelvic Floor Muscle Training for Urinary and Faecal Incontinence in Antenatal and Postnatal Women

Pelvic floor muscle training (PFMT) appears to be effective as well for prevention of urinary incontinence in late pregnancy and postpartum as for treatment of urinary incontinence in postpartum compared to usual care or no treatment. PFMT may not be effective for faecal incontinence postpartum. Level of evidence: "B"

The quality of evidence is downgraded by risk of bias (study quoality).

Pelvic floor muscle training is recommended in antenatal and postnatal women to prevent or treat urinary incontinence.

The recommendation is strong because pelvic floor muscle training is an effective, cheap and harmless treatment for urinary incontinence.

Summary

A Cochrane review [Abstract] 1 included 46 studies involving a total of 10 832 pregnant or postnatal women with urinary and faecal incontinence. Included were randomised or quasi-randomised trials in which one arm included PFMT. Another arm was no PFMT, usual antenatal or postnatal care, another control condition, or an alternative PFMT intervention.

Early, structured PFMT in early pregnancy for continent women may prevent the onset of UI in late pregnancy and postpartum. Population approaches (recruiting antenatal women regardless of continence status) may have a smaller effect on UI, although the reasons for this are unclear. A population-based approach for delivering postnatal PFMT is not likely to reduce UI. Uncertainty surrounds the effects of PFMT as a treatment for UI in antenatal and postnatal women, which contrasts with the more established effectiveness in mid-life women.

There was no evidence that antenatal PFMT led to a difference in the prevalence of FI in late pregnancy. Similarly, for postnatal PFMT in a mixed population, there was no evidence that PFMT reduces the risk of FI in the late postnatal period.

References

  • Woodley SJ, Lawrenson P, Boyle R et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;(5):CD007471. [PubMed]

Primary/Secondary Keywords