Abbreviations used: PFM = pelvic floor muscles; SUI = stress urinary incontinence. 0 1990 Wiley-Liss, Inc. 480 BB et al.simultaneous observation of inward movement of the balloon catheter. Vaginal pressure rise due to simultaneous contraction of other muscles is probably not larger than pressure rise due to intended PFM contraction. Reinforced balloon tip will not change pressure recording, and rise in EMG activity of lower abdominal muscles seems unavoidable during maximal PFM contraction.
Fifty-two women. mean age 45.9 years (24-64) with clinically and urodynamically proven stress urinary incontinence (SUI) were randomly assigned to one of two different pelvic floor muscle (PFM) exercise groups. Both groups performed 8-12 maximal PFM contractions 3 times a day for 6 months. In addition one group exercised with an instructor intensively 45 min once a week performing long-lasting contractions with the supplement of 3-4 fast contractions at the end of each long-lasting contraction.Initially and after 6 months an examination was performed comprising history, urinary leakage index, pad test, maximum urethral closure pressure, functional urcthral profile length, and recording of vaginal pressure during PFM contractions. The latter was performed monthly.After the treatment 60% of the intensive exercise (IE) group and 17.3% of the home exercisc (HE) group reported to be continent or almost contincnt (P < .01). Only the IE group demonstrated significant reduction in urinc loss: from mean 27 g to 7.1 g (P < . O l ) and iniprovemcnt in maximum resting urcthral closure prcssure (mean improvement 4.6 cin H,O, P = .02). PFM strength improved with mean 15.5 cm H,O (P < .01) in the 1E group while the HE group improved with 7.4 cm H,O (P < .01).It is concluded that the results of PFM exercise for female SUI is highly dependent upon the degrce and duration of treatmcnt and frequent supervision by thc therapist.Abbreviations used: CI = confidence intervals; FPL = functional profile length; MUCP = maximum urethral closure pressure; PFM = pelvic floor muscles; SUI = stress urinary incontinence.
The reliability of measurements of pelvic floor muscle strength using a vaginal balloon catheter connected to a pressure transducer was tested in 28 healthy women, mean age 32.3 years (21-50).Fourteen women (group 1) performed three pelvic floor muscle contractions in three series with reinstallation of the balloon catheter to the same vaginal position between each series. Additionally, retest was done after a period of 2 wceks. Reproducibility of the results was tested in another similar group of 14 women (group 2) who did a 1 day test.In the first group the maximum contraction value (resting pressure not included) varied from 5 to 40 cm H,O. However, the median difference value of the three series tested on two different days was only 3, 1, and 1 cm H,O, respectively. The two groups of women demonstrated similar values of vaginal pressure measurements. Thus, a balloon with a given vaginal position for measurements of pelvic floor muscle strength gives reliable pressure recordings. Abbreviations used: PFM = pelvic floor muscles; SUI = stress urinary incontinence. 0 1990 Wiley-Liss, Inc.
The marked benefit of intensive pelvic floor muscle training seen short-term was not maintained 15 years later. Long-term adherence to training is low. Urinary symptoms were equally common in both operated and nonoperated women. Further studies are needed to understand factors associated with long-term effectiveness of stress urinary incontinence treatments.
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