Pelvic floor muscle training for overactive bladder symptoms – A prospective study

Abstract

Introduction: Pelvic floor muscle training (PFMT) involves the contraction of the puborectal, anal sphincter and external urethral muscles, inhibiting the detrusor contraction, what justify its use in the treatment of overactive bladder (OAB) symptoms. Objective: To verify the effects of isolated PFMT on the symptoms of OAB. Method: Prospective clinical trial with 27 women with mixed urinary incontinence (MUI), with predominance of OAB symptoms and loss ≥ 2 g in the pad test. It was evaluated: pelvic floor muscles (PFMs) function (digital palpation and manometry); urinary symptoms (nocturia, frequency and urinary loss); degree of discomfort of OAB symptoms; and quality of life (Incontinence Quality-ofLife Questionnaire [I-QoL]). The PFMT program consisted of 24 outpatient sessions (2x/week + home PFMT). The Mann-Whitney and Wilcoxon tests (with a significance level of 5%) were used to analyse the data. Results: There was a significant improvement of the urinary symptoms to the pad test (5.8±9.7, p<0.001), urinary loss (0.7±1.1, p=0.005) and nocturia (0.8±0.9, p=0.011). Reduction in the degree of discomfort of urinary symptoms was observed according to OAB-V8 questionnaire (10.0±7.7, p=0.001). There were also significant results in PFMs function: Oxford (3.6±0.9, p=0.001), endurance (5.2±1.8, p<0.001), fast (8.9±1.5, p<0.001) and manometry (26.6±15.8, p=0.003).In addition, quality of life had a significant improvement in the three domains evaluated by I-QoL. Conclusion: The PFMT without any additional guidelines improves the symptomatology, the function of PFMs and the quality of life of women with OAB symptoms.

Comparação entre oxibutinina, eletroestimulação do nervo tibial posterior e exercícios perineais no tratamento da síndrome da bexiga hiperativa

“…As for the measurement of nocturia based on the VD, there was a 35% improvement in the perineal exercise group and a 28% improvement in the TPTNS group after the treatments (statistically significant reductions). Corroborating our results, Fitz et al 47 also observed reduction in nocturia after the PFM training protocol. Differing from our findings, Arruda et al 36 noted a significant reduction in nocturia in the group treated with oxybutynin, and the symptom did not change in patients who were treated with perineal exercises.…”

“…In addition to the benefit achieved with the technique, helping the patient reach the restroom without urinary loss, the perineal exercise was the only modality of treatment performed in groups, promoting not only the improvement of the PFM function, but also socialization, mutual support, motivation and intensive instructions provided by the physical therapist, contributing to the patients' high percentage of satisfaction (91%) with the exercises 47,[61][62][63][64] .…”

Rehabilitation of Stress Urinary Incontinence: A Review Article

“…There is a wide range of treatments for urinary problems. Pharmacotherapy, surgery, and conservative interventions such as pelvic floor muscle training, lifestyle interventions, anti-incontinence devices, and absorbent products are some of the options [14,15]. Unfortunately, more than 50% of cases with incontinence were inadequately managed after diagnosis [16].…”

“…According to previous studies, WBVT increases muscle strength [19,20], induces muscle hypertrophy [11], improves proprioceptors [12], enlarges slow-and fasttwitch fibers, and promotes hormonal changes [10]. WBVT also improves muscle weakness, especially in patients with different chronic diseases [13][14][15][16][17][18]. Electrical Stimulation (ES) is also recommended for the treatment of patients with SUI [14][15][16][17]21].…”

“…WBVT also improves muscle weakness, especially in patients with different chronic diseases [13][14][15][16][17][18]. Electrical Stimulation (ES) is also recommended for the treatment of patients with SUI [14][15][16][17]21]. Acupuncture is another treatment for managing SUI with the advantage of its new version, electroacupuncture [22][23][24].…”