Effects of visceral manipulation associated with pelvic floor muscles training in women with urinary incontinence: A randomized controlled trial

Abstract

Aims: To compare the effects of manual visceral therapy (MVT) associated with pelvic floor muscle training (PFMT) on urinary incontinence (UI) symptoms, vaginal resting pressure, and maximum voluntary contraction of the pelvic floor muscles (PFM). Methods: A double-blinded randomized controlled trial of 5 weeks duration with two active intervention arms: PFMT + MVT and PFMT + manual sham therapy (MST). Participants were women over 18 years of age with complaint or diagnosis of UI symptoms. The primary outcome was the severity of UI symptoms, assessed by the International Consultation on Incontinence Questionnaire -Short Form. The secondary outcomes measures included the vaginal resting pressure and the maximum voluntary contraction of PFM assessed by digital manometry.Results: Fifty-two incontinent women participated in the study. There was no significant difference between groups in UI symptoms (F (1.74, 86.9) = 0.406; p = 0.638), vaginal resting pressure (mean difference −1.5 cmH₂0 [95% confidence interval [CI] −4.5 to 1.5; p = 0.33]), and maximum voluntary contraction of PFM (median 0.0 cmH₂0 [25%-75% interquartile range 0.0-5.6; p = 0.12]) after the intervention period.Conclusions: Combining MVT with PFMT was not more effective than PFMT alone in reducing UI symptoms, in change vaginal resting pressure and maximum voluntary contraction of PFM. Due to the limitations of the study, further investigations are still needed to confirm these findings.

The role of visceral therapy, Kegel’s muscle, core stability and diet in pelvic support disorders and urinary incontinence — including sexological aspects and the role of physiotherapy and osteopathy

“…It was shown that the use of visceral therapy and pelvic floor muscle training did not have a positive effect on improving urinary incontinence in women [20].…”

Visceral Therapy and Physical Activity for Selected Dysfunctions, with Particular Emphasis on Locomotive Organ Pain in Pregnant Women—Importance of Reducing Oxidative Stress

“…The pelvic urogenital diaphragm should also show similar movement characteristics. If the intra-abdominal pressure is disturbed, the viscera will also yield to compression, and their mobility and motility will be disturbed [ 82 ]. According to Andrew Taylor Still, the founder of osteopathy, multiple dysfunctions of the reproductive organs are due to the retention of body fluids.…”

“…The blood pressure decreases, and the supply with oxygen and nutrients deteriorates significantly [ 54 ]. We cannot rule out external reasons for dysfunctions of the uterus and the reproductive organs, such as surgical treatments that cause intraperitoneal adhesions within scars, which can also result from the inflammation process [ 82 ].…”

“…The pelvis is tilted forward. The posterior projection features the expiratory position of the diaphragm, a backward tilted pelvis, as well as tension at the level of the sacroiliac joints and the cervicothoracic junction [ 82 ].…”

Visceral therapy in disorders of the female reproductive organs

“…Abnormal pressure between the respiratory diaphragm and the urogenital diaphragm can cause urinary incontinence. Randomised double-blind studies carried out among women suffering from urinary incontinence have shown that the groups which had undergone pelvic floor training and visceral therapy recorded significantly better results and improved quality of life [10].…”