Efficacy of Biofeedback and Electrostimulation-Assisted Pelvic Floor Muscle Training between Women with Mild and Moderate to Severe Stress Urinary Incontinence

Hwang, Jiun-Chyi; Sun, Fang‐Ju; Su, Tsung-Hsien; Lau, Hui-Hsuan

doi:10.3390/jcm11216424

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…Hwang et al in their retrospective cohort study claim that PFMT with BFD is only beneficial for patients with mild SUI. [ 25 ]. A meta-analysis by Nunez et al, including only 2 RCTs, aimed to determine if add-on BFD for PFMT offers any difference in terms of urine leakage, episodes of urinary loss, quality of life, and muscle strength.…”

Section: Discussionmentioning

confidence: 99%

The effect of pelvic floor muscle training on urodynamic parameters in women with stress urinary incontinence

2023

Cent European J Urol

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Introduction Pelvic floor muscle training (PFMT) is suggested for women with stress urinary incontinence (SUI). The aim of our study is to examine the effectiveness of PFMT on urodynamic (UDS) parameters. Material and methods This is a prospective observational study enrolling women with SUI. Pelvic surgery, prolapse, body mass index >30, and cognitive disability were exclusion criteria. Patients had baseline UDS, then PFMT only (Group A) or PFMT plus biofeedback (BFD) (Group B) for 6 months and UDS 3 months after treatment. The primary investigated parameters were the number of pads used per day and Valsalva leak point pressure (VLPP). Results Forty-six women completed the study, 22 in Group A and 24 in Group B. At baseline, all patients documented SUI with 3 median pads used per day. Urodynamic SUI was documented with a median Valsalva leak point pressure (mVLPP) of 45 cmH 2 O. At the re-evaluation, 12 women (26.1%) had SUI in BDs with median number pads per day of 1, which was statistically different to baseline (p = 0.02). Urodynamic SUI was reported in 8 (17.4%) women with a mVLPP of 88 cmH 2 O. Six patients were from Group A and 6 from Group B. In Group A, the median number of pads per day was 1, and urodynamic SUI was found in 3 women. In Group B, the median number of pads per day was 1, and urodynamic SUI was found in 5 women. Thirty-four women (73.9%) were dry – 16 (47.1%) from Group A and 18 (52.9%) from Group B. Conclusions PFMT improves urodynamic parameters among women with SUI.

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Section: Discussionmentioning

confidence: 99%

The effect of pelvic floor muscle training on urodynamic parameters in women with stress urinary incontinence

2023

Cent European J Urol

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“…Moterys, kurios negali arba nenori vyktį į gydymo įstaigą, gali naudoti ektrostimuliatorius, kurie yra saugūs naudoti namuose, neprižiūrint specialistui (Hwang et al, 2022). Vienas tokių elektrostimuliatorių yra "Kegel8" -populiariausio pasaulyje elektroninio dubens raumenų treniruoklio versija, turinti 20 medicininiais tyrimais patvirtintų programų.…”

Section: įVadasunclassified

Efcacy of Electrostimulation and Pelvic Floor Muscle Exercises in the Treatment of Stress Urinary Incontinence in Women: Randomised Controlled Trial

Nepaitė-Stabingė,

Katinė,

Karkauskienė

et al. 2023

Reabilitacijos mokslai

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Background. Pelvic ﬂoor muscle training (PFMT) is the most commonly used physiotherapy method in the treatment of female stress incontinence; pelvic ﬂoor muscles (PFM) can be trained not only with exercise but also with electrostimulation. The aim. To determine the efcacy of four weeks of pelvic ﬂoor muscle exercises and electrical stimulation in the treatment of stress urinary incontinence in women. Methods. The study involved 24 subjects who were randomly divided into two groups: pelvic ﬂoor muscle training (PFMT) and pelvic ﬂoor muscle exercises combined with electrostimulation (PFMES). Before and after the interventions, women’s quality of life (QoL) was assessed according to the International Incontinence Counselling Questionnaire – Short Form. Perineometry with Pelvexiser perineometer was used to measure pelvic ﬂoor muscle strength, endurance and vaginal resting pressure. Results. Both interventions signifcantly reduced urinary incontinence episodes and improved the subjects’ quality of life. PFM strength improved after the interventions in the PFMT group from 12.33±3.37 to 19.97±3.38 mmHg (p=0.0008, d=2.26) and in the PFMES group from 8.31±2.41 to 11.84 ±2.78 mmHg (p=0.003, d=2.6). PFM endurance improved in the PFMT group from 3.50±1.15 to 4.53±1.12 s (p=0.03, d=0.9), and in PFMES from 2.92±0.47 to 3.67±0, 52 s (p=0.001, d=1.45). Resting vaginal pressure in the PFMT group improved from 5.3±0.85 to 6.44±1.03 mmHg (p=0.005, d=1.25) and in the PFMES group from 4.4±0.70 to 6.14± 1.47 mmHg (p=0.001, d=1.5). Conclusions. PFMT and PFMES interventions signifcantly improved subjects’ PMF strength, endurance, resting vaginal pressure, and quality of life. Both applied interventions can be applied in the treatment of stress urinary incontinence, as they were safe and well tolerated by the patients. The trial is registered at ClinicalTrials.gov Identifer: NCT05871281. Keywords: female, strength, endurance, incontinence, questionnaire.

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“…However, even though PFMT is the most commonly used physical therapy for women with SUI, up to 30% of women may struggle to accurately contract pelvic floor muscles during the training. 3 To overcome this problem, adjunctive therapies with biofeedback and/or electrostimulation are considered to be effective to strengthen the pelvic floor muscles in patients who are unable to contract properly and effectively. 3 …”

Section: Introductionmentioning

confidence: 99%

“… 3 To overcome this problem, adjunctive therapies with biofeedback and/or electrostimulation are considered to be effective to strengthen the pelvic floor muscles in patients who are unable to contract properly and effectively. 3 …”

Section: Introductionmentioning

confidence: 99%

Impact of pelvic floor muscle training on sexual function in women affected by stress urinary incontinence

Lau,

Su,

Hwang

2024

Sexual Medicine

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Background Pelvic floor muscle training can effectively improve pelvic floor muscle strength and activities; however, its impact on sexual function in women with stress urinary incontinence remains unclear. Aim The study sought to investigate the impact of pelvic floor muscle training on pelvic floor muscle and sexual function in women with stress urinary incontinence. Methods This was a retrospective observational study involving women who visited a urogynecologic clinic at a tertiary medical center. Patients with stress urinary incontinence without pelvic organ prolapse underwent pelvic floor muscle training programs that included biofeedback and intravaginal electrostimulation. Other evaluations included pelvic floor manometry, electromyography, and quality-of-life questionnaires, including the short forms of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Outcomes Clinical characteristics, vaginal squeezing and resting pressure, maximal pelvic floor contraction, duration of sustained contraction, quality-of-life scores, and sexual function were compared between baseline and after the pelvic floor muscle training programs. Results There were 61 women included in the study. The mean number of treatment sessions was 12.9 ± 6.3, and the mean treatment duration was 66.7 ± 32.1 days. The short forms of the Urogenital Distress Inventory (7.7 ± 3.8 vs 1.8 ± 2.1; P < .001) and Incontinence Impact Questionnaire (5.9 ± 4.3 vs 1.8 ± 2.0; P < .001) scores significantly improved after the pelvic floor muscle training program. In addition, all pelvic floor muscle activities significantly improved, including maximal vaginal squeezing pressure (58.7 ± 20.1 cmH2O vs 66.0 ± 24.7 cmH2O; P = .022), difference in vaginal resting and maximal squeezing pressure (25.3 ± 14.6 cmH2O vs 35.5 ± 16.0 cmH2O; P < .001), maximal pelvic muscle voluntary contraction (24.9 ± 13.8 μV vs 44.5 ± 18.9 μV; P < .001), and duration of contraction (6.2 ± 5.7 s vs 24.9 ± 14.6 s; P < .001). Nevertheless, the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire score demonstrated no significant improvement (28.8 ± 9.7 vs 29.2 ± 12.3; P = .752). Clinical Implications Pelvic floor muscle training programs may not improve sexual function in women with stress urinary incontinence. Strengths and Limitations The strength of this study is that we evaluated sexual function with validated questionnaires. The small sample size and lack of long-term data are the major limitations. Conclusion Pelvic floor muscle training can improve pelvic floor muscle activities and effectively treat stress urinary incontinence; however, it may not improve sexual function.

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Efficacy of Biofeedback and Electrostimulation-Assisted Pelvic Floor Muscle Training between Women with Mild and Moderate to Severe Stress Urinary Incontinence

Cited by 3 publications

References 18 publications

The effect of pelvic floor muscle training on urodynamic parameters in women with stress urinary incontinence

The effect of pelvic floor muscle training on urodynamic parameters in women with stress urinary incontinence

Efcacy of Electrostimulation and Pelvic Floor Muscle Exercises in the Treatment of Stress Urinary Incontinence in Women: Randomised Controlled Trial

Impact of pelvic floor muscle training on sexual function in women affected by stress urinary incontinence

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