Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women

Woodley, Stephanie J.; Lawrenson, Peter; Boyle, Rhianon; Cody, June D; Mørkved, Siv; Kernohan, Ashleigh; Hay‐Smith, Jean

doi:10.1002/14651858.cd007471.pub4

Cited by 173 publications

(291 citation statements)

References 174 publications

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“…However, at the moment the only existing evidence-based mApp is not specifically developed for pregnant women and focusses on self-treatment and adherence to UI treatment and not on providing information on pelvic floor dysfunctions in pregnancy [25]. Although PFMT is an effective and well-established treatment option for women with UI, the treatment effect for UI during pregnancy is still uncertain [26]. Heterogeneity in studies due to differences in characteristics such Screening for the presence of UI and the degree of bother it causes in daily life (e.g., on activity and participation level) by health care professionals who see pregnant women is relevant to check for misconceptions and to have proper indications for subsequent interventions.…”

Section: Principal Findingsmentioning

confidence: 99%

Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior

Moossdorff-Steinhauser

Berghmans

Spaanderman

et al. 2020

Int Urogynecol J

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Introduction and hypothesis Pregnancy and delivery are thought to induce urinary incontinence (UI), but its clinical impact is less known. Therefore, we investigated the prevalence of self-reported UI, level of experience of bother, and beliefs to gain a greater understanding of help-seeking behavior in adult pregnant women. Methods A digital survey shared on social media was used for recruitment. The survey consists of: (1) demographic variables, (2) International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), (3) ICIQ Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTSqol), and (4) questions on beliefs and help-seeking behavior. For analysis, descriptive statistics and the independent samples t-test were used to determine differences between help- and non-help-seekers. Results Four hundred seven women were eligible for data analysis. The prevalence of UI rises from 55.1% in the first to 70.1% in the third trimester, with an overall prevalence of 66.8%. Nearly 43.0% of the respondents reported UI occurring once a week or less; 92.5% of women lost a small amount; 90% reported slight to moderate impact on quality of life. Only 13.1% of the respondents sought help for their UI. The main reasons for not seeking help were: minimal bother and the idea that UI would resolve by itself. Help-seeking women showed significantly higher scores than non-help-seeking women regarding ICIQ-UI SF (p < 0.001), ICIQ-LUTSqol (p ≤ 0.001), and interference in daily life (p < 0.001). Conclusions During pregnancy, UI affects two out of three women, but only one in eight women sought professional help. Non-help-seeking women experience less bother.

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Section: Principal Findingsmentioning

confidence: 99%

Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior

Moossdorff-Steinhauser

Berghmans

Spaanderman

et al. 2020

Int Urogynecol J

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“…A Cochrane review from 2018 considered PFM training as first-line conservative management to SUI and all other types of UI nevertheless they didn't include PS-UI treatment on the revision [7]. Another Cochrane review from 2020 showed that due to the quality and quantity of well designed studies when antenatal or postnatal populations were evaluated the influence of PFM training for treatment and/or prevetion is uncertain or not at all clear [5]. So a little is know about UI during pregnancy, particullary the impact of the diabetes status on the PS-UI [5].…”

Section: Data Availability Statementmentioning

confidence: 99%

“…Another Cochrane review from 2020 showed that due to the quality and quantity of well designed studies when antenatal or postnatal populations were evaluated the influence of PFM training for treatment and/or prevetion is uncertain or not at all clear [5]. So a little is know about UI during pregnancy, particullary the impact of the diabetes status on the PS-UI [5].…”

Section: Data Availability Statementmentioning

confidence: 99%

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Effectiveness of the pelvic floor muscle training on muscular dysfunction and pregnancy specific urinary incontinence in pregnant women with gestational diabetes mellitus: A systematic review protocol

et al. 2020

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Background There is ample evidence that gestational diabetes mellitus has a direct influence on urinary incontinence and pelvic floor muscles. There are no standardized pelvic floor muscle exercise programs in the literature for the physiotherapy and differ in the type of exercise, intensity, type and duration of application, and the frequency and duration of treatment sessions. The aim of this systematic review will be to investigate that Pelvic Floor Muscle Training can prevent and/or decrease the pregnancy specific urinary incontinence in women with gestational diabetes mellitus or gestational hyperglycemia. Methods We will perform a systematic review according to the Cochrane methodology of Randomized Controlled Trials. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases, with the date of consultation until June 2020. The MeSH terms used will be "Pregnancy", "Hyperglycemia", "Diabetes Mellitus, Type 2", "Diabetes Mellitus, Type 1", "Pregnancy in Diabetics", "Diabetes, Gestational", "Urinary Incontinence", "Pelvic Floor Muscle Strength". Primary outcomes: improvement or cure of pregnancy specific urinary incontinence (which can be assessed by questionnaires, and tools such as tampon test, voiding diary, urodynamic study). Secondary outcomes: improvement of pelvic floor muscle strength (pelvic floor functional assessment, perineometer, electromyography, functional ultrasonography), improved quality of life (questionnaires), presence or absence of postpartum Urinary Incontinence and adverse effects. Quality assessment by Cochrane instrument. Metanalysis if plausible, will be performed by the software Review Manager 5.3. Discussion The present study will be the first to analyze the effectiveness of pelvic floor exercises in pregnant women with Gestational Diabetes Mellitus or Hyperglycemia, who suffer from pregnancy specific urinary incontinence. Randomized Controlled Trials design will be chosen because they present the highest level of evidence. It is expected to obtain robust and conclusive evidence to support clinical practice, in addition to promoting studies on the theme and contributing to new studies. Trial registration Systematic review registration: PROSPERO CRD42017065281.

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“…PFMT can also be used as a preventive mode of treatment during pregnancy with moderate results. Recently, a Cochrane review of 46 trials, provided evidence that PFMT in early pregnancy for continent women may prevent the onset of UI in late pregnancy and postpartum 13 . However, prolonged and continuous exercise as well as compliance and perseverance are needed in order to achieve satisfactory results 14 .…”

Section: Introductionmentioning

confidence: 99%

The Influence of Pelvic Floor Fascial (Manual) Mobilization in Multiparous Women -A randomized controlled trial

Navot¹,

Carmeli²,

Mohr–Sasson³

et al. 2020

Preprint

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Objective Pelvic Floor Fascial Mobilization (PFFM) is an innovative intervention to improve pelvic floor dysfunction. Design Pregnant women at 24-30 weeks gestation, complaining of pelvic pain, and or stress urinary incontinence, were prospectively randomized to PFFM (study group) vs. pelvic floor muscle training (PFMT). Strength and function of the pelvic floor muscles was compared before and after interventions. Setting-Outpatient pregnancy clinic at a tertiary medical center Sample-40 women randomly allocated to PFFM or PFMT Methods Each patient was treated twice, one week apart and was assessed immediately before and after each intervention, and one week after the second treatment. Main Outcome Measures PFDI 20 questionnaire , Oxford grading scale, perineometry to measure pelvic floor symptoms function and strength, transvaginal ultrasound cervical length Results PFFM group Oxford scale improved from 2.65±1.18 to 3.45±1.28 after the first session (p<0.001) with no difference in the PFMT group 3.40±1.05 vs 3.40±1.05 (p=1). Cervical Length elongated in the PFFM group after one treatment (39.8±6.5 vs 43.4±10.2 mm, p<0.05, but not in the PFMT group 40.9±6.7 vs 40.0±8.6 respectively (p=n.s). Among 26 participants who lasted the entire study-PFMT was associated with more than 40% improvement in both Oxford as well as PFDI-20 and Perineometry was improved by 23% (23.13±15.15 vs 28.58±16.07 cmH2O (p<0.05) while no such difference was found with PFMT; 30.03±12.73 vs 30.25±9.61 cmH2O respectively (p=n.s). Conclusions PFFM may improve pelvic floor function and strength, alleviate symptoms and elongate the cervix. Further bigger study is needed to better evaluate this method.

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Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women

Cited by 173 publications

References 174 publications

Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior

Urinary incontinence during pregnancy: prevalence, experience of bother, beliefs, and help-seeking behavior

Effectiveness of the pelvic floor muscle training on muscular dysfunction and pregnancy specific urinary incontinence in pregnant women with gestational diabetes mellitus: A systematic review protocol

The Influence of Pelvic Floor Fascial (Manual) Mobilization in Multiparous Women -A randomized controlled trial

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