Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women

Dumoulin, Chantale; Cacciari, Licia; Hay‐Smith, Jean

doi:10.1002/14651858.cd005654.pub4

Cited by 356 publications

(463 citation statements)

References 133 publications

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“…Guidelines all agree that PFMT is recommended for SUI and UUI, and that when undergoing PFMT, patients should allow 3 months to see results. The literature clearly supports that PFMT improves UI and QoL in women with SUI, MUI and UUI . The EAU specifies that the first‐line use of PFMT should include elderly and post‐natal populations .…”

Section: Conservative Managementmentioning

confidence: 95%

Guideline of guidelines: urinary incontinence in women

2020

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Keywords urinary incontinence, overactive bladder, diagnosis, stress urinary incontinence, urgency urinary ncontinence Key Points• Guidelines are not exhaustive, but practical evidencebased reviews of 'index patients'.• Evaluation should include detailed history and characterisation of urinary incontinence (UI).• Guidelines suggest a stepwise approach to treat both urgency UI and stress UI, starting with conservative therapy, advancing to more invasive procedures as needed • Urodynamics should be used when it will change management and if there is recurrent UI after failure of invasive treatments.• When treating women with mixed UI, focus on treating the predominant symptom.

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Section: Conservative Managementmentioning

confidence: 95%

Guideline of guidelines: urinary incontinence in women

2020

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“…Interventions for UI are chosen based on diagnosis and adults (in the absence of a neurological diagnosis) may be offered some type of voiding programme, frequency and urgency strategies, in combination with pelvic floor muscle training (PFMT). However, even though interventions such as PFMT can improve UI [3] it may be that only a minority of people with UI seek help [4]. Those that seek help, they will tend to consult a primary health care clinician, and some will never be referred to a clinician with training in continence management.…”

Section: Introductionmentioning

confidence: 99%

A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

Toye

Barker

2020

BMC Urol

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Background: Urinary incontinence (UI) is highly prevalent and affects the lives of many men and women. We aimed to conduct a qualitative evidence synthesis (QES) to explore the experience of living with UI and to develop a conceptual model that can help us to understand this experience, and the potential barriers to appropriate healthcare. Methods: We used the methods of meta-ethnography developed by Noblit and Hare and recently refined for larger studies. Meta-ethnography involves identifying concepts from the studies and abstracting these concepts into a line of argument. We searched for studies that explored the experience of adults with UI. We used the GRADE-CERQual framework to assess confidence in review findings.Results: We screened 2307 titles, 429 abstracts, 107 full texts and included 41 studies (36 unique samples) in the synthesis. We organised the concepts into 26 conceptual categories, which we further abstracted into 6 themes: (1) Am I ill or is this normal? (2) It effects who I am and how I feel; (3) I feel stigmatised, ashamed and guilty; (4) talking can be difficult but it can help; (5) keeping incontinence under control; (6) have I got to the point that I need help? Our model conceptualises living with UI as navigating antagonists: Is UI normal or am I ill? Do I need help or am I managing? Do I keep UI to myself (and manage alone) or do I tell other people (and get the support that I need)? Do I use control strategies that focus on concealing (avoid risky situations, wear pads) versus, I use strategies that focus on improving the bodily function to improve continence. Our model highlights the experience of stigma, shame and guilt which exert a pull towards concealment. Conclusions:The culture of secrecy and profound sense of shame is barrier to seeking help. An environment which reduces the shame and stigma of UI may help people to switch the focus to strategies that will improve continence, rather than conceal incontinence.

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“…In a systematic review of PFMT in women with stress incontinence, long‐term adherence (≥1 year) was found to vary from 10% to 70% 7 . In line with recommendations for more research on long‐term effectiveness, 1,6 the present study reports on factors associated with continence 12 months after the end of a cluster‐randomized trial (CRT) of PFMT and mobility group‐based exercises, led by physiotherapists with village women aged 60 to 75 years in Bangladesh 8 . Furthermore, it describes an extension of the program using exercise groups led by village paramedics who provide front‐line health care within Gonoshasthaya Kendra (GK), the Bangladeshi nongovernmental organization in which the CTR was conducted.…”

Section: Introductionmentioning

confidence: 93%

“…Although pelvic floor muscle training (PFMT) has been found to be effective in women with stress, urgency and mixed urinary incontinence 1 information about long‐term effectiveness has not been systematically collected. There is some evidence that effects continue after the end of the intervention 2‐4 and that this may depend on the continuation of the exercise regime (compliance) 2,5,6 .…”

Section: Introductionmentioning

confidence: 99%

Promoting and maintaining urinary continence: Follow‐up from a cluster‐randomized trial of elderly village women in Bangladesh

Haque

Kabir

Naher

et al. 2020

Neurourology and Urodynamics

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Aims: Pelvic floor and mobility exercises were shown to be effective in managing incontinence in a cluster-randomized trial (CRT) of village women aged 60 to 75 years in Bangladesh. The present analysis examines continence 12 months after the CRT and exercise program implementation with village paramedics as preceptors.Methods: Women from nine villages in the exercise arm of the CRT were followed-up 12 months after the 6-month intervention. They provided information about exercise since the CRT and a 3-day continence record (3DCR). Posttrial, a further 6-month exercise intervention led by village paramedics was initiated in 20 villages. Women completed the two-item Sandvik severity questionnaire before and after the intervention. Paramedics kept a record of each woman's attendance at the 48 exercise sessions Results: A total of 130 of 150 women from the CRT completed the 12-month follow-up; 61.5% were dry on the 3DCR at follow-up. Total continence was related to the continuation of exercises carried out in the home and absence of urinary tract infection at follow-up. Those exercising at follow-up had an odds ratio (OR) of 3.49 (95% confidence interval [CI], 1.86-6.58) of being continent at follow-up. Higher end-of-CRT body mass index was associated with greater follow-up leakage. In the 20-village roll-out, with 316 incontinent women, improvement in both severity and total continence on the Sandvik questionnaire were related to a total number of sessions attended (OR = 1.09; 95% CI, 1.05-1.13). At roll-out, 38.6% achieved continence, comparable to 43.0% in the CRT using physiotherapy preceptors Conclusions: Group exercise classes led by paramedics resulted in a marked improvement in continence but maintenance requires exercise postintervention. K E Y W O R D Sadherence, Bangladesh, group exercises, paramedics, PFMT, rural health, urinary incontinence

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Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women

Abstract: Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women.

Cited by 356 publications

References 133 publications

Guideline of guidelines: urinary incontinence in women

Guideline of guidelines: urinary incontinence in women

A meta-ethnography to understand the experience of living with urinary incontinence: ‘is it just part and parcel of life?’

Promoting and maintaining urinary continence: Follow‐up from a cluster‐randomized trial of elderly village women in Bangladesh

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