Prospective Double Blind Controlled Trial of Intensive Physiotherapy with and without Stimulation of the Pelvic Floor in Treatment of Genuine Stress Incontinence

Pelvic floor maximal strength using vaginal digital assessment compared to dynamometric measurements

“…Recently, Jundt et al [2002] reported no di¡erence in PFM strength before and after childbirth as assessed by the modi¢ed Oxford grading system. Furthermore, some studies had reported that after physiotherapy for SUI, a reduction in urinary leakage occurred while no improvement in the pelvic £oor maximal strength was actually demonstrated [Blowman et al, 1991;Laycock and Jerwood, 1993]. A similar lack of sensitivity has been demonstrated in the extremities: the strength gain measured by the dynamometer was not detected by manual testing [Schwartz et al, 1992;Herbison et al, 1996].…”

Pelvic floor stimulation: What are the good vibrations?

“…25 SRV could be an alternative to any vaginal electrical stimulation which is occasionally not appreciated because of cultural or personal reasons. The role of electrical stimulation in pelvic floor muscle strength remains unclear; an improvement of pelvic floor muscle strength was reported in the study Neurourology and Urodynamics DOI 10.1002/nau by Blowman et al 26 in both groups comparing pelvic floor muscle training (PFMT) to PMFT with additional electrical stimulation. More improvement in the PMFT with electrical stimulation was reported; however, no statistical tests were performed to test significance.…”

Useful parameters helping proctologists to identify patients with defaecatory disorders that may be treated with pelvic floor rehabilitation

“…However, such relaxation patterns have been reported to be not likely identifiable, by simultaneously using the previously mentioned diagnostic procedures [34]. On the other hand, the contraction pattern is evaluated by using the pubococcygeal test that, by examining the phasic and tonic components of each contraction, along with the muscular fatigue, allows determining the patient's capability to retain urine and stool [24,25]. Another important physiatric pattern to be evaluated is the perineal defence reflex.…”

“…We classified this contraction as good (when >9 s), moderate (2-9 s) or fair (<2 s). Then, we evaluated muscular fatigue by asking the patient to contract the anus as many times as possible, for at least 5 s, and to rest for 10 s. We classified these contractions as good (when >9 times), moderate (2-9 times) or fair (<2 times) [24,25]. -Perineal defence reflex.…”