The Role of Pelvic Floor Muscle Training in the Conservative and Surgical Management of Female Stress Urinary Incontinence: Does the Strength of the Pelvic Floor Muscles Matter?

Abstract

The purpose of this review is to provide an in-depth overview of the role of pelvic floor muscle (PFM) training in the management of stress urinary incontinence (SUI). The definition, epidemiology, and pathogenesis of SUI are described. We review the anatomy of the PFM and the importance of PFM strength in maintaining urinary continence and establishing normal voiding function. A brief description of the surgical options currently available for SUI and the existing data regarding the role of perioperative PFM training for SUI are included. Critical research questions to better evaluate and assess PFM training during the perioperative period are proposed. Promising novel approaches in the treatment of SUI are also presented. This review is useful for physiatrists, urogynecologists, female urologists, and nurse practitioners who specialize in the management and treatment of women with SUI. LEVEL OF EVIDENCE: IV.

The Rolf Method of Structural Integration and Pelvic Floor Muscle Facilitation: Preliminary Results of a Randomized, Interventional Study

“…Therefore, firstly, the balance of the whole body in the field of gravity should be restored, and the pelvis "set" as horizontally as possible [47], in particular. PFMs keep the abdominal and pelvic organs in the correct position, create abdominal pressure (in cooperation with the diaphragm), close the lumen of the urethra, narrow the transverse dimension of the vagina and the urogenital hiatus, and participate in sexual functions and activities, and together with the respiratory diaphragm and abdominal muscles, they perform postural functions [40,[48][49][50]. In 2016, Ramin et al [51] published an extensive anatomical analysis of the so-called "fascial continuum" within the area of the pelvis and torso [51].…”

The effect of a comprehensive care and rehabilitation program on enhancing pelvic floor muscle functions and preventing postpartum stress urinary incontinence

“…[1–4] Due to the insufficient support of pelvic floor fascia of postpartum SUI puerperae, the urine easily flows through the urethra when the intraabdominal pressure increases (when coughing, laughing, exercising, sneezing, and so on), resulting in the leakage of urine. [5,6] Although postpartum SUI is not a life-threatening disease, it greatly decreases quality of life and daily activities of puerperae. [7] More importantly, postpartum SUI causes dramatic psychologic disorders to puerperae such as low self-esteem, anxiety, and depression.…”

Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study

“…The pelvic floor is composed of three layers of muscles combined with ligaments and fascia that act as a sling to support the bladder, reproductive organs, and rectum [ 1 , 2 ]. The pelvic floor muscles (PFMs) function to regulate the storage and evacuation of urine and stool by coordinated contraction and relaxation.…”