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Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing.
Neurourol Urodyn. 2013 Nov; 32(8):1096-102.NU

Abstract

AIMS

The purpose of this study was to determine the effect of a 12-week pelvic floor muscle (PFM) training program on urethral morphology and mobility in women with stress urinary incontinence (SUI).

METHODS

Forty women with SUI were randomly assigned to one of two groups: the treatment group received 12 weekly physiotherapy sessions during which they learned how to properly contract their pelvic floor muscles (PFMs) and a home exercise program was prescribed, reviewed, and progressed; the control group received no treatment. Before and after the 12-week study period, ultrasound imaging was used to evaluate bladder neck position and mobility during coughing and Valsalva maneuver in supine and in standing, as well as urethral morphology. Secondary outcome measures included a 3-day bladder diary, 30-min pad test, the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6).

RESULTS

The women in the treatment group demonstrated reduced bladder neck mobility during coughing and increased cross-sectional area of their urethra after as compared to before the training. These changes were not evident in the control group. No differences in the resting position of the bladder neck or in bladder neck excursion during Valsalva maneuver were noted in either group. Concomitantly the women in the treatment group demonstrated significant improvements in the 3-day bladder diary and IIQ-7 after the PFM training and improved significantly more than the control group.

CONCLUSION

Physiotherapist-supervised PFM training reduces bladder neck motion during coughing, and results in hypertrophy of the urethral sphincter in women who present with SUI.

Authors+Show Affiliations

School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23861324

Citation

McLean, Linda, et al. "Pelvic Floor Muscle Training in Women With Stress Urinary Incontinence Causes Hypertrophy of the Urethral Sphincters and Reduces Bladder Neck Mobility During Coughing." Neurourology and Urodynamics, vol. 32, no. 8, 2013, pp. 1096-102.
McLean L, Varette K, Gentilcore-Saulnier E, et al. Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing. Neurourol Urodyn. 2013;32(8):1096-102.
McLean, L., Varette, K., Gentilcore-Saulnier, E., Harvey, M. A., Baker, K., & Sauerbrei, E. (2013). Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing. Neurourology and Urodynamics, 32(8), 1096-102. https://doi.org/10.1002/nau.22343
McLean L, et al. Pelvic Floor Muscle Training in Women With Stress Urinary Incontinence Causes Hypertrophy of the Urethral Sphincters and Reduces Bladder Neck Mobility During Coughing. Neurourol Urodyn. 2013;32(8):1096-102. PubMed PMID: 23861324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing. AU - McLean,Linda, AU - Varette,Kevin, AU - Gentilcore-Saulnier,Evelyne, AU - Harvey,Marie-Andree, AU - Baker,Kevin, AU - Sauerbrei,Eric, Y1 - 2013/07/17/ PY - 2012/06/11/received PY - 2012/09/27/accepted PY - 2013/7/18/entrez PY - 2013/7/19/pubmed PY - 2014/6/21/medline KW - exercise KW - pelvic floor KW - physiotherapy KW - stress urinary incontinence KW - ultrasound KW - urethra SP - 1096 EP - 102 JF - Neurourology and urodynamics JO - Neurourol Urodyn VL - 32 IS - 8 N2 - AIMS: The purpose of this study was to determine the effect of a 12-week pelvic floor muscle (PFM) training program on urethral morphology and mobility in women with stress urinary incontinence (SUI). METHODS: Forty women with SUI were randomly assigned to one of two groups: the treatment group received 12 weekly physiotherapy sessions during which they learned how to properly contract their pelvic floor muscles (PFMs) and a home exercise program was prescribed, reviewed, and progressed; the control group received no treatment. Before and after the 12-week study period, ultrasound imaging was used to evaluate bladder neck position and mobility during coughing and Valsalva maneuver in supine and in standing, as well as urethral morphology. Secondary outcome measures included a 3-day bladder diary, 30-min pad test, the Incontinence Impact Questionnaire (IIQ-7) and the Urogenital Distress Inventory (UDI-6). RESULTS: The women in the treatment group demonstrated reduced bladder neck mobility during coughing and increased cross-sectional area of their urethra after as compared to before the training. These changes were not evident in the control group. No differences in the resting position of the bladder neck or in bladder neck excursion during Valsalva maneuver were noted in either group. Concomitantly the women in the treatment group demonstrated significant improvements in the 3-day bladder diary and IIQ-7 after the PFM training and improved significantly more than the control group. CONCLUSION: Physiotherapist-supervised PFM training reduces bladder neck motion during coughing, and results in hypertrophy of the urethral sphincter in women who present with SUI. SN - 1520-6777 UR - https://www.unboundmedicine.com/medline/citation/23861324/Pelvic_floor_muscle_training_in_women_with_stress_urinary_incontinence_causes_hypertrophy_of_the_urethral_sphincters_and_reduces_bladder_neck_mobility_during_coughing_ L2 - https://doi.org/10.1002/nau.22343 DB - PRIME DP - Unbound Medicine ER -