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Does it work in the long term?—A systematic review on pelvic floor muscle training for female stress urinary incontinence
Author(s) -
Bø Kari,
Hilde Gunvor
Publication year - 2013
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.22292
Subject(s) - medicine , urinary incontinence , pelvic floor muscle , pelvic floor , physical therapy , biofeedback , psychological intervention , rehabilitation , randomized controlled trial , urology , surgery , nursing
Aims There is level 1, grade A evidence that pelvic floor muscle training (PFMT) is effective in treatment of stress urinary incontinence (SUI), but long‐term outcome has been questioned. The aim of this systematic review was to evaluate the long‐term outcome of PFMT for female SUI. Methods Computerized search on PubMed up to year 2012 was undertaken with the search strategy: pelvic floor AND (urinary incontinence OR stress urinary incontinence) AND (training OR exercise OR physical activity) AND (follow‐up OR long‐term). Limitations were: humans, female, clinical trial, English, and adults. Inclusion criteria were: studies on SUI using PFMT with or without biofeedback as the intervention, follow‐up period of ≥1 year. Exclusion criteria were studies using electrical stimulation alone and studies in the peripartum period. Results Nineteen studies were included (1,141 women followed between 1 and 15 years). Statistical meta‐analysis was not performed due to high heterogeneity. Only two studies provided follow‐up interventions. Losses to follow‐up during the long‐term period ranged between 0% and 39%. Long‐term adherence to PFMT varied between 10% and 70%. Five studies reported that the initial success rate on SUI and MUI was maintained at long‐term. Long‐term success based on responders to the original trial varied between 41% and 85%. Surgery rates at long term varied between 4.9% and 58%. Conclusions Short‐term outcome of PFMT can be maintained at long‐term follow‐up without incentives for continued training, but there is a high heterogeneity in both interventional and methodological quality in short‐and long‐term pelvic floor muscle training studies. Neurourol. Urodynam. 32: 215–223, 2013. © 2012 Wiley Periodicals, Inc.