Pelvic Floor Exercise Best for Stress Incontinence
This multicenter, single-blind, randomized controlled trial compared pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment to manage stress incontinence in women. Researchers recruited 107 women, 24-70 years old, with clinically and urodynamically proven stress incontinence. Subjects were placed in four groups:
• pelvic floor exercise (n=25): comprised 8-12 contractions TID and weekly group exercise;
• electrical stimulation (n=25): vaginal intermittent stimulation using the MS 106 Twin at 50 Hz, 30 minutes daily;
• vaginal cones (n=27): vaginal cones 20 minutes/day;
• or untreated control group: offered use of a continence guard.
Results were measured by a pad test with standardized bladder volume and self-report of severity. They showed muscle strength was significantly greater after pelvic floor exercises (improved 8.2 cm H2O) than electrical stimulation (3.8 cm H2O) or vaginal cones (3.6 cm H2O). Pad leakage reduction also was greater in the exercise group than in the other groups. By study end, 56% of the exercise group reported incontinence resolved, compared with 12% of the electrical stimulation group, 7% of the vaginal cone group, and 3% of the control group.
Researchers concluded that pelvic floor muscle training is superior to electrical stimulation and vaginal cones and should be considered the treatment of choice for genuine stress incontinence. — JAU
Source
Bo K, Talseth T, Holme I. Single blind, randomized controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. BMJ 1999;318:487-93.
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