Effect of postpartum pelvic floor muscle training in prevention and treatment of urinary incontinence: a one-year follow up

Abstract

Objective: To evaluate the long term effect of a postpartum pelvic floor muscle training course in prevention and treatment of urinary incontinence.

Design: A prospective matched controlled trial.

Sample and methods: All women who had participated in a matched controlled study evaluating the effect of an eight-week pelvic floor muscle training program in prevention and treatment of urinary incontinence in the immediate postpartum period were contacted by telephone one year after delivery. They were invited to participate in a follow up study. The study group consisted of 81 matched pairs (n = 162), with a mean age (range) 28 years (19-40), and mean number (range) of deliveries 1.8 (1-5). Seventy-six pairs had normal vaginal deliveries and five elective caesarean sections. Registration of continence status was by structured interview and a standardised pad test. Clinical assessment of pelvic floor muscle function and strength were by vaginal palpation and vaginal squeeze pressure.

Main outcome measure: Stress urinary incontinence.

Results: At the one year follow up, significantly more women in the former control group than in the training group reported stress urinary incontinence and/or showed urinary leakage at the pad test (P < 0.01). A significantly greater (P < 0.01) muscle strength increase in the period between 16th week and one year postpartum was demonstrated in the former training group (mean 4.4 cm H2O, 95% CI 3.2-5.6) than in the control group (mean 1.7 cm H2O, 95% CI 0.8-2.7).

Conclusion: This one year follow up study demonstrates that a specially designed postpartum pelvic floor muscle training course was effective in the prevention and treatment of stress urinary incontinence. The benefits from pelvic floor muscle training are still present one year after delivery.