Comparison of the efficacy of perineal and intravaginal biofeedback assisted pelvic floor muscle exercises in women with urodynamic stress urinary incontinence

Abstract

Objective: To assess the effectiveness of intravaginal pressure biofeedback (P-BF) and perineal electromyographic biofeedback (EMG-BF) assisted pelvic floor muscle (PFM) exercises in women with stress urinary incontinence (SUI).

Material and methods: Fifty-three women with SUI were randomized into three groups as follows: the Group 1 received PFM home exercise program alone (n:18); the Group 2 received PFM home exercise program plus intravaginal P-BF assisted PFM exercise program (n:17); and the Group 3 received PFM home exercise program plus perineal EMG-BF assisted PFM exercise program (n:18). Subjects were also assessed with the 1-h pad test (severity of incontinence), perineometer (PFM strength), social activity index (SAI), IIQ7 (quality of life associated with incontinence), treatment success (cure and improvement rate) and treatment satisfaction.

Results: A statistically significant improvement was found in all parameters for all groups at 4th week and 8th week compared to the baseline values. It was found that severity of incontinence, PFM strength, and SAI scores were significantly improved in both BF groups compared to the Group 1 at 8th week. Also, statistically higher cure and improvement rate and treatment satisfaction values were detected in both BF groups compared to the Group 1. There was no statistically significant difference between Group 2 and Group 3 in all parameters evaluated at the follow-up period.

Conclusions: We conclude that both the home exercises plus intravaginal P-BF and home exercises plus perineal EMG-BF are superior to home exercises in women with SUI. Intravaginal P-BF and perineal EMG-BF were similarly effective and they can be used as their alternatives.

Keywords: biofeedback; pelvic floor muscle exercises; stress urinary incontinence.