Postpartum Stress Urinary Incontinence: Current Advances in Non-Pharmacological Therapies

Abstract

Stress urinary incontinence (SUI) is a prevalent postpartum condition that significantly impacts women's quality of life and mental health. This systematic review synthesizes current advances in non-pharmacological therapies for postpartum SUI, focusing on pelvic-floor muscle training (PFMT), electrical and magnetic stimulation, acupuncture, and other therapies like Pilates and breathing exercises. Our literature search in PubMed, Cochrane Library, and Web Science identified studies examining these interventions, which are crucial for treating SUI due to their safety and efficacy. PFMT, also known as Kegel exercises, is the cornerstone of SUI treatment, enhancing pelvic-floor muscle strength and function. Electrical and magnetic stimulation is emerging as effective adjuncts to PFMT, improving muscle endurance and urinary control. Acupuncture, a traditional Chinese medicine therapy, shows promise in regulating pelvic-floor muscle function and is particularly appealing due to its safety and reliability. Pilates and breathing exercises are also considered, with evidence suggesting that they improve core strength and urinary incontinence symptoms when combined with PFMT. Despite the variety of treatments available, several questions remain, including the optimal duration of pelvic-floor electrical and magnetic stimulation, the potential synergistic effect of these stimulations with PFMT, and whether prolonged stimulation provides additional benefits. Future research should address patient compliance, long-term treatment effects, and the biological mechanisms underlying these therapies. A multimodal treatment approach may yield synergistic effects and improved outcomes. This review provides evidence to support clinical treatment recommendations and highlights areas for future research, aiming to optimize non-pharmacological treatment programs for postpartum SUI.

Keywords: after delivery; non-drug therapy; puerpera; review; stress incontinence.