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. 2025 Sep 5;22(3):257-265.
doi: 10.4274/tjod.galenos.2025.22470.

Effectiveness of pelvic floor muscle training in managing urinary incontinence in pregnant women with and without gestational diabetes mellitus

Parisa Ghadiri Harati  1 , Seyed Majid Hosseini  1 , Atiyeh Javaheri  2 , Farideh Dehghan Manshadi  1 , Alireza Akbarzadeh Baghban  3
Affiliations

Effectiveness of pelvic floor muscle training in managing urinary incontinence in pregnant women with and without gestational diabetes mellitus

Parisa Ghadiri Harati et al. Turk J Obstet Gynecol. .

Abstract
in English, Turkish

Objective: Urinary incontinence (UI) is a common issue during pregnancy. Pelvic floor muscle training (PFMT) may offer an effective solution for managing this condition. This study aimed to evaluate the effect of PFMT on reducing UI symptoms in pregnant women.

Materials and methods: This study was conducted on 40 UI pregnant women with gestational diabetes mellitus (GDM) and 40 UI pregnant women without GDM. The participants in the experimental group were treated for 10 weeks in the third trimester, whereas the control groups received an educational pamphlet. Quality of life and UI severity were assessed using questionnaires, and pelvic floor muscle performance was measured through ultrasound-based bladder base displacement. Assessments were performed before treatment, after 10 weeks, and 2 weeks postpartum.

Results: In the non-diabetic group, significant reductions in UI symptoms were observed at the end of the third trimester and 2 weeks postpartum [adjusted difference -7.56, 95% confidence interval (CI) -10.62 to -4.49, p<0.001]. However, in the diabetic group, a reduction was noted, but it was not statistically significant. Additionally, the intervention positively impacted quality of life in the non-diabetic group (adjusted difference 30.8, 95% CI 17.6 to 44.1, p<0.001) but not in the diabetic group. Notably, no significant improvement in pelvic floor muscle performance was observed in either group.

Conclusion: This study suggests that PFMT can be more effective than routine pamphlets in reducing UI symptoms and improving the quality of life in pregnant women, both with and without GDM. Further research is needed to explore effects on pelvic floor muscle performance.

Amaç: İdrar kaçırma (UI) gebelikte sık görülen bir sorundur. Pelvik taban kas eğitimi (PFMT), bu durumu yönetmek için etkili bir çözüm sunabilir. Bu çalışma, PFMT’nin gebe kadınlarda UI semptomlarını azaltmadaki etkisini değerlendirmeyi amaçlamıştır.

Gereç ve yöntemler: Bu çalışma, gestasyonel diyabetli (GDM) 40 UI gebe kadın ve GDM’siz 40 UI gebe kadın üzerinde yürütülmüştür. Deney grubundaki katılımcılar üçüncü trimesterde 10 hafta tedavi edilirken, kontrol gruplarına eğitim broşürü verilmiştir. Yaşam kalitesi ve UI şiddeti anketler kullanılarak değerlendirilmiş ve pelvik taban kas performansı ultrason tabanlı mesane tabanı yer değiştirmesi yoluyla ölçülmüştür. Değerlendirmeler tedaviden önce, 10 hafta sonra ve doğumdan 2 hafta sonra yapılmıştır.

Bulgular: Diyabetik olmayan grupta, üçüncü trimesterin sonunda ve doğumdan 2 hafta sonra UI semptomlarında önemli azalmalar gözlemlendi [ayarlanmış fark -7,56, %95 güven aralığı (GA) -10,62 ila -4,49, p<0,001]. Diyabetik grupta bir azalma kaydedildi, ancak istatistiksel olarak anlamlı değildi. Ek olarak, müdahale diyabetik olmayan grupta yaşam kalitesini olumlu yönde etkiledi (ayarlanmış fark 30,8, %95 GA 17,6 ila 44,1, p<0,001) ancak diyabetik grupta etkilemedi. Özellikle, her iki grupta da pelvik taban kas performansında önemli bir iyileşme gözlenmedi.

Sonuç: Bu çalışma, PFMT’nin hem GDM’li hem de GDM’siz gebe kadınlarda UI semptomlarını azaltmada ve yaşam kalitesini iyileştirmede rutin broşürlerden daha etkili olabileceğini öne sürmektedir. Pelvik taban kas performansı üzerindeki etkileri araştırmak için daha fazla araştırmaya ihtiyaç vardır.

Keywords: Urinary incontinence; pelvic floor muscle training; pregnant women; quality of life; ultrasonography.

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Conflict of interest statement

Conflict of Interest: No conflict of interest was declared by the authors.

Figures

Figure 1
Figure 1
Flow diagram of pregnant women without diabetes
Figure 2
Figure 2
Flow diagram of pregnant women with diabetes
Figure 3
Figure 3
a) Comparison of mean total of ICIQ-UI SF score between the control and intervention groups, categorized by diabetes status T0: Beginning of the third trimester, T1: End of the third trimester, T2: Two weeks postpartum. The values are presented as “mean with 95% confidence interval”. P-values are based on ANCOVA
Figure 4
Figure 4
Comparison of mean total I-QoL score between the control and intervention groups, categorized by diabetes status I-QoL: Incontinence quality of life, T0: Beginning of the third trimester; T1: End of the third trimester; T2: Two weeks postpartum. The values are presented as “mean with 95% confidence interval” P-values are based on ANCOVA
Figure 5
Figure 5
Comparison of mean bladder neck displacement between the control and intervention groups, categorized by diabetes status BBD: Bladder base displacement, T0: Beginning of the third trimester; T1: End of the third trimester; T2: Two weeks postpartum. The values are presented as “mean with 95% confidence interval”. P-values are based on ANCOVA
See this image and copyright information in PMC

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