Efficacy of pelvic floor musculature training to prevent or treat urinary incontinence after childbirth: systematic review

Abstract

Urinary incontinence is defined as any involuntary leakage of urine. Women suffer more from urinary incontinence than men. Stress urinary incontinence is the more related to pregnancy. Pelvic floor muscle training (PFMT) or “Kegel” exercises are the most common technique used for the improvement of pelvic floor function. However, there is conflicting scientific evidence regarding its effectiveness for the treatment of urinary incontinence. Therefore, this study aimed to analyze the effectiveness of PFMT or “Kegel” exercises for preventing and treating urinary incontinence. To achieve this aim a systematic review was performed on the Pubmed and PEDro databases. Nine articles were found. Methodological quality was assessed using the PEDro scale. In the analyzed studies women in the intervention group performed PFMT. In most studies the duration of the intervention was of eight weeks and the evaluation of the pelvic floor was performed before and after the training. In general, women received one supervised training session and they also practiced exercises on their own. Type of contraction, series and repetition number was heterogeneous among studies. Due to the use of adherence strategies less than 10% of women left the treatment in most of the studies. Results showed that after PFMT the urinary incontinence in the intervention groups decreased significantly. Also, the strength and resistance of pelvic floor muscles was significantly improved. Therefore, PFMT is effective for preventing and treating urinary incontinence, and to strengthen the pelvic floor musculature. However, it was not possible to determine the best training protocol.