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Pelvic floor muscle training for urinary and faecal incontinence in antenatal and postnatal women

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Pelvic floor muscle training for urinary and faecal incontinence in antenatal and postnatal women

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06.03.2014 • Sonuncu dəyişiklik 06.03.2014
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Pelvic floor muscle training is effective as well for prevention of urinary incontinence in late pregnancy and postpartum as for treatment of urinary and faecal incontinence in postpartum compared to usual care or no treatment.

A Cochrane review included 22 studies involving a total of 8 485 women. Pregnant women without prior urinary incontinence who were randomised to intensive antenatal pelvic floor muscle training (PFMT) were less likely than women randomised to no PFMT or usual antenatal care to report urinary incontinence in late pregnancy (RR 0.44, 95% CI 0.30 to 0.65; 3 trials, n=307) and up to 6 months postpartum (about 30% less; risk ratio (RR) 0.71, 95% CI 0.54 to 0.95, combined result of 5 trials). Postnatal women with persistent urinary incontinence 3 months after delivery and who received PFMT were less likely than women who did not receive treatment or received usual postnatal care to report urinary incontinence 12 months after delivery (about 40% less; RR 0.60, 95% CI 0.35 to 1.03, combined result of 3 trials). It seemed that the more intensive the programme the greater the treatment effect. The results of 7 studies showed a statistically significant result favouring PFMT in a mixed population (women with and without incontinence symptoms) in late pregnancy (RR 0.74, 95% CI 0.58 to 0.94, random-effects model). Based on the trial data to date, the extent to which mixed prevention and treatment approaches to PFMT in the postnatal period are effective is less clear (that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not). It is possible that mixed prevention and treatment approaches might be effective when the intervention is intensive enough.

Ədəbiyyat

  1. Boyle R, Hay-Smith EJ, Cody JD et al. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2012;(10):CD007471.