PELVIC FLOOR REHABILITATION IN THE TREATMENT OF INCONTINENCE

This study assessed the effectiveness of a pelvic floor rehabilitation program in a clinical practice. A retrospective convenience sample of 48 women was evaluated Pretreatment and posttreatment with follow-up interviews from six months to three years. This group consisted of 81% with stress urinary incontinence, 6% with unstable bladder and 10% wi th mixed incontinence. Fecal incontinence was present as well in 35% o f the subjects. The patients were taught pelvic floor muscle exercises and instruction reinforced with electromyographic biofeedback. Neurom uscular electrical stimulation was used when clinically indicated. Two women did not continue the program beyond the first vis and were excl uded- Sixty-two percent of patients with two or more visits demonstrat ed an improvement. Thirteen percent were completely dry, and 49% demon strated a significant improvement. Patients with genuine stress urinar y incontinence, unstable bladder and mixed incontinence showed a 66%, 33% and 50% improvement rate, respectively. Fecal incontinence was imp roved in 63% of women trained in pelvic floor muscle exercises. A sign ificant decrease (P <.001) was found in the frequency of self-reported leakage at the six-month to three-year follow-up. The strength and du ration of a pelvic muscle contraction was significantly greater betwee n the first and last visit in all patients, regardless of the subjecti ve improvement. A pelvic floor rehabilitation program was an effective alternative to surgical intervention in reducing the frequency of uri nary leakage. Further studies are needed to identify factors predictin g success and to determine the most cost-effective method of achieving pelvic floor rehabilitation.