Efficacy of pelvic floor rehabilitation for treatment of genuine stress incontinence

To assess the clinical efficacy of a pelvic floor rehabilitation (PFR) prog ram for treatment of genuine stress incontinence (GSI), we studied 72 patie nts with slight to moderate (2-10 g of urine loss per hour) or severe (11-5 0 g of urine loss per hour) GSI who underwent PFR. Objective and subjective assessments were performed before and 3, 6, 12, 18, and 24 months after th e start of treatment. The overall success rate (complete cure or marked imp rovement in symptoms) was 61% (44/72) at the S-year follow-up. The number o f leakages per 24 hours and urine loss in the 1-hour pad test were signific antly reduced, and vaginal muscle strength was significantly increased in s uccessfully-treated patients. Significant changes were also observed in sym ptoms of micturition frequency and nocturia and in volume at first desire t o void during cystometry in the treatment success group. Patient compliance with the exercise program was a significant predictor of success. The succ ess rate during the 2-year follow-up period, estimated according to patient compliance, also differed significantly among groups, with good, moderate, and poor compliance. Patients experienced no serious adverse effects. Thes e results show that the PFR program used in this study is an effective alte rnative to surgical intervention for the treatment of GSI in selected patie nts.