The theory behind the use of physical therapies (electrical stimulation or
pelvic floor muscle [PFM] training with or without biofeedback) for overact
ive bladder is to (1) inhibit detrusor muscle contraction by voluntary cont
raction of the PFMs at the same time as the urge to void; and (2) prevent s
udden falls in urethral pressure by a change in PFM morphology, position, a
nd neuromuscular function.
Few trials have evaluated the effect of PFM training on symptoms of overact
ive bladder. Most studies are flawed because they include several diagnoses
and treatment modalities in the same intervention.
Because of the lack of evidence, no firm conclusion can be drawn on the eff
ect of PFM exercise on overactive bladder. There are some initially promisi
ng results, but there is still a need for high-quality, randomized controll
ed trials on the effect of PFM training on the inhibition of detrusor contr
action in human beings. The efficacy of PFM training in combination with ot
her treatments, such as pharmacotherapy, also requires investigation. UROLO
GY 55 (Suppl 5A): 7-11, 2000. (C) 2000, Elsevier Science Inc.