Nonpharmacologic treatments for overactive bladder - Pelvic floor exercises

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.