Self-management in women with stress incontinence: strategies, outcomes and integration into clinical care

Sarah C Titman, Stephen C Radley, Thomas G Gray, Sarah C Titman, Stephen C Radley, Thomas G Gray

Abstract

The objective of this review is to present and discuss up-to-date conservative treatment strategies for the management of stress urinary incontinence (SUI) in women. This review aims to provide an overview of the importance of initial self-management strategies and conservative management options for women with SUI and how these treatments can be integrated into clinical practice. The various treatment modalities available including pelvic floor physiotherapy, biofeedback, and neuromuscular electrical stimulation devices, in addition to lifestyle changes which can significantly affect symptoms, are discussed. The relevance and importance of individual assessment and training programs is highlighted in addition to additional adjuncts available to facilitate rehabilitation and symptom improvement. Expected outcomes for women with mild to moderate SUI who participate in targeted individualized conservative management programs are generally good, with a high likelihood of substantial improvement in symptoms.

Keywords: pelvic floor disorders; physical therapy modalities; stress; urinary incontinence.

Conflict of interest statement

Professor Stephen Radley is the Director and shareholder in ePAQ Systems Ltd, an NHS Spin-out Technology Company. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Neen PeritoneTM Biofeedback device used to provide biofeedback on the effectiveness of pelvic floor muscle activation.
Figure 2
Figure 2
Neen PericalmTM neuro-muscular electrical stimulation kit. Note: The probe on the right is inserted into the vagina and provides electrical stimulation to provoke pelvic floor muscle contraction to aid power and contractility of the pelvic floor as part of a pelvic floor muscle training regime.
Figure 3
Figure 3
An example of two of the many intravaginal devices designed to reduce stress urinary incontinence. ContiformTM (left) UrestaTM (right). Note: ContiformTM (left); UrestaTM (right).

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