Pelvic floor muscle training versus no treatment for urinary incontinence in women. A Cochrane systematic review

Abstract

Background: Pelvic floor muscle training is the most commonly used physical therapy treatment for stress urinary incontinence. It is sometimes recommended for mixed and less commonly for urge urinary incontinence.

Objectives: The aim of this paper was to determine the effects of pelvic floor muscle training for women with urinary incontinence in comparison to no treatment, placebo or sham treatments, or other inactive control treatments.

Method: The Cochrane Incontinence Group Specialized Trials Register was searched up until December 1, 2004. The review included randomized or quasi-randomized trials in women with stress, urge or mixed urinary incontinence. One arm of the trial comprised pelvic floor muscle training, the other comprised either no treatment, placebo, sham, or other inactive control treatment. The trials were independently assessed for eligibility and methodological quality. Data were extracted then cross-checked by the two authors. Disagreements were resolved by discussion. The data were processed as described in the Cochrane Handbook. The trials were sub-grouped by diagnosis. Formal meta-analysis was not undertaken because of study heterogeneity.

Results: Thirteen trials involving 714 women met the inclusion criteria; however, only six trials (403 women) contributed to data analysis.

Conclusion: Overall, the review provides support for the widespread recommendation that pelvic floor muscle training be included in first-line conservative management programs for women with stress, urge or mixed urinary incontinence.