Pelvic floor muscle group therapy for the treatment of urinary incontinence during pregnancy and post-partum: a randomized controlled trial

Objective: Pelvic Floor Muscle Group Therapy (PFMGT) is an effective treatment option in the general population. However, the effect of therapy during pregnancy and shortly thereafter is unclear. Therefore, this study investigates the effect of PFMGT in peri-partum women with UI compared to care-as-usual. Materials and Methods: Two randomized controlled trials: study 1: pregnant women and study 2: 6 weeks post-partum women, were performed. The primary outcome was UI severity based on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short form (ICIQ-UI SF). Secondary outcomes were the Global Impression of Severity (GPE) measuring patient’s self-reported improvement and the Incontinence Impact Questionnaire-7 (IIQ-7), measuring UI impact. Descriptive and univariate analysis were reported and the non-parametric Mann-Whitney U test was used to compare differences between groups. Results: Inclusion numbers could not be met, and therefore all women received individual Pelvic floor muscles training (PFMT). Study 1 showed no significant results regarding the prevalence of UI (ICIQ-UI SF), GPE and IIQ-7 at any measurement moment. As compared to baseline, study 2 showed a significant improvement for prevalence of UI and impact of UI at 4 months post-partum, however there was no significant difference between groups at other measurement moments. Significant subjective improvement was seen at 4th and 9th months post-partum, in favor of the PFMT group (p=0.02). Conclusion: PFMT, started after childbirth, demonstrated improved UI and quality of life with a lower number of complaints at the 4 months post-partum assessment. However, the full potential of effectiveness of PFMT could not be established due to insufficient inclusions.