Optimal Duration for Supervised Pelvic Floor Muscle Training in Stress Urinary Incontinence Women: A Prospective Study

Abstract

Objectives: We evaluated the optimal duration of pelvic floor muscle training (PFMT) in stress urinary incontinence (SUI) patients. Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2018 to June 2019. We recruited 55 subjects diagnosed with SUI based on the questionnaire for urinary incontinence diagnosis (QUID) score >4 and more than 2 grams of 1-hour pad test. Considering the inclusion and exclusion criteria, we taught and supervised them for PFMT and evaluated them every four weeks to observe the urogenital distress inventory-6 (UDI-6), incontinence impact questionnaire-7 (IIQ-7), 1-hour pad test, and perineometer score. We used the Wilcoxon test to evaluate the improvement at a significance level of P<0.05. Results: Our subjects were mostly obese (65%), 30-55 years old (60%), and had >2 children (90%). There were improvements in UDI-6 and IIQ-7 for every four weeks up to 12 weeks of PFMT (P<0.05, 95% CI). Pelvic floor muscle strength only improved significantly (P=0.001 and P=0.006, respectively) after eight weeks of PFMT. Also, the 1-hour pad test score decreased significantly after four weeks of training (P<0.001). Discussion: SUI distress and symptoms decrease after four weeks of Kegel exercises and continue to improve until 12 weeks of therapy. However, the 1-hour pad test reaches clinical and statistical significance during the first month of exercise with no further improvement clinically. Pelvic floor muscle strength increased significantly after eight weeks of training.