Pelvic floor education after vaginal delivery.
OBJECTIVE
To assess the effect of pelvic floor education after vaginal delivery on pelvic floor characteristics in nulliparous women.


METHODS
We examined 107 nulliparas during pregnancy and at 9 weeks and 10 months after vaginal delivery. Methods used included a questionnaire, clinical examination, perineosonography, urethral pressure profiles, and intravaginal and intra-anal pressure recordings during pelvic floor contraction. After the second examination, the women were assigned in alternating manner to either 12 sessions of pelvic floor exercises with biofeedback and electrostimulation (n = 51) or no training (n = 56). The two groups were compared at the third examination.


RESULTS
Stress urinary incontinence incidence decreased in 2% of control subjects compared with 19% of women who underwent pelvic floor education (P =.002), whereas the incidence of fecal incontinence (5% versus 4%, P = 1) and the percentage of women who recovered predelivery pelvic floor contraction strength (33% versus 41%, P =.4) were no different. We observed no significant differences in bladder neck position and mobility, urethral functional length, maximal urethral closure pressure, pressure transmission ratio, residual area of continence at stress standing, or intravaginal or intra-anal pressures during pelvic floor contraction between groups at the third examination.


CONCLUSIONS
Pelvic floor education, begun 2 months postpartum, significantly reduced the incidence of stress urinary incontinence, but not fecal incontinence or weak pelvic floor. Similarly, bladder neck behavior, urodynamic characteristics, intravaginal or intra-anal pressures during pelvic floor squeezing also were not modified.
Meyer
S
S
Urogynecology Unit, Department of Obstetrics and Gynecology, CHUV, Lausanne, Switzerland sylvain.meyer@chuv.hospvd.ch
Hohlfeld
P
P
Achtari
C
C
De Grandi
P
P
D000328:Adult; D001676:Biofeedback, Psychology; D036861:Delivery, Obstetric / Q000379:methods*; D004558:Electric Stimulation / Q000379:methods*; D015444:Exercise; D005260:Female; D006801:Humans; D015994:Incidence; D010353:Patient Education as Topic / Q000379:methods*; D017773:Pelvic Floor / Q000502:physiology*; D049590:Postpartum Period; D011247:Pregnancy; D011336:Probability; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000517:prevention & control*; D014621:Vagina