title: Physical therapies for prevention of urinary and faecal incontinence in adults.
abstract: BACKGROUND
  Physical therapies, particularly pelvic floor muscle training, have been recommended for prevention of incontinence associated with childbearing, and prostate surgery.
  
  
  OBJECTIVE
  To assess the effectiveness of physical therapies in preventing incontinence in adults.
  
  
  METHODS
  The Cochrane Incontinence Group trials register was searched to September 2001. Trials were also sought from the Reference Lists of relevant articles and from experts in the field.
  
  
  METHODS
  Randomised and quasi-randomised trials in adults without incontinence symptoms that compared a physical therapy with no treatment, or any other treatment to prevent incontinence.
  
  
  METHODS
  Two reviewers independently assessed eligibility, trial quality and extracted data. Data were processed as described in the Cochrane Collaboration Handbook.
  
  
  RESULTS
  Two trials in men (155 men) and 13 trials in women (4661 women) were included. As most trials recruited regardless of continence status, and there was much heterogeneity, only a qualitative synthesis was undertaken. Three of seven trials in childbearing women reported less urinary incontinence after pelvic floor muscle training compared to control treatment three months postpartum. Two trials selected women at higher risk of postnatal incontinence. The third used an intensive training programme. Four trials did not find any difference between the groups at the primary endpoint. Two trials compared pre-prostate surgery pelvic floor muscle training with control treatment, and no difference in the occurrence of postoperative urinary incontinence was reported between the groups.
  
  
  CONCLUSIONS
  There is insufficient evidence to determine whether physical therapies can prevent incontinence in childbearing women, or men following prostate surgery. Further, better quality research is needed.
authors.affiliation: Department of Women's and Children's Health, University of Otago, PO Box 913, Dunedin, New Zealand. jean.hay-smith@stonebow.otago.ac.nz
authors.forename: J
authors.initials: J
authors.lastname: Hay-Smith
authors.forename: P
authors.initials: P
authors.lastname: Herbison
authors.forename: S
authors.initials: S
authors.lastname: Mørkved
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005081:Exercise Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011247:Pregnancy; D011467:Prostate / Q000601:surgery; D014549:Urinary Incontinence / Q000517:prevention & control*