Who will benefit from pelvic floor muscle training for stress urinary incontinence?
OBJECTIVE
The purpose of this study was to determine which patient characteristics are predictive of outcome before pelvic floor muscle training for stress urinary incontinence.


METHODS
This was an observational study at a single-center outdoor patient clinic in Brussels, Belgium, that comprised 447 women, aged 26 to 80 years (mean, 52.7 years), who had urinary stress incontinence. All the women received individual pelvic floor muscle training under the guidance of the same physiotherapist. Twenty-two patient characteristics were considered for outcome measurements.


RESULTS
Forty-nine percent of the women considered their treatment to be successful; 51% of the women had experienced only some improvement, no change, or a worsening of their condition or had interrupted therapy. Three independent predictors of treatment failure were > or =2 leakages per day before treatment ( P < .0001), the chronic use of psychotropic medication ( P = .002), and a baseline positive stress test result at first cough ( P = .042). The odds were only 15% for an individual patient to be treated successfully when these 3 predictors were present.


CONCLUSIONS
Pelvic floor muscle training is beneficial in one half of the patients who are treated in this manner. Two or more leakages per day at baseline and the chronic use of psychotropic medication significantly predicted therapy failure.
Cammu
Hendrik
H
Department of Gynecology and Obstetrics, Vrije Universiteit Brussel, Acadenisch Ziekenhuis, Laarbeeklaan 101, Brussels, Belgium. hendrik.cammu@az.vub.ac.be
Van Nylen
Michelle
M
Blockeel
Christophe
C
Kaufman
Leon
L
Amy
Jean-Jacques
JJ
D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D018579:Patient Selection; D017773:Pelvic Floor; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D014550:Urinary Incontinence, Stress / Q000453:epidemiology / Q000628:therapy*; D014596:Uterine Prolapse / Q000453:epidemiology