Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence.
OBJECTIVE
To compare the effectiveness of pelvic floor exercises, electrical stimulation, vaginal cones, and no active treatment in women with urodynamic stress urinary incontinence.


METHODS
One hundred eighteen subjects were randomly selected to receive pelvic floor exercises (n=31), ES (n=30), vaginal cones (n=27), or no treatment (untreated control) (n=30). Women were evaluated before and after completion of six months of treatment by the pad test, quality of life questionnaire (I-QOL), urodynamic test, voiding diary, and subjective response.


RESULTS
In the objective evaluation, we observed a statistically significant reduction in the pad test (p=0.003), in the number of stress urinary episodes (p<0.001), and a significant improvement in the quality of life (p<0.001) in subjects who used pelvic floor exercises, electrical stimulation, and vaginal cones compared to the control group. No significant difference was found between groups in the urodynamic parameters. In the subjective evaluation, 58%, 55%, and 54% of women who had used pelvic floor exercises, electrical stimulation, and vaginal cones, respectively, reported being satisfied after treatment. In the control group, only 21% patients were satisfied with the treatment.


CONCLUSIONS
Based on this study, pelvic floor exercises, electrical stimulation, and vaginal cones are equally effective treatments and are far superior to no treatment in women with urodynamic stress urinary incontinence.
Castro
Rodrigo A
RA
Urogynecology and Vaginal Surgery Section, Department of Gynecology, Universidade Federal de São Paulo, São Paulo, SP, Brazil. rodrigo.castro@uol.com.br
Arruda
Raquel M
RM
Zanetti
Miriam R D
MR
Santos
Patricia D
PD
Sartori
Marair G F
MG
Girão
Manoel J B C
MJ
D004558:Electric Stimulation; D004599:Electric Stimulation Therapy / Q000592:standards*; D005081:Exercise Therapy / Q000592:standards*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D017773:Pelvic Floor / Q000503:physiopathology*; D010570:Pessaries / Q000592:standards*; D011788:Quality of Life; D016037:Single-Blind Method; D014550:Urinary Incontinence, Stress / Q000628:therapy*; D014563:Urodynamics