title: Pelvic floor muscle training for stress urinary incontinence: a randomized, controlled trial comparing different conservative therapies.
abstract: OBJECTIVE
  Pelvic floor muscle training (PFMT) is an effective therapy for stress urinary incontinence (SUI). There is little and inconsistent data about different strategies of PFMT. Finding the right, patient-oriented treatment decision seems to be essential in order to achieve good results in conservative management of SUI. It was the aim of this prospective randomized controlled trial (RCT) to compare three different strategies using electromyography (EMG) biofeedback-assisted PFMT with and without electrical stimulation (ES) for treatment of SUI in women capable of voluntarily contracting the pelvic floor when a home-training device with vaginal electrode was used.
  
  
  METHODS
  Three-arm RCT comparing 1) EMG biofeedback-assisted PFMT and conventional ES; 2) EMG biofeedback-assisted PFMT and dynamic ES; and 3) EMG biofeedback-assisted PFMT. Primary outcome measures were quality of life (King's Health Questionnaire) and degree of suffering (rated on a visual analogue scale from 1 to 10). Secondary outcome measures were number of pads used, pad weight test, contractility of the pelvic floor measured by digital palpation and intra-vaginal EMG.
  
  
  RESULTS
  The quality of life significantly increased over the 12-week training. The number of pads used was reduced, the pad weight test and the contractility of the pelvic floor significantly improved. There were no significant differences between the three groups.
  
  
  CONCLUSIONS
  This RCT shows significant improvement in patients' quality of life for conservative therapy of SUI. Differences between the three therapeutic options analyzed could not be found. Additional ES showed no benefit for patients with SUI, capable of voluntary pelvic floor contraction.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Huebner
authors.forename: Katja
authors.initials: K
authors.lastname: Riegel
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Hinninghofen
authors.forename: Diethelm
authors.initials: D
authors.lastname: Wallwiener
authors.forename: Ralf
authors.initials: R
authors.lastname: Tunn
authors.forename: Christl
authors.initials: C
authors.lastname: Reisenauer
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength; D017773:Pelvic Floor / Q000503:physiopathology*; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000628:therapy*