title: Does it work in the long term?--A systematic review on pelvic floor muscle training for female stress urinary incontinence.
abstract: OBJECTIVE
  There is level 1, grade A evidence that pelvic floor muscle training (PFMT) is effective in treatment of stress urinary incontinence (SUI), but long-term outcome has been questioned. The aim of this systematic review was to evaluate the long-term outcome of PFMT for female SUI.
  
  
  METHODS
  Computerized search on PubMed up to year 2012 was undertaken with the search strategy: pelvic floor AND (urinary incontinence OR stress urinary incontinence) AND (training OR exercise OR physical activity) AND (follow-up OR long-term). Limitations were: humans, female, clinical trial, English, and adults. Inclusion criteria were: studies on SUI using PFMT with or without biofeedback as the intervention, follow-up period of ≥1 year. Exclusion criteria were studies using electrical stimulation alone and studies in the peripartum period.
  
  
  RESULTS
  Nineteen studies were included (1,141 women followed between 1 and 15 years). Statistical meta-analysis was not performed due to high heterogeneity. Only two studies provided follow-up interventions. Losses to follow-up during the long-term period ranged between 0% and 39%. Long-term adherence to PFMT varied between 10% and 70%. Five studies reported that the initial success rate on SUI and MUI was maintained at long-term. Long-term success based on responders to the original trial varied between 41% and 85%. Surgery rates at long term varied between 4.9% and 58%.
  
  
  CONCLUSIONS
  Short-term outcome of PFMT can be maintained at long-term follow-up without incentives for continued training, but there is a high heterogeneity in both interventional and methodological quality in short-and long-term pelvic floor muscle training studies.
authors: Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway. kari.bo@nih.no
authors: Kari
authors: K
authors: Bø
authors: Gunvor
authors: G
authors: Hilde
mesh_terms: D000328:Adult; D000368:Aged; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics; D055815:Young Adult