title: Rectal balloon training as an adjunctive method for pelvic floor muscle training in conservative management of stress urinary incontinence: a pilot study.
abstract: BACKGROUND
  Pelvic floor muscle training (PFMT) is currently considered as the first line conservative management for women with stress urinary incontinence (SUI). However, it is difficult for some women to self-identify the contraction of the pelvic floor muscle after they were trained by verbal instruction. Various techniques including rectal balloon probe have been developed to improve PFMT.
  
  
  OBJECTIVE
  To compare vaginal squeezing pressure, one-hour pad test, leakage episodes, rating scores about severity of SUI, and patient satisfaction between traditional PFMT and rectal balloon training (RBT).
  
  
  METHODS
  Twenty-eight patients with SUI were randomized into two groups, PFMT, and RBT groups. The PFMT group was verbally instructed to perform exercise as the traditional technique. In the RBT group, a Foley catheter filled with tap water to create balloon was inserted into the rectum in combination with the same exercise as in the PFMT group. The vaginal squeezing pressure before and after 6-week exercise program was measured by biofeedback machine model MYO420.
  
  
  RESULTS
  One patient in each group was lost to follow-up. This left 13 patients in each group. Both groups had statistically significant gained in vaginal squeezing pressure after exercise. The different pressure between pre and post exercise were 9.9 mmHg and 9.2 mmHg in PFMT and RBT group respectively (p = 0.84). Significant improvement of leakage episodes and self-rating scores assessed the severity of SUI after exercise was reported in both groups, although there was no significant difference between both groups. The number of patients wearing protection after exercise was lowered in both groups, which were 75% in PFMT group and 80% in RBT group. However satisfaction was greater after completing exercise in both groups.
  
  
  CONCLUSIONS
  PFMT is an effective conservative treatment of SUI. PFMT combined with rectal balloon training did not provide greater strength of the pelvic floor muscle than isometric contraction.
authors.affiliation: Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Sujira
authors.initials: S
authors.lastname: Roongsirisangrat
authors.forename: Sarissa
authors.initials: S
authors.lastname: Rangkla
authors.forename: Tarinee
authors.initials: T
authors.lastname: Manchana
authors.forename: Natthiya
authors.initials: N
authors.lastname: Tantisiriwat
mesh_terms: D005081:Exercise Therapy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor; D014550:Urinary Incontinence, Stress / Q000628:therapy*