Standardized pelvic floor exercises improve stress urinary incontinence in women with intrinsic sphincter deficiency.
Pelvic floor rehabilitation is the conservative therapy of choice for women with stress urinary incontinence (SUI). The success rate of surgical procedures in SUI patients with intrinsic sphincter deficiency (ISD) is low. The aim of this study was to analyse the effect of a standardized physiotherapy on patients with SUI and normotonic urethra and ISD.



In this study, 64 patients with ISD and 69 patients with normotonic urethra were enrolled. Maximum urethral pressure (MUCP) >20 cm H2 O was considered as normotonic urethral pressure. Before and after physiotherapy MUCP was measured and cough testing was performed. Additionally, patient reported outcome was assessed using the King's Health Questionnaire (KHQ). For statistical analyses Excel 2010 (Microsoft Inc; Redmond, Washington) and SPSS 20 (SPSS Inc; Chicago, Illinois) for Windows were used. Power calculation was based on the primary endpoint incontinence impact and general health. For power calculation, GraphPad Statmate version 2.00 for Windows was used.



Sixty-four patients with ISD and 69 patients with normotonic urethra were included in the study. In SUI patients with normotonic and hypotonic urethra KHQ-scores regarding the primary endpoins "general health" and "incontinence impact" significantly improved following standardized physiotherapy. In both groups MUCP increased after physiotherapy. In SUI patients with ISD standardized physiotherapy resulted in a decreased incidence of a positive cough test.



Standardized physiotherapy should be offered to patients with SUI and ISD. Long-term results are subject to future studies. Neurourol. Urodynam. 35:711-716, 2016. © 2015 Wiley Periodicals, Inc.
Institute for Physiotherapy, Department of Physiotherapy, Bern, Switzerland.
Corinne
C
Lehmann
Departments of Obstetrics and Gynaecology, Urogynaecology Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Ingrid
I
Zipponi
Departments of Obstetrics and Gynaecology, Urogynaecology Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Marc U
MU
Baumann
Bern University of Applied Sciences Health, Bern, Switzerland.
Lorenz
L
Radlinger
Departments of Obstetrics and Gynaecology, Urogynaecology Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Michael D
MD
Mueller
Departments of Obstetrics and Gynaecology, Urogynaecology Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Annette
A
Kuhn
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014521:Urethra / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000534:rehabilitation*
intrinsic spincter deficiency; king's health questionnaire; quality of life; stress urinary incontinence