title: Multimodal vaginal toning for bladder symptoms and quality of life in stress urinary incontinence.
abstract: OBJECTIVE
  Treatment options for women with stress urinary incontinence (SUI) have limitations. We hypothesized that multimodal vaginal toning therapy would improve bladder symptoms and quality of life in women with postpartum SUI and sexual function complaints.
  
  
  METHODS
  Patients self-administered 24 sessions of multimodal vaginal toning therapy lasting 10 min each over 50 days. Outcomes included 1-h pad weight test, Urogenital Distress Inventory Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Female Sexual Distress Scale-Revised 2005 (FSDS-R), Female Sexual Function Index (FSFI), pelvic floor muscle strength, patient satisfaction, and adverse events.
  
  
  RESULTS
  Of the 55 patients enrolled (safety population), 48 completed the study per-protocol (PP population). A total of 38 (79%) patients had a positive 1-h pad weight test at baseline. In this group, urine leakage was moderate or severe in 82% of patients at baseline, but in only 18% after treatment. Treatment success was 84%, defined as >50% improvement in pad weight relative to baseline. In the PP population, mean UDI-6 score improved by 50% (p < 0.001) and IIQ-7 score improved by 69% (p < 0.001). Sexual function quality of life improved by 54% for FSDS-R and 15% for FSFI (both p < 0.001). Pelvic floor muscle strength significantly improved (p < 0.001). Patient satisfaction with therapy was reported in 83% of patients. In the safety population, 2 (3.6%) adverse events were reported-1 urinary tract infection and 1 report of discomfort due to excessive warmth.
  
  
  CONCLUSIONS
  Multimodal vaginal toning therapy yields clinically meaningful improvements in bladder symptoms, pelvic floor muscle strength, and quality of life in women with SUI.
authors.affiliation: Seattle OB/GYN Group, 1101 Madison Street, Suite 950, Seattle, WA, 98104, USA. sdltconsult@gmail.com.
authors.forename: Sarah
authors.initials: S
authors.lastname: de la Torre
authors.affiliation: Miller Scientific Consulting, Asheville, NC, USA.
authors.forename: Larry E
authors.initials: LE
authors.lastname: Miller
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D028022:Low-Level Light Therapy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D053580:Muscle Strength; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000503:physiopathology; D011446:Prospective Studies; D011788:Quality of Life; D055070:Resistance Training / Q000295:instrumentation / Q000379:methods*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D014550:Urinary Incontinence, Stress / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D014621:Vagina / Q000503:physiopathology; D014732:Vibration / Q000627:therapeutic use*
keywords: Female sexual dysfunction; Low-level light; Postpartum; Stress urinary incontinence; Vaginal toning