https://doi.org/10.4081/uij.2022.290
Evaluation of the factors contributing to success of pelvic floor muscle training in stress urinary incontinence
Submitted: 12 March 2022
Accepted: 20 June 2022
Published: 8 July 2022
Accepted: 20 June 2022
Abstract Views: 1843
PDF: 431
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Pelvic Floor Muscle Training (PFMT) is an effective, non-invasive, and cost-effective treatment for Stress Urinary Incontinence (SUI). However, its success rate varies. We evaluated the factors predicting success in PFMT, such as age, initial urinary leakage, initial pelvic floor muscle contraction strength, urethral hypermobility, and myostatin level. A nested case-control study was conducted at Dr. Cipto Mangunkusumo hospital between February and October 2021. We evaluated demographic characteristics, UDI-6 and IIQ-7 questionnaire scores, physical exam, pad weight test, urethral hypermobility ultrasound, perineometry, myostatin level, and we instructed the subjects in PFMT according to a guidebook. After 12 weeks of PFMT, we evaluated therapy success, defined as less than 3g on the pad weight test. The study involved 58 women: 5 subjects dropped out, 47 subjects reached treatment success, and 6 subjects did not reach treatment success. Following bivariate analysis, we found that initial pad weight was the only variable that was significantly associated with treatment success (p=0.001, 95% CI: 1.02 – 2.25). The PFMT success rate was 88.68%, and initial urine leakage lower than 6.5g predicts PMFT success with 80.9% sensitivity and 83.3% specificity (p=0.001, 95% CI1.02–2.25).
Haylen BT, De Ridder D, Freeman RM, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodynam 2010;29:4-20.
DOI: https://doi.org/10.1002/nau.20798
Markland AD, Richter HE, Fwu C-W, et al. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urol 2011;186:589-93.
DOI: https://doi.org/10.1016/j.juro.2011.03.114
Capobianco G, Madonia M, Morelli S, et al. Management of female stress urinary incontinence: A care pathway and update. Maturitas 2018;109:32-8.
DOI: https://doi.org/10.1016/j.maturitas.2017.12.008
Petros PE, Ulmsten UI. An integral theory of female urinary incontinence. Experimental and clinical considerations. Acta Obstet Gynecol Scand Suppl 1990;153:7-31.
DOI: https://doi.org/10.1111/j.1600-0412.1990.tb08027.x
Bettez M, Le Mai Tu KC, Corcos J, et al. 2012 update: guidelines for adult urinary incontinence collaborative consensus document for the Canadian Urological Association. Canadian Urolog Assoc J 2012;6:354.
DOI: https://doi.org/10.5489/cuaj.12248
Minister of Health of the Republic of Indonesia. Peraturan menterl kesehatan republik indonesia nomor 64 tahun 2016 tentang perubahan atas peraturan menteri kesehatan nomor 52 tahun 2016 tentang standar tarif pelayanan kesehatan dalam penyelenggaraan program jaminan kesehatan 2016. [Regulation of the Minister of Health of the Republic of Indonesia number 64 of 2016 concerning amendments to the regulation of the minister of health number 52 of 2016 concerning standards for health service rates in the implementation of the 2016 health insurance program].
Nyström E, Asklund I, Sjöström M, Stenlund H, Samuelsson E. Treatment of stress urinary incontinence with a mobile app: factors associated with success. Inte Urogynecol J 2018;29:1325-33.
DOI: https://doi.org/10.1007/s00192-017-3514-1
Bo K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol 2012;30:437-43.
DOI: https://doi.org/10.1007/s00345-011-0779-8
Lindh A, Sjöström M, Stenlund H, Samuelsson E. Non-face-to-face treatment of stress urinary incontinence: Predictors of success after 1 year. Int Urogynecol J 2016; 27:1857-65.
DOI: https://doi.org/10.1007/s00192-016-3050-4
Neumann PB, Grimmer KA, Deenadayalan Y. Pelvic floor muscle training and adjunctive therapies for the treatment of stress urinary incontinence in women: a systematic review. BMC Women's Health 2006;6:11.
DOI: https://doi.org/10.1186/1472-6874-6-11
Madhu RT, Freeman RM. Natural history and prevention of urinary incontinence and urogenital prolapse. In: Cardozo L, Staskin D, eds. Textbook of female urology and urogynecology. CRC Press; 2017.
Hung HC, Chih SY, Lin HH, Tsauo JY. Exercise adherence to pelvic floor muscle strengthening is not a significant predictor of symptom reduction for women with urinary incontinence. Arch Physical Med Rehab 2012;93:1795-800.
DOI: https://doi.org/10.1016/j.apmr.2012.03.010
Radzimińska A, Weber-Rajek M, Strączyńska A, et al. The impact of pelvic floor muscle training on the myostatin concentration and severity of urinary incontinence in elderly women with stress urinary incontinence–A pilot study. Clinical Interventions Aging 2018;13:1893.
DOI: https://doi.org/10.2147/CIA.S177730
Laurens C, Bergouignan A, Moro C. Exercise-released myokines in the control of energy metabolism. Front Physiol 2020;11:91.
DOI: https://doi.org/10.3389/fphys.2020.00091
Santoso BIM, Fernandi Meria R. Bladder neck mobility in stress continent and incontinent malay women. 42nd Annual Meeting – Vancouver, Canada, June 20 – 24, 2017: Intern Urogynecol J 2017;28:1-282.
DOI: https://doi.org/10.1007/s00192-017-3337-0
Al-Saadi WI. Transperineal ultrasonography in stress urinary incontinence: The significance of urethral rotation angles. Arab J Urol 2016;14:66-71.
DOI: https://doi.org/10.1016/j.aju.2015.11.003
Xiao T, Xiao T, Chen Y, et al. Can stress urinary incontinence be predicted by ultrasound? Am J Roentgenol 2019;213:1163-9.
DOI: https://doi.org/10.2214/AJR.18.20893
Dahlan MS. Statistik untuk kedokteran dan kesehatan. [Statistics for medicine and health]. Penerbit Salemba; 2011
Brooks KCL, Varette K, Harvey MA, et al. A model identifying characteristics predictive of successful pelvic floor muscle training outcomes among women with stress urinary incontinence. Int Urogynecol J 2021;32:719-28.
DOI: https://doi.org/10.1007/s00192-020-04583-z
Obloza A, Teo R, Marriott E, et al. Association of baseline severity of lower urinary tract symptoms with the success conservative therapy for urinary incontinence in women. Int Urogynecol J 2019;30:705-10.
DOI: https://doi.org/10.1007/s00192-018-3778-0
Singh N, Rashid M, Bayliss L, Graham P. Pelvic floor muscle training for female urinary incontinence: Does it work? Arch Gynecol Obstet 2016;293:1263-9.
DOI: https://doi.org/10.1007/s00404-015-3965-x
Dumoulin C, Tang A, Pontbriand-Drolet S, et al. Pelvic floor morphometry: a predictor of success of pelvic floor muscle training for women with stress and mixed urinary incontinence. Int Urogynecol J 2017;28:1233-9.
DOI: https://doi.org/10.1007/s00192-016-3254-7
Labrie J, Lagro-Janssen A, Fischer K, et al. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence. Int Urogynecol J 2015;26:329-34.
DOI: https://doi.org/10.1007/s00192-014-2473-z
Yoo EH, Kim YM, Kim D. Factors predicting the response to biofeedback‐assisted pelvic floor muscle training for urinary incontinence. Int J Gynecol Obstet 2011;112:179-81.
Moegni F, Ocsilia Wengkang IF. Correlation of levator ani muscle strength measurement between Modified Oxford Grading Scale and perineometer on pelvic organ prolapse patient. Urogynaecologia 2021;33:268.
DOI: https://doi.org/10.4081/uij.2021.268
Yoo EH, Kim YM, Kim D. Factors predicting the response to biofeedback-assisted pelvic floor muscle training for urinary incontinence. Int J Gynaecol Obstet 2011;112:179-81.
DOI: https://doi.org/10.1016/j.ijgo.2010.09.016
Hittel DS, Berggren JR, Shearer J, et al. Increased secretion and expression of myostatin in skeletal muscle from extremely obese women. Diabetes 2009;58:30-8.
DOI: https://doi.org/10.2337/db08-0943
Louis E, Raue U, Yang Y, et al. Time course of proteolytic, cytokine, and myostatin gene expression after acute exercise in human skeletal muscle. J Appl Physiol 2007;103:1744-51.
DOI: https://doi.org/10.1152/japplphysiol.00679.2007
Kabak B, Belviranli M, Okudan N. Irisin and myostatin responses to acute high-intensity interval exercise in humans. Horm Mol Biol Clin Investig. 2018 Mar 20;35:0008.
DOI: https://doi.org/10.1515/hmbci-2018-0008
Yuan H, Ruan Y, Tan Y, et al. Regenerating urethral striated muscle by CRISPRi/dCas9-KRAB-Mediated myostatin silencing for obesity-associated stress urinary incontinence. Crispr J 2020;3:562-72.
DOI: https://doi.org/10.1089/crispr.2020.0077
Akita Y, Sumino Y, Mori K, et al. Myostatin inhibits proliferation of human urethral rhabdosphincter satellite cells. Int J Urol 2013;20:522-9.
DOI: https://doi.org/10.1111/j.1442-2042.2012.03186.x
Baczek J, Silkiewicz M, Wojszel ZB. Myostatin as a biomarker of muscle wasting and other pathologies-state of the art and knowledge gaps. Nutrients 2020;12:2401.
DOI: https://doi.org/10.3390/nu12082401
Calvani R, Marini F, Cesari M, et al. Biomarkers for physical frailty and sarcopenia: state of the science and future developments. J Cachexia Sarcopenia Muscle 2015;6:278-86.
DOI: https://doi.org/10.1002/jcsm.12051
Kalejaiye O, Vij M, Drake MJ. Classification of stress urinary incontinence. World J Urol 2015;33:1215-20.
DOI: https://doi.org/10.1007/s00345-015-1617-1
How to Cite
Hidayah, G. N., Hakim, S., Moegni, F., Ibrahim, N., Santoso, B. I., Djusad, S., … Meutia, A. P. (2022). Evaluation of the factors contributing to success of pelvic floor muscle training in stress urinary incontinence. Urogynaecologia, 34(1). https://doi.org/10.4081/uij.2022.290
Copyright (c) 2022 The Authors
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
An Open Access Publication is one that meets the following two conditions:
- the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.
- a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
Similar Articles
- Aniefiok J. Umoiyoho, Emmanuel C. Inyang-Etoh, Obstetric fistula repair: a guide to patient selection , Urogynaecologia: Vol. 25 No. 1 (2011)
- Abdullahi Khalid, Abdullahi Alhassan, James Oche Ejembi, Abdullahi Abdulwahab-Ahmed, Atypical presentation of vesicouterine fistula (Youssef’s syndrome) post-caesarean gossypiboma: a case report , Urogynaecologia: Vol. 35 No. 1 (2023)
- Pau Sarrio-Sanz, Ana Isabel Lopez-Lopez, Laura Martinez-Cayuelas, Luis Gomez-Perez, Manuel Angel Ortiz-Gorraiz, Jesús Romero-Maroto, Is pelvic organ prolapse correction with vaginal mesh suitable with a correct indication and protocolized follow-up? , Urogynaecologia: Vol. 34 No. 1 (2022)
- D. Riva, V. Saccà, A. Borsani, A. Mattucci, PERSISTENT URINARY RETENTION AFTER TVT: CASE REPORT AND COMMENTS , Urogynaecologia: Vol. 20 No. 3 (2006)
- J. BECO, J. MOUCHEL, PERINEOLOGY: A NEW AREA , Urogynaecologia: Vol. 17 No. 2 (2003)
- Sujatha Narayanamoorthy, Kimen Singh Balhotra, Michael Silver, Rodney McLaren Jr., Elishia McKay, Residents’ experience and training in obstetric anal sphincter injury repair in the United States , Urogynaecologia: Vol. 35 No. 1 (2023)
- F. BERNASCONI, M. GRASSO, C. MANTOVANI, E. LUCCHINI, S. ARIENTI, C. CERRI, SOCIAL COST OF FEMALE URINARY INCONTINENCE: EPIDEMIOLOGY, COST OF ILLNESS AND COST/EFFECTIVENESS ANALYSIS , Urogynaecologia: Vol. 17 No. 1 (2003)
- Harold P. Drutz, FEMALE URINARY INCONTINENCE IN CANADA , Urogynaecologia: Vol. 16 No. 3 (2002)
- A. Albiero, A. Gazzoni, S. Giudici, S. Poggi, L. Fedele, EVALUATION OF EFFICACY OF DIFFERENT SURGICAL PROCEDURES IN THE TREATMENT OF SUI AND GENITAL PROLAPSE , Urogynaecologia: Vol. 15 No. 3 (2001)
- S. Dati, V. De Lellis, P. Palermo, G. Carta, A COMPARISON BETWEEN SYNTHETIC AND BIOSYNTHETIC MESHES IN THE SURGICAL TREATMENT OF SEVERE GENITAL PROLAPSE: RESULTS AND COMPLICATIONS , Urogynaecologia: Vol. 23 No. 3 (2009)
You may also start an advanced similarity search for this article.