Effect of Pelvic Floor Muscle Training on the Quality of Life and Sexual Dysfunction in Stress Incontinence Women

Introduction: Urinary incontinence is defined by the International Continence Society (ICS) as the complain of any involuntary leakage of urine. The most common type of urinary incontinence in women is stress urinary incontinence (SUI), defined as the complaint of involuntary leakage on effort or when the body engages in physical motions like running, coughing, heavy lifting or sneezing exertion. This problem is common among women and when it happens in public, it can be very embarrassing and demoralizing. Most women with urinary incontinence have limitations in participating in social activities such as sports and even working in conditions that demand too much energy and most of them complained of various forms of sexual dysfunction. Pelvic floor muscle training is defined as the ability to perform a correct contraction, meaning a squeeze around vaginal openings and an inward movement of the pelvic floor.

Objective: The objective of the study was to evaluate the impact of the pelvic floor muscle training on the quality of life and sexual dysfunction in stress incontinence women.

Methods: Twenty women complaining of stress urinary incontinence were evaluated by voiding diary, muscle power (oxford scale), UDI- 6 Questionnaires and with FSFI before and after 6 months of the exercises. All had an urogynecologic evaluation and urodynamic study.

Main outcome measures: In the voiding diary the women reported the urinary frequency, and episodes of urgency and urine leakage. The domain scores of the FSFI, including desire, arousal, lubrication, orgasm, satisfaction, and pain, were calculated together with domain scores of UDI-6 questionnaires. The supervised Pelvic Floor Muscle Training (PFMT) was conducted for 15-30 min. twice a week for 2 months, once/week for another month (total of three months were supervised PFM), and follow up once/month for another three months to review and check the compliance with the exercises. (Total treatment 6 months since the patient started their treatment until the last session).

Results: After the six months of PFMT only three out of twenty patients were completely cured, eight complain of leakage with strong sneezing, if the bladder is full, three had leakage with strong coughing and six had leakage with coughing and sneezing. One of the twenty patients had pain with intercourse VAS 2/10 and one decreased interest in intercourse.