RecruitingNot ApplicableNCT06957795

Preoperative Pelvic Floor Muscle Training in Female Urinary Incontinence

Investigation of the Preoperative Effectiveness of Intensive Pelvic Floor Muscle Training in Women With Urinary Incontinence: a Randomized Controlled Trial.

Sponsor

Gulhane School of Medicine

Enrollment

60 participants

Start Date

Jan 1, 2025

Study Type

INTERVENTIONAL

Conditions

Pelvic Floor Muscle Training Women Urinary Incontinence (UI)Preoperative Period

Summary

Pelvic floor muscles (PFM) play a crucial role in supporting pelvic organs and maintaining continence. Weakness in these muscles can lead to dysfunctions such as pelvic organ prolapse, urinary incontinence (UI), and sexual or anorectal disorders. UI, defined as the involuntary loss of urine, is common globally and classified as stress, urge, or mixed incontinence. Stress urinary incontinence (SUI) - the most prevalent type among women - occurs during activities that increase intra-abdominal pressure. Risk factors include female sex, aging, obesity, smoking, chronic constipation, previous gynecological surgeries, and childbirth. Treatment options for SUI include conservative and surgical methods. Pelvic floor training (PFT), first described by Arnold Kegel in 1948, is a conservative approach that strengthens PFM and alleviates symptoms. Although surgery is often used for SUI, with over 200 procedures described, this study aims to evaluate the preoperative effectiveness of intensive PFT in women with SUI. It will assess changes in muscle function and symptoms before surgery, guiding pelvic rehabilitation strategies to potentially reduce surgical burden and improve outcomes.

Eligibility

Sex: FEMALEMin Age: 18 YearsMax Age: 65 Years

Inclusion Criteria7

Being a woman between the ages of 18-65
Being diagnosed with SUI or SUI-predominant mixed type urinary incontinence by an obstetrician-gynecologist
Having active pelvic floor muscle contraction
No genital anatomical abnormality
Being able to understand and follow verbal and written instructions
The patient was referred to physiotherapy at least 6 weeks before the planned surgery date
Patients performed 75% or more of the given exercises (categorized as adequate compliance)

Exclusion Criteria7

Not volunteering to participate
Being pregnant
Having had previous pelvic floor surgery
Having received previous pelvic floor physiotherapy
Having a vaginal or urinary infection
Being unable to tolerate pelvic floor muscle function measurement
Having a neuromuscular or neurological disease that may affect muscle function

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Interventions

OTHERIntensive Pelvic Floor Exercise Program

Intensive pelvic floor exercise program targeting the fast (tap) and slow twitch fibers (elevator) of the pelvic floor. The tap exercise will be performed by instructing the patient to quickly contract and release the pelvic floor muscles. For the elevator exercise, the patient will be asked to contract the pelvic floor muscles for 5 seconds and hold them for 5 seconds and then slowly relax them within 5 seconds. Patients will do the exercises as a home program. The exercise program will last for 6 weeks. One set of exercise will be counted as 10 taps and 10 elevator. In the first week, patients will be asked to do 5 sets of exercises per day and the number of sets will be increased by five for 6 weeks.