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Purpose: To describe experiences of a 3-month pelvic floor muscle training (PFMT) period, with or without support from a physiotherapist, among females with urinary and/or fecal incontinence after pelvic radiotherapy. Method: This qualitative interview study included eleven women (aged 47–83 years) with urinary and/or fecal incontinence after radiotherapy treatment for pelvic cancer (radiotherapy completed 3–60 months ago). The eleven informants were part of a larger randomized controlled intervention study where they practiced PFMT, with or without support from a physiotherapist, for 3 months. The support from a physiotherapist included individual support with biofeedback as well as group training. The women were interviewed individually soon after the completion of the pelvic floor muscle training period, and data were analyzed with qualitative content analysis. Result: A structured training program, individual support from a physiotherapist, and strategies to establish a daily workout routine were described as valuable when practicing pelvic floor muscle training. Participating in the study gave a sense of meaningfulness and motivation to practice, partly due to the knowledge of a follow-up after the study period. Group and home training were described as both a facilitator and a barrier to PFMT. The women experienced that PFMT had influenced pelvic floor function in terms of increased pelvic floor strength, reduced urinary and fecal incontinence, and an increased ability to hold urine and feces during urgency. PFMT had a relieving effect on pelvic floor pain, although it also contributed to some increase in pain. The perceived improvement in pelvic muscle function led to decreased anxiety, increased safety, feelings of greater freedom in everyday life, a changed attitude toward physical activity, and improved sexual health. All women expressed an intention to continue practicing PFMT and a desire for information and opportunities for PFMT, under the guidance of a physiotherapist, to be implemented in conventional pelvic cancer rehabilitation and made available to all women after pelvic cancer treatment. Conclusion: The women who live with the experience of pelvic cancer experienced PFMT as a meaningful intervention for managing urinary and/or fecal incontinence after pelvic radiotherapy. They considered that information and support from a physiotherapist are essential in pelvic cancer rehabilitation, such as PFMT, and should be offered to all women after pelvic cancer treatment. [ABSTRACT FROM AUTHOR]

Objective: To systematically review and synthesise what is known about the effectiveness of non‐pharmaceutical conservative interventions for the management of urinary incontinence (UI) experienced by women during physical exercise. Methods: A systematic search was performed in the following databases in September 2023: the Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica dataBASE (EMBASE), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), and Physiotherapy Evidence Database (PEDro). Studies were deemed eligible if population consisted of females who reported symptoms of UI while participating in physical exercise, and the interventions involved any non‐pharmaceutical conservative treatment to manage symptoms during exercise. The primary outcome was severity of UI signs and symptoms. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO identifier: CRD42022379138). Results: Of the 3429 abstracts screened, 19 studies were retained. Pelvic floor muscle training (PFMT) and intravaginal devices were the most commonly investigated modalities. Only two randomised controlled trials (RCTs), both among volleyball players, compared PFMT with no PFM exercise, showing a reduction in pad weight gain after the intervention in the experimental groups only. PFMT with and without biofeedback randomised among soldiers demonstrated a reduction in the frequency of urine leakage episodes in both groups, while supervised and unsupervised PFMT randomised among athletes from different sports showed pad weight gain reduction in the supervised group only. Seven single‐arm studies suggested that PFMT alone or combined with other modalities may reduce UI severity in active women based on questionnaires, bladder diaries, and self‐reported symptoms. A single‐arm and a crossover study found pessary use beneficial in reducing urine leakage based on questionnaires and pad weight gain, respectively. When comparing pessary, tampon, and no intervention, two repeated‐measures studies found tampons may reduce leakage more than pessaries in CrossFit exercisers and women performing aerobic exercises. A vaginal sponge also reduced pad weight gain during aerobic exercises. Other modalities (i.e., an intraurethral device, photobiomodulation, and combined therapies) were investigated using case series or single case studies. While all interventions showed some evidence of effectiveness, the results must be interpreted with caution due to methodological limitations and high risk of bias. In particular, despite a high reliance on pad tests as a primary outcome, we identified inconsistencies in how pad tests were administered and interpreted. Conclusion: Only the effectiveness of PFMT to reduce urine leakage during exercise has been evaluated through RCTs, with some evidence of effectiveness. We identified a clear need for higher quality studies, with better reporting on the interventions, and more judicious use and interpretation of outcome measures. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectivesMethodsMajor FindingsConclusionMenopause is considered a risk factor for pelvic organ prolapse (POP). Although level 1 evidence exists for pelvic floor muscle training (PFMT) for reducing POP symptoms in the adult population, it is less clear whether it is as effective in post-menopausal women.This scoping review investigates supervised PFMT for improving POP signs or symptoms in this population.Seven databases were searched in December 2023. Five articles were included in the literature review (four RCTs and one SR). Included articles were assessed for quality and risk of bias using the Physiotherapy Evidence Database (PEDro) scale.The included studies found small but statistically significant results in favour of PFMT compared to controls to improve either POP symptoms or signs in post-menopausal women, with no adverse events from PFMT. Further robust studies are needed.Clinicians can offer PFMT to post-menopausal patients presenting with POP based on evidence, sound underlying physiological principles, and a lack of adverse events. A sample pelvic floor muscle training program is described, along with recommendations for multi-disciplinary input. [ABSTRACT FROM AUTHOR]

• We aimed to understand biomechanical changes from pelvic floor muscle training (PFMT). • Examined PFMT impact on pelvic floor biomechanics in SUI women using Vaginal Tactile Imager. • The clinically Improved Group showed significant differences in three key VTI parameters. • Findings suggest specific muscle changes can guide personalized SUI interventions. Our study aimed to improve the understanding of the biomechanical changes occurring in the pelvic floor due to pelvic floor muscle training (PFMT), which is responsible for improving stress urinary incontinence (SUI) symptoms. In this prospective cohort study, we examined the impact of a six-week PFMT program in women with stress or stress-predominant urinary incontinence on the biomechanical parameters of the pelvic floor. Fifty-two biomechanical parameters were measured by Vaginal Tactile Imager (VTI) at baseline and at a six-week follow-up. In addition, we have assessed the Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Patient's Global Impression of Severity (PGI-S) scores at enrolment and at six-week follow-up. We have divided our cohort into two groups, Improved Group (IG) and Not-improved Group (NIG), based on the change in UDI-6 score after six weeks and compared the biomechanical changes within and between the two groups. The overall cohort included twenty women with stress or stress-predominant SUI based on MESA questionnaire [MESA SUI index (mean ± SD) 63.3 % ± 24.0 %, MESA UUI index (mean ± SD) 13.3 % ± 15.3 %, p < 0.01]. Nine of the 52 VTI parameters have changed significantly after six weeks of PFMT in the entire cohort. Eleven women (IG) achieved the minimum 11-point change in the UDI-6 scaled score. In IG, we found that three VTI parameters differed significantly: Parameter 1: the maximum value of force measured during the VTI probe insertion [(N, mean ± SD) 0.55 ± 0.18 vs. 0.78 ± 0.31, p < 0.049], parameter 18: the maximum gradient at the upper third of the vagina (posterior) [(kPa/mm, mean ± SD) 0.16 ± 0.05 vs. 0.36 ± 0.28, p < 0.048], and parameter 47: integral force change in the anterior compartment at reflex pelvic muscle contraction (cough) [(N, mean ± SD) 1.61 ± 0.85 vs. 1.97 ± 0.71, p < 0.045]. Our study revealed a significant association between the improvement of strength in targeted muscle groups and a reduction in urinary incontinence symptoms. Identifying specific muscles changing PFMT provides valuable insights for specific interventions. Our findings may help to create personalized and targeted interventions to improve the quality of life of women affected by SUI. [ABSTRACT FROM AUTHOR]

Radical prostatectomy and radiotherapy are common first-line treatments for clinically localized prostate cancer. Despite advances in surgical technology and multidisciplinary management, post-prostatectomy urinary incontinence (PPI) remains a common clinical complication. The incidence and duration of PPI are highly heterogeneous, varying considerably between individuals. Post-prostatectomy urinary incontinence may result from a combination of factors, including patient characteristics, lower urinary tract function, and surgical procedures. Physicians often rely on detailed medical history, physical examinations, voiding diaries, pad tests, and questionnaires-based symptoms to identify critical factors and select appropriate treatment options. Post-prostatectomy urinary incontinence treatment can be divided into conservative treatment and surgical interventions, depending on the severity and type of incontinence. Pelvic floor muscle training and lifestyle interventions are commonly conservative strategies. When conservative treatment fails, surgery is frequently recommended, and the artificial urethral sphincter remains the "gold standard" surgical intervention for PPI. This review focuses on the diagnosis and treatment of PPI, based on the most recent clinical research and recommendations of guidelines, including epidemiology and risk factors, diagnostic methods, and treatment strategies, aimed at presenting a comprehensive overview of the latest advances in this field and assisting doctors in providing personalized treatment options for patients with PPI. [ABSTRACT FROM AUTHOR]

Objective Methods Search Strategy Data Collection and Analysis Conclusions This integrative review identified studies that reported the prevalence of physiotherapeutic interventions for urinary incontinence among postpartum women.This is an integrative literature review study. We used the integrative literature review framework proposed by Whittemore and Knafl to search for relevant literature.The search strategy for electronic databases was developed from the research question and definitions of key concepts, assisted by the librarian. Databases that were searched include Google Scholar, Medline (PubMed), CINAHL, and the Joanna Briggs Institute databases. Both qualitative and quantitative studies that met the inclusion criteria were included. We used the CASP tool to assess the quality of selected papers.The included articles were thematically analyzed. Thirty‐six papers met the inclusion criteria for the review. Six themes emerged from the analysis: prevalence of postpartum UI; risk factors for postpartum UI; antenatal pelvic floor muscle training; conservative treatment and quality of life; experiences of postpartum women with UI; and possible coping strategies adopted by women. Most of the articles were quantitative studies (80.5%); 16.6% were qualitative and 2.7% adopted mixed methods.Urinary incontinence is common in postpartum women. Antenatal pelvic floor muscle training is protective against postpartum UI and should be the first‐line treatment option. [ABSTRACT FROM AUTHOR]

Background: Urinary Incontinence (UI) is a global health issue that mainly affects the female population worldwide. Different approaches have been sought for the management of UI including Pelvic floor muscle training (PFMT) using Virtual Reality (VR) gaming. We conducted this study to evaluate the effectiveness of VR gaming for rehabilitation of pelvic floor muscles (PFM) and improving urinary symptoms in patients with UI. Method: We've included studies that contain any type of VR in all geographic locations and settings with no restrictions on the date of publication, age, or gender. Our exclusion criteria include reviews, case series, case reports, unextractable data, unavailable full text, abstract only articles, and studies don't show the effects of VR as a treatment for UI. A pre‐specified search term was used and modified according to the requirements of each of the following databases: PubMed, Web of Science, Scopus, Cochrane, Google scholar, and ScienceDirect. For risk of bias assessment, two assessment tools have been used: ROB 2.0 for RCTs and NIH for single arm studies. Results: Of 915 papers identified from 6 databases, 341 papers were assigned for screening after removing duplicates, 11 papers were eligible for full text screening, and 4 papers were finally included. The qualitative analysis of the results identifies six outcomes grouped into three primary categories: PFM, urinary symptoms, and quality of life. Only urinary loss outcome was eligible for meta‐analysis. The net effect between Game therapy + PFMT and PFMT reached MD = −5.49, 95% CI [−12.36:1.38] (heterogeneity; I2 = 95%, p < 0.01). Conclusion: Our research underscores the potential of VR gaming as a valuable adjunctive therapy for pelvic floor muscle rehabilitation in patients with UI. However, further studies are needed to explore its long‐term effectiveness, optimal therapy parameters, and cost‐effectiveness. Registration: Our protocol has been registered in PROSPERO (CRD42022384500). [ABSTRACT FROM AUTHOR]

• Combination therapy is efficacious in treating women with OAB. • Rapid effect and persistent clinical improvement were evident from week 2. • There were fewer side effects over time. We hypothesized that combination therapy would provide a synergistic effect to improve treatment outcomes for overactive bladder (OAB), thus enhancing the motivation for continuous exercise, and that it would be associated with fewer adverse events than monotherapy. Therefore, we investigated whether biofeedback-assisted pelvic floor muscle training (PFMT), drug therapy, or a combination of both would be more effective in improving the symptoms of OAB. This randomized controlled trial included women diagnosed with OAB. Group 1 received biofeedback-assisted pelvic muscle floor training (PFMT) for 12 weeks; group 2 took 5 mg of solifenacin/day for 12 weeks; and group 3 received 5 mg of solifenacin/day in combination with biofeedback-assisted PFMT during the first 4 weeks and biofeedback-assisted PFMT for another 8 weeks. All participants had 5 follow-up visits. The primary outcomes were objective improvement of OAB symptoms and quality of life. The secondary outcomes were treatment-related adverse events, subjective improvement of OAB symptoms, and electromyographic activity of pelvic floor muscle (PFM) contraction. All participants reported significant improvement of OAB symptoms and quality of life. Participants in group 2 experienced more pronounced adverse events than those in group 3. Intervention duration was positively associated with subjective improvement in OAB symptoms in groups 2 and 3. Drug-related adverse events, including dry mouth, myalgia, and restlessness, had a negative impact on the subjective improvement of OAB symptoms in group 2. In group 1, exercise adherence was positively correlated with subjective improvement of OAB symptoms, whereas in group 3, PFM contraction and biofeedback effect were positively correlated with symptom improvement. Combination therapy is efficacious in treating women with OAB. [ABSTRACT FROM AUTHOR]

The aim of the study is to determine how electromagnetic stimulation and visceral manipulation can improve pelvic floor strength and reduce the severity of symptoms of postmenopausal stress urinary incontinence (SUI). This randomized controlled trial was conducted on 50 postmenopausal female participants aged 50–66 years with a body mass index (BMI) ≥ 30 kg/m2. Participants were equally randomized into the study (A) and control (B) groups. The study group (A) underwent 36 pulsed electromagnetic stimulation (PEMS) sessions (20 min/session; 3 sessions a week/12 weeks), 12 sessions of visceral manipulation therapy (VMT) maneuvers (once weekly/weeks), and 24 supervised pelvic floor muscle training (PFMT) sessions (45–60 min/session; twice weekly/12 weeks), along with general advice. For 12 weeks, the control group (B) received the same PFMT and general advice. Kegel perineometer was used to measure vaginal squeeze pressure (VSP) and the urogenital distress inventory questionnaire-short form (UDI-6) to assess the severity of urinary incontinence (UI) symptoms in both groups before and after the treatment. The results revealed statistically significant improvements (p < 0.05) in both VSP and UDI-6 scores in group A compared to group B. Electromagnetic stimulation combined with visceral manipulation and supervised PFMT is more efficient than PFMT alone on SUI in postmenopausal women. Therefore, it is advisable to incorporate this combined approach into pelvic floor rehabilitation programs. [ABSTRACT FROM AUTHOR]

Genitourinary syndrome of menopause（GSM） is a symptom of external genitalia, urinary system, and sexual disorders in perimenopausal and postmenopausal women. This is a chronic progressive disease which becomes increasingly with age and prolonged menopause, seriously affects the quality of life of middle-aged and elderly women. For GSM patients, menopause hormone therapy (MHT) is the most effective measure，but long-term use of MHT is not suitable for all women. This article will review the non-hormone treatment of GSM and provide treatment strategies for doctors.

Abstract Background Urinary incontinence (UI) is the most prevalent pelvic floor disorder following treatment for gynaecological cancer with a distressing impact on quality-of-life in survivors. Physiotherapist-supervised pelvic floor muscle (PFM) training is recommended as the first-line intervention for UI in community-dwelling women. However, it is not known if this intervention is effective in women following treatment for gynaecological cancer, nor whether PFM training can be delivered entirely remotely. The primary aim of this study is to investigate if a telehealth-delivered PFM training program incorporating a novel biofeedback device reduces UI compared with usual care, following gynaecological cancer. Methods This is a pragmatic, two-arm parallel-group, stratified superiority randomised controlled trial recruiting 72 participants (ACTRN12622000580774). Recruitment sites include gynaecology-oncology outpatient clinics, supplemented by advertisements through community foundations/social media/care groups. Participants must have completed primary cancer treatment at least 6 months prior or adjuvant therapy at least 3 months prior, for Stage I, II or III uterine, cervical, fallopian tube, primary peritoneal or ovarian cancer or borderline ovarian tumour, and have UI occurring at least weekly. Participants randomised to the usual care group will receive bladder and bowel advice handouts and one audio telehealth physiotherapist consultation to answer any queries about the handouts. Participants randomised to the intervention group will receive the same handouts plus eight video telehealth physiotherapist consultations for PFM training with a biofeedback device (femfit®), alongside a home-based program over 16 weeks. The primary outcome measure is a patient-reported outcome of UI frequency, amount and interference with everyday life (measured using the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form), immediately post-intervention compared with baseline. Secondary outcomes include quality-of-life measures, bother of pelvic floor symptoms, leakage episodes, use of continence pads and global impression of change. We will also investigate if the intervention improves intra-vaginal resting and squeeze pressure in women in the intervention arm, using data from the biofeedback device. Discussion If clinical effectiveness of telehealth-delivered physiotherapist-supervised PFM training, supplemented with home biofeedback is shown, this will allow this therapy to enter pathways of care, and provide an evidence-based option for treatment of post-cancer UI not currently available. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ID 12622000580774. Registered 20 April 2022.

Abstract Background The potential benefit of exercise in alleviating symptoms of endometriosis is unclear. Still, exercise may be used to empower women and manage disease symptoms. The purpose of this study was to explore how regular supervised group- and individual exercise training, including pelvic floor muscle training (PFMT), is experienced among women with endometriosis after participating in a randomized controlled trial (RCT). Methods Among 41 women randomized to exercise training for four months, ten women were interviewed about their experiences with exercise training after participation in the trial. The weekly group training was led by women’s health physiotherapists and included individualized and progressive muscular strength training of large muscle groups and the pelvic floor muscles, in addition to endurance-, flexibility, and relaxation training. An individual training program followed the same principles as the group training and was to be performed 3–5 times per week, depending on the level of intensity. PFMT was recommended daily. The women also received a group pain management course emphasizing exercise training as self-management. Using inductive reflexive thematic analysis, responses to the question “Did participation in the study change your view of exercise as part of the treatment for endometriosis?“ were analyzed. Results The women brought forward the importance of knowledge about the benefits of exercise to make informed decisions in disease management. Further, the women described how exercise training was perceived as less frightening and manageable when exposed to various intensities, dosages, and types of exercises in a safe and supportive environment. PFMT was especially brought forward as something new and appreciated, and for some of the women, to be performed on days when their bodies could not handle the general exercise training. They also expressed that the supervised exercise brought an extra dimension of belonging through group participation. Conclusions Individualization and regular supervision seem important to empower women with knowledge about exercise training as self-management and to experience exercise training as safe and non-threatening. Further, creating a sense of belonging through group training may improve social support and build active coping strategies that are essential for disease management of endometriosis. Trial registration NCT05091268 (registered 23.09.2021).

The purpose of this study is to examine the effect of pelvic floor muscle training on faecal incontinence. Faecal incontinence is a condition in which stool leaks from the anus involuntarily or uncontrollably. Faecal incontinence is common in elderly people and patients with underlying diseases, but the pathophysiology of faecal incontinence is diverse, and treatment methods must be varied accordingly. Among the known treatment methods, in this study, we focused on pelvic floor muscle training, which can be performed in daily life. The literature was searched for papers that present existing knowledge and address current perspectives. Extracted studies included papers that report scientific consensus. After reviewing the literature, it appears that it is possible to effectively train patients to defecate twice a day, approximately 30 min after breakfast and dinner, by having them attempting to defecate, even when there is no such urge. Pelvic floor muscle training can improve urinary and faecal incontinence by strengthening the contractile force of the pelvic floor muscles such as the external anal sphincter and levator ani. However, the specific types of faecal incontinence patients that can effectively benefit from pelvic floor muscle training is unclear. It is important for patients to understand the pelvic floor muscle training program and to develop sufficient motivation to continue training at home.

Fangfang Du,1,&ast; Yujing Dong,2,&ast; Tian Tian,1 Weili Li,1 Feifei Wan,1 Suling Shi3 1Department of Nursing, Henan Vocational College of Tuina, Luoyang City, Henan Province, People’s Republic of China; 2Shool of Nursing,Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, People’s Republic of China; 3Department of Nursing, the First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang City, Henan Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fangfang Du, Department of Nursing, Henan Vocational College of Tuina, No. 10 Xuefu Street, Luolong District, Luoyang City, Henan Province, 471023, People’s Republic of China, Email dufangfang8119@163.comBackground: Stress urinary incontinence (SUI) is effectively managed through pelvic floor muscle training (PFMT), yet poor adherence often undermines its efficacy. Given square dancing’s popularity among middle-aged women, its integration with PFMT could potentially increase patient compliance. This study aims to investigate the impact of a hybrid program combining square dance and PFMT on SUI symptoms, quality of life, and treatment adherence in this demographic.Methods: Seventy-seven female participants from Luoyang were randomly allocated to an intervention group undergoing a 12-week program combining square dancing with PFMT, and two control groups receiving standard health advice or square dancing alone. Outcomes were assessed using subjective urinary incontinence rating, the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), and the Urinary Incontinence Quality of Life Scale (I-QOL), and a PFMT diary for compliance. Satisfaction was scored on a 10-point scale.Results: Participants (mean age: 53.35± 5.11 years) did not differ significantly at baseline. Post-intervention, the intervention group showed significant improvements in SUI symptoms and quality of life compared to both control groups (P < 0.05), with higher compliance (96.54% vs 54.82% in control I) and satisfaction (8.86± 0.85).Conclusion: Combining PFMT with square dancing significantly improved SUI symptoms, quality of life, and adherence among middle-aged women. Notably, despite the COVID-19 pandemic and associated restrictions during the 12-week intervention period, the communal and enjoyable nature of square dancing likely contributed to enhanced motivation and satisfaction. Keywords: stress urinary incontinence, pelvic floor muscle training, compliance, square dance, women, quality of life

Background The prevalence of pelvic floor dysfunction in postmenopausal women is progressively increasing, leading to a significant impact on both physical and mental well-being due to stress urinary incontinence (SUI) . Objective To investigate the impact of menopausal hormone therapy (MHT) in conjunction with Kegel exercises on pelvic floor structure and clinical symptoms in individuals experiencing mild to moderate SUI. Methods A total of 75 patients with menopausal syndrome accompanied by mild to moderate SUI who visited the Menopause Clinic at Beijing Shijitan Hospital, Capital Medical University in 2022 were selected. They were allocated into the MHT group and the control group in a 2∶1 ratio using a random number table method, and the MHT group was further randomly divided into subgroups receiving Tibolone and estrogen combined with progestogen therapy (EPT) in a 1∶1 ratio. Both the control group and the MHT group underwent pelvic floor muscle training (PFMT), commonly referred to as Kegel exercises, for 15-30 minutes per session, 2-3 times daily, and 2-3 d per weekly, over a continuous period of 12 months. The control group received Kuntai capsules orally in combination with PFMT, with 4 capsules taken per dose, 3 times a day, for 12 months. The MHT group received menopausal hormone therapy in conjunction with PFMT. The EPT subgroups include continuous combined estrogen-progestin therapy (1 mg estradiol valerate + 10 mg dydrogesterone, once daily), continuous sequential estrogen-progestin therapy (femoston 12 courses), and the Tibolone subgroup takes tibolone orally, all of which were administered continuously for 12 months. The study examined serum estradiol (E2) and follicle-stimulating hormone (FSH) levels within and between groups and subgroups before and after treatment. In addition, measurements were obtained for urethral rotation angle (URA), bladder detrusor thickness (BDT), posterior vesicourethral angle (PVUA), levator hiatus area (LHA), urinary incontinence quantification, ICI-Q-SF score, clinical efficacy, as well as changes in the modified Kupperman Menopausal Index (KMI) score, and the modified oxford staging (MOS) . Results Upon completion of the study, 7 participants from the MHT group were lost to follow-up (5 in the Tibolone subgroup and 2 in the EPT subgroup), with 3 participants from the control group also lost to follow-up. In the end, a total of 65 participants were included. After 1 year of treatment, there were no statistically significant differences in FSH, E2, and MOS between the MHT group and the control group (P>0.05). After 1 year of treatment, there were no statistically significant differences in PUVA, BDT, and URA between the MHT group and the control group (P>0.05). However, the LHA of the MHT group was significantly lower than that of the control group (P=0.028). After 1 year of treatment, there were no statistically significant differences in PUVA, BDT, URA, and LHA between the EPT and Tibolone subgroups (P>0.05). Statistically significant differences were found in the comparison of clinical efficacy between the control group and the MHT group (P=0.005). Conversely, no statistically significant differences were observed in the comparison of clinical efficacy between the EPT and Tibolone subgroups (P=0.727). After 1 year of treatment, the MHT group showed lower urinary incontinence quantity, ICI-Q-SF score, and KMI score compared to the control group (P0.05) . Conclusion The combination of MHT with PFMT yields a positive effect on the pelvic floor structure and markedly alleviates symptoms of urinary incontinence. Nevertheless, there is no significant differences between EPT and Tibolone in the improvement of pelvic floor structure and alleviation of clinical symptoms in patients.

Background: Urinary incontinence (UI) is the most prevalent pelvic floor disorder following treatment for gynaecological cancer with a distressing impact on quality-of-life in survivors. Physiotherapist-supervised pelvic floor muscle (PFM) training is recommended as the first-line intervention for UI in community-dwelling women. However, it is not known if this intervention is effective in women following treatment for gynaecological cancer, nor whether PFM training can be delivered entirely remotely. The primary aim of this study is to investigate if a telehealth-delivered PFM training program incorporating a novel biofeedback device reduces UI compared with usual care, following gynaecological cancer. Methods: This is a pragmatic, two-arm parallel-group, stratified superiority randomised controlled trial recruiting 72 participants (ACTRN12622000580774). Recruitment sites include gynaecology-oncology outpatient clinics, supplemented by advertisements through community foundations/social media/care groups. Participants must have completed primary cancer treatment at least 6 months prior or adjuvant therapy at least 3 months prior, for Stage I, II or III uterine, cervical, fallopian tube, primary peritoneal or ovarian cancer or borderline ovarian tumour, and have UI occurring at least weekly. Participants randomised to the usual care group will receive bladder and bowel advice handouts and one audio telehealth physiotherapist consultation to answer any queries about the handouts. Participants randomised to the intervention group will receive the same handouts plus eight video telehealth physiotherapist consultations for PFM training with a biofeedback device (femfit®), alongside a home-based program over 16 weeks. The primary outcome measure is a patient-reported outcome of UI frequency, amount and interference with everyday life (measured using the International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form), immediately post-intervention compared with baseline. Secondary outcomes include quality-of-life measures, bother of pelvic floor symptoms, leakage episodes, use of continence pads and global impression of change. We will also investigate if the intervention improves intra-vaginal resting and squeeze pressure in women in the intervention arm, using data from the biofeedback device. Discussion: If clinical effectiveness of telehealth-delivered physiotherapist-supervised PFM training, supplemented with home biofeedback is shown, this will allow this therapy to enter pathways of care, and provide an evidence-based option for treatment of post-cancer UI not currently available. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), ID 12622000580774. Registered 20 April 2022. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is a highly prevalent condition in women with a profound influence on their well-being and quality of life. Pelvic floor muscle training (PFMT) is a widely accepted conservative management of incontinence. Adequate knowledge of PFMT can enhance the ability of individuals to perform them effectively unsupervised. Objectives: This study aimed to determine the prevalence of UI and knowledge of PFMT among older women in a selected suburban community in Nigeria. Design: A cross-sectional design. Methods: This study consecutively recruited 121 older women (65 years and above) with a mean age of 68.59 ± 4.94 years in Nnewi North LGA Anambra state, Nigeria. The International Consultation on Incontinence Questionnaire Short Form and an adopted pre-tested questionnaire were used to assess the prevalence of UI and knowledge of PFMT. Data was analyzed using Statistical Package of Social Sciences (SPSS) version 26 Descriptive statistics, and the chi-square test was utilized with significance determined at an alpha level of 0.05. Results: The results revealed that 33.88% of the respondents experience UI, and 3.3% of them have heard about PFMT. There was significant association between prevalence of UI and number of pregnancies (χ2 = 11.16, p = 0.03) and children (χ2 = 9.77, p = 0.04). There was no significant association between the prevalence of UI and level of education (χ2 = 4.20, p = 0.12) and knowledge of PFMT (χ2 = 0.48, p = 0.42). There was no significant association between knowledge of PFMT and number of pregnancies (χ2 = 04.25, p = 0.37), and number of children (χ2 = 4.02, p = 0.40). There was a significant association between knowledge of PFMT and level of education among the participants (χ2 = 7.46, p = 0.02). Conclusion: The study showed a significant prevalence of UI and poor knowledge of PFMT in older women. Health professionals should sensitize older women in hospitals and care homes on the benefits of PFMT to improve their knowledge of PFMT. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA). Materials and Methods: This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound. Results: The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P < 0.001, η2 P = 0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P < 0.001, η2 P = 0.787) com- pared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased. Conclusion: PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy. [ABSTRACT FROM AUTHOR]

Introduction and Hypothesis: Pelvic floor muscle training (PFMT) is effective at improving urinary incontinence (UI) symptoms; however, patients often cannot properly contract their pelvic floor muscles. We hypothesized that contraction of the gluteal muscles alone would have the same effect as PFMT on improving UI symptoms. The aim of this study was to compare the effectiveness of gluteal muscles contraction alone with that of conventional PFMT at home for reducing UI symptoms in women. Methods: Sixty women 30–59 years in age who had stress urinary incontinence (SUI) were randomly assigned to the gluteal muscles training (GMT) group or the PFMT group. The participants in each group performed 3 min of training twice/day using a leaflet unsupervised at home during the 12-week intervention period. Three self-administered UI symptom measures (UI episodes/week, 1-h pad test, and the International Consultation of Incontinence Questionnaire-Short Form score) were compared before the observation period (baseline) and at the 6th or 12th week of the intervention period. Results: Fifty women who completed the 12-week intervention period were analyzed. After the 12-week intervention period, the three UI symptom outcome measures significantly decreased compared with baseline in both groups (α < 0.05). The rate of improvement in UI symptoms (decrease of at least 50% in UI episodes/week and in the 1-h pad test compared with baseline) was 65.2% in the GMT group and 63.0% in the PFMT group, with no significant differences between the two groups (p = 0.898). Conclusions: In unsupervised training using a leaflet at home, contraction of the gluteal muscles alone was shown to be as effective as conventional PFMT in reducing UI symptoms in women with SUI. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of pre‐ and postoperative supervised pelvic floor muscle training (PFMT) on the recovery of continence and pelvic floor muscle (PFM) function after robot‐assisted laparoscopic radical prostatectomy (RARP). Patients and Methods: We carried out a single‐blind randomised controlled trial involving 54 male patients scheduled to undergo RARP. The intervention group started supervised PFMT 2 months before RARP and continued for 12 months after surgery with a physiotherapist. The control group was given verbal instructions, a brochure about PFMT, and lifestyle advice. The primary outcome was 24‐h pad weight (g) at 3 months after RARP. The secondary outcomes were continence status (assessed by pad use), PFM function, and the Expanded Prostate Cancer Index Composite (EPIC) score. Results: Patients who participated in supervised PFMT showed significantly improved postoperative urinary incontinence (UI) compared with the control group (5.0 [0.0–908.0] g vs 21.0 [0.0–750.0] g; effect size: 0.34, P = 0.022) at 3 months after RARP based on 24‐h pad weight. A significant improvement was seen in the intervention compared with the control group (65.2% continence [no pad use] vs 31.6% continence, respectively) at 12 months after surgery (effect size: 0.34, P = 0.030). Peak pressure during a maximum voluntary contraction was higher in the intervention group immediately after catheter removal and at 6 months, and a longer duration of sustained contraction was found in the intervention group compared with the control group. We were unable to demonstrate a difference between groups in EPIC scores. Conclusion: Supervised PFMT can improve postoperative UI and PFM function after RARP. Further studies are needed to confirm whether intra‐anal pressure reflects PFM function and affects continence status in UI in men who have undergone RARP. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is common among postpartum women, but many do not seek medical help due to limited knowledge. Understanding the level of knowledge about UI in this population is essential for improving care‐seeking behaviors and implementing targeted interventions. Objective: The objective was to examine knowledge regarding UI among postpartum women with UI within 6 weeks to 1 year after delivery. Methods: A cross‐sectional study was conducted at obstetric clinic in two level‐three grade A hospitals in Shenzhen, China, from January 2023 to June 2023. Women in their 6 weeks to 1 year after delivery with UI were asked to complete a questionnaire comprising three sections: (1) demographic variable; (2) International Consultation on Incontinence Questionnaire Short Form (ICIQ‐UI SF); and (3) The Urinary Incontinence Quiz (UIQ). Results: A total of 1228 women completed the questionnaire. Their mean UIQ score was 6.63 ± 3.51 (minimum = 2, maximum = 15), indicating the deficiency of UI knowledge among Chinese postpartum women. A total of 86.4% of participants experienced slight or moderate postpartum UI. The results of multivariate linear regression models for UIQ reveal significant independent associations between questionnaire scores and two variables: experience in pelvic floor muscle training (PFMT) (p < 0.001) and UI treatment in the past (p < 0.001). The overall model fit was R2 = 0.559 (p < 0.001). The regression coefficients for the experience in PFMT and UI treatment in the past were 2.301 and 4.916, respectively. However, no other discernible factors were identified to distinguish between those with and without adequate knowledge. Conclusions: Postpartum women with UI within 6 weeks to 1 year after delivery had poor knowledge of UI. Targeted educational interventions focusing on PFMT and early treatment for UI are essential. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the effect of pelvic floor muscle training on faecal incontinence. Faecal incontinence is a condition in which stool leaks from the anus involuntarily or uncontrollably. Faecal incontinence is common in elderly people and patients with underlying diseases, but the pathophysiology of faecal incontinence is diverse, and treatment methods must be varied accordingly. Among the known treatment methods, in this study, we focused on pelvic floor muscle training, which can be performed in daily life. The literature was searched for papers that present existing knowledge and address current perspectives. Extracted studies included papers that report scientific consensus. After reviewing the literature, it appears that it is possible to effectively train patients to defecate twice a day, approximately 30 min after breakfast and dinner, by having them attempting to defecate, even when there is no such urge. Pelvic floor muscle training can improve urinary and faecal incontinence by strengthening the contractile force of the pelvic floor muscles such as the external anal sphincter and levator ani. However, the specific types of faecal incontinence patients that can effectively benefit from pelvic floor muscle training is unclear. It is important for patients to understand the pelvic floor muscle training program and to develop sufficient motivation to continue training at home. [ABSTRACT FROM AUTHOR]

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Introduction: Urinary incontinence (UI) is common in postpartum women and can lead to a reduced quality of life and withdrawal from fitness and exercise activities. Conservative management interventions such as pelvic floor muscle training (PFMT), use of vaginal cones, and biofeedback have been recommended as first‐line treatment. We aimed to explore the effects of conservative interventions on UI rate, severity, and incontinence‐specific quality of life in postpartum women with UI. Methods: Nine databases were searched from inception to August 2022: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, Wanfang, China National Knowledge Infrastructure, China Biological Medicine, and VIP Journal Integration Platform. Randomized controlled trials examining the effects of conservative interventions on postpartum UI were included. Results: Initial searches produced 1839 results, of which 17 studies were eligible. All included studies had a low to moderate risk of bias. Supervised PFMT and use of a vaginal cone were more effective than individual PFMT in decreasing rates of UI (odds ratio, 0.29; 95% CI, 0.14‐0.61). Individual PFMT combined with acupuncture (mean difference, −1.91; 95% CI, −2.46 to −1.37) or electroacupuncture and supervised PFMT combined with moxibustion were more effective than individual supervised PFMT alone in improving the severity of symptoms. Furthermore, electrical stimulation and biofeedback combined with acupoint stimulation or core training were more effective than electrical stimulation and biofeedback alone. For improving the incontinence‐specific quality of life, supervised PFMT was more efficacious than individual PFMT; electrical stimulation and biofeedback plus core training were more beneficial than electrical stimulation and biofeedback alone. Discussion: Supervised PFMT and use of a vaginal cone were more beneficial in decreasing rates of UI compared with individual PFMT. Superior effects in decreasing UI severity may be achieved by combining PFMT or electrical simulation and biofeedback with other therapies. Electrical stimulation and biofeedback plus core training, as well as supervised PFMT, are most effective in improving incontinence‐specific quality of life. Further research is required to provide more evidence on the efficacy of these therapies. [ABSTRACT FROM AUTHOR]

Background: Vaginal laxity (VL) is a complaint of excessive vaginal looseness with a prevalence ranging from 24% to 38% across studies. Aim: The study sought to compare the effect of radiofrequency (RF) and pelvic floor muscle training (PFMT) on the treatment of women with VL. Methods: From February 2020 to December 2021, a prospective, parallel, noninferiority, randomized clinical trial was carried out in women ≥18 years of age and complaining of VL in a tertiary hospital. Two groups (RF and PFMT) were evaluated at the beginning of the study and 30 days and 6 months postintervention. A total of 42 participants per arm was sufficient to demonstrate a difference in sexual function on the Female Sexual Function Index at 90% power, 1-sided type 1 error of 0.025 with a noninferiority margin of 4 on the FSFI total score. Analysis was intention-to-treat and per-protocol based. Outcomes: The primary endpoint was the change of FSFI score after treatment, and the secondary outcomes were improvement in symptoms of VL and changes in questionnaire scores of sexual distress, vaginal symptoms, and urinary incontinence, in the quantification of pelvic organ prolapse, and pelvic floor muscle (PFM) contraction. Results: Of 167 participants recruited, 87 were included (RF: n = 42; PFMT: n = 45). All questionnaires improved (P < .05) their total scores and subscales in both groups and during the follow-ups. After 30 days of treatment, RF was noninferior to PFMT to improving FSFI total score (mean difference −0.08 [95% confidence interval, −2.58 to 2.42]) in the per-protocol analysis (mean difference −0.46 [95% confidence interval, −2.92 to 1.99]) and in the intention-to-treat analysis; however, this result was not maintained after 6 months of treatment. PFM contraction improved significantly in both groups (RF: P = .006, 30 days; P = .049, 6 months; PFMT: P < .001, 30 days and 6 months), with better results in the PFMT group. Clinical Implications: Sexual, vaginal, and urinary symptoms were improved after 30 days and 6 months of treatment with RF and PFMT; however, better results were observed in the PFMT group after 6 months. Strengths & Limitations: The present randomized clinical trial used several validated questionnaires evaluating quality of life, sexual function and urinary symptoms, in addition to assessing PFM contraction and classifying the quantification of pelvic organ prolapse aiming at anatomical changes in two follow-up periods. The limitations were the lack of a sham-controlled group (third arm) and the difficulty of blinding researchers to assess treatments due to the COVID-19 pandemic. Conclusion: After 30 days and 6 months of treatment, sexual, vaginal, and urinary symptoms improved with RF and PFMT; however, better results were observed in the PFMT group after 6 months. RF was noninferior to PFMT in improving FSFI total score after 30 days; however, this result was not maintained after 6 months of treatment. [ABSTRACT FROM AUTHOR]

Objectives: This project aimed to implement best practices for pelvic floor muscle training to manage urinary incontinence among older women in long-term care in Kerala, India. Introduction: Urinary incontinence is a prevalent and distressing condition that affects a significant proportion of older adults and is characterized by involuntary loss of urine, leading to social embarrassment, decreased quality of life, and increased health care costs. It is more prevalent in women and is associated with dementia, limited mobility, and other comorbidities in long-term care. Pelvic floor muscle training is a first-line treatment option for urinary incontinence in older adults, given its potential to improve quality of life and reduce health care costs. Methods: This project was based on the JBI Evidence Implementation Framework. A baseline audit was conducted to evaluate current practice against best practices. After identifying barriers and implementing strategies, follow-up audits were conducted after 3 and 6 months. Results: The baseline audit showed 0% compliance with all best practices. Barriers such as lack of knowledge and practice of pelvic floor exercises for urinary incontinence among participants and nurses; unknown cognitive status; and health emergencies were identified. Strategies including video-assisted training of pelvic floor muscle exercises, training calendars, and flip charts with instructions. The follow-up audits showed significant improvements in compliance. Conclusions: This project reduced urinary incontinence in the participants. Although two of the audit criteria did not reach 100% compliance by the end of 6 months, the stakeholders of the long-term care facility understood the importance of pelvic floor muscle training, which will be beneficial for future residents with urinary incontinence. [ABSTRACT FROM AUTHOR]

This study was conducted to investigate the effect of biofeedback (BF) on the rehabilitation of children with nonneurological dysfunctional voiding (NDV). RCTs were retrieved from various databases (published from inception to February 29, 2024). The effects of the BF and non-BF treatments were compared. A random-effects model was used to evaluate the combined data. Meta-analysis revealed that BF increased the maximum urinary flow rate (SMD = 3.78, 95% CI 1.33∼6.22), improved urination time (SMD = 5.88, 95% CI 3.75∼8.01), and reduced the postvoid residual (SMD = −19.18, 95% CI -27.03∼-11.33) and urinary tract infection incidence (RR = 0.43, 95% CI 0.21∼0.87). Electromyogram activity (RR = 0.46, 95% CI 0.25∼0.84) and abnormal urination patterns (RR = 0.51, 95% CI 0.35∼0.74) improved, with effects persisting for more than 1 year. However, the effect of BF on the mean urinary flow rate in children with NDV was significant only after 1 year of follow-up (SMD = 1.90, 95% CI 0.87∼2.92). Existing evidence indicates that BF can enhance urinary parameters and patterns in children with NDV. However, its effectiveness in addressing constipation, daytime urinary incontinence, and nocturnal urinary incontinence is not substantial. High-quality randomized controlled trials can offer additional insights. [ABSTRACT FROM AUTHOR]

• PFMT-P is a valid and reliable measurement tool suitable for Turkish culture that consists of knowledge, knowledge source and implementation variables. • The PFMT-P is a short, comprehensive and useful tool that can be used in both reproductive and menopausal women. Although there are several patient reported outcome measures (PROM) regarding knowledge, source of knowledge and practice about pelvic floor muscle training (PFMT), there is a lack of a valid and reliable PROM that includes the practice component of PFMT along with knowledge and source of knowledge. There is no valid and reliable measurement tool in Turkish used for this purpose. In this context, the aim of our study is to evaluate the psychometric properties of Pelvic Floor Muscle Training Patient Reported Outcome Measures (PROM) (PFMT-P) and to test whether it is a valid and reliable measurement tool for Turkish women. This study has been carried out psychometric testing (validity and reliability) of a new assessment tool concerning PFMT-P. A total of 170 female healthcare professionals (midwives, nurses, doctors, physiotherapists) who were between the ages of 23 and 49 and who volunteered to participate were included in the study. SPSS 25.0 and LİSREL 8.80 statistical programs were used for the analysis of data. Descriptive statistics were evaluated with numbers, percentages and means. Content validity index and confirmatory factor analysis were used for validity. Cronbach Alpha value and test–retest were used for reliability. Level of significance was p < 0.05. Content validity index (CVI) was found to be 0.96 for the overall scale. Model fit indices were found as perfect and good matched. Cronbach's alpha coefficient was found as 0.813 for the overall scale. Test-retest correlation was found as 0.658, it was 0.998 for practice component and 0.997 for source of knowledge component and a positive, significant and high correlation was found. It has been determined that PFMT-P is a valid and reliable measurement tool suitable for Turkish culture. With this, it is a short, comprehensive and useful tool that can be used in both pregnancy and the postpartum period for women of reproductive age or menopause. [ABSTRACT FROM AUTHOR]

Abstract Background Urinary incontinence is highly prevalent in women while pelvic floor muscle training is recommended as the first-line therapy. However, the exact treatment regimen is poorly understood. Also, patients with pelvic floor muscle damage may have decreased muscle proprioception and cannot contract their muscles properly. Other conservative treatments including electromagnetic stimulation are suggested by several guidelines. Thus, the present study aims to compare the effectiveness of electromagnetic stimulation combined with pelvic floor muscle training as a conjunct treatment for urinary incontinence and different treatment frequencies will be investigated. Methods/design This is a randomized, controlled clinical trial. We will include 165 patients with urinary incontinence from the outpatient center. Participants who meet the inclusion criteria will be randomly allocated to three groups: the pelvic floor muscle training group (active control group), the low-frequency electromagnetic stimulation group (group 1), and the high-frequency electromagnetic stimulation group (group 2). Both group 1 and group 2 will receive ten sessions of electromagnetic stimulation. Group 1 will be treated twice per week for 5 weeks while group 2 will receive 10 days of continuous treatment. The primary outcome is the change in International Consultation on Incontinence Questionnaire–Short Form cores after the ten sessions of the treatment, while the secondary outcomes include a 3-day bladder diary, pelvic floor muscle function, pelvic organ prolapse quantification, and quality of life assessed by SF-12. All the measurements will be assessed at baseline, after the intervention, and after 3 months of follow-up. Discussion The present trial is designed to investigate the effects of a conjunct physiotherapy program for urinary incontinence in women. We hypothesize that this strategy is more effective than pelvic floor muscle training alone, and high-frequency electromagnetic stimulation will be superior to the low-frequency magnetic stimulation group.

Introduction Climacteric period signifies a transitional phase characterized by ovarian failure and a decline in estrogen levels, leading to various urogynecological alterations, including potential sexual dysfunctions. Among these, pelvic floor muscle (PFM) function plays a pivotal role in female sexual function. This study aims to evaluate the efficacy of pelvic floor muscle training (PFMT) on the sexual function of climacteric women. Methods Experimental or quasi-experimental studies published in peer-reviewed journals, assessing the sexual function of perimenopausal women with PFMT as an intervention, will be included. Studies conducted in institutionalized populations or with neurological and cognitive diseases will be excluded. This systematic review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The searches will be carried out in the Pubmed, LILACS (Latin American and Caribbean Literature on Health Sciences), Scopus, Web of Science, and PEDro, using the Search equation: climacteric women/menopause and PFMT and (sexual function or sexual dysfunction). The assessment of methodological quality will be carried out using the Pedro and GRADE scale, which will involve two independent researchers to evaluate the criteria. A third researcher will resolve discrepancies. Ethics and disclosure Ethical approval is not required as this is a secondary data study. This systematic review began in April 2024 and all steps are expected to be completed by November 2024. PROSPERO registration number CRD42024534297

Introduction and hypothesis: Stress urinary incontinence (SUI) is defined as involuntary leakage of urine on physical effort and is prevalent among power- and weightlifters. However, there is scant knowledge on treatment options for this population. The aim of this pilot study was to evaluate the potential outcomes and feasibility of a pelvic floor muscle training (PFMT) program on SUI in nulliparous female power- and weightlifters. Methods: This was a case-series study, including one weightlifter and two powerlifters aged 21–32 years. The participants conducted 12 weeks of PFMT at home, with weekly follow-up by a physiotherapist. Change in total score of the International Consensus of Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI-SF) was the primary outcome. Secondary outcome was perceived change assessed by the Patient Global Impression of Improvement (PGI-I) Scale and impact on sport participation. PFM strength, endurance, and resting pressure was measured using vaginal manometry. Feasibility was evaluated as adherence to training and self-efficacy (Self Efficacy Scale for Practicing Pelvic Floor Exercises). Results: One athlete reduced their ICIQ-UI-SF score and experienced improvement in symptoms. One athlete reported no change, and one reported a worsening of symptoms. All three participants improved PFM strength and endurance, completed the testing, and 12 weeks of PFMT, but adherence varied between 40 and 80%. Participants reported a lack of time and energy and forgetting to perform the exercises, as reasons for low adherence. Conclusion: There were varying effects of a 12-week PFMT program on SUI in three strength athletes. The results can create the basis for a future randomized controlled trial. [ABSTRACT FROM AUTHOR]

Introduction: The complex process of pregnancy and childbirth significantly influences the well‐being of both mother and child. Today all pregnant women without medical contraindications are recommended to start or continue regular aerobic and strength training for at least 150 min per week to prevent pregnancy‐related diseases and conditions. Urinary incontinence in pregnancy, episiotomy and third‐ or fourth‐degree perineal tear during labor can greatly impact womens' health, quality of life and ability to be physically active. The aim of this study was to examine the efficacy of pelvic floor muscle training (PFMT) during pregnancy in the prevention of urinary incontinence, episiotomy, and third‐ or fourth‐degree perineal tear. Material and methods: A systematic review and meta‐analysis (CRD42022370600) was performed. Only randomized clinical trials published between 2010 and 2023 were included. The following databases were examined: EBSCO (including Academic Search Premier, Education Resources Information Center, MEDLINE, SPORTDiscus and OpenDissertations databases), Clinicaltrials.gov, Web of Science, Scopus, Cochrane Database of Systematic Reviews and Physiotherapy Evidence Database (PEDro). Three meta‐analyses to investigate the effect of PFMT exclusively or implemented as a section within a physical activity program during pregnancy on urinary incontinence, episiotomy, and third‐ or fourth‐degree perineal tear were conducted. Results: Thirty studies were analyzed (N = 6691). An effective preventive action of PFMT was found for urinary incontinence (z = 3.46; p < 0.0005; relative risk [RR] = 0.72, 95% confidence interval [CI]: 0.59, 0.87, I2 = 59%) and third‐ or fourth‐degree perineal tear (z = 2.89; p = 0.004; RR = 0.50, 95% CI: 0.31, 0.80, I2 = 48%) but not for episiotomy (z = 0.80; p = 0.42; RR = 0.95, 95% CI: 0.85, 1.07, I2 = 75%). Conclusions: PFMT during pregnancy proves to be an effective preventive intervention for reducing the risk of urinary incontinence and the occurrence of third‐ or fourth‐degree perineal tears. These findings highlight the importance of incorporating PFMT into antenatal care and training programs to improve maternal well‐being and overall childbirth outcomes. [ABSTRACT FROM AUTHOR]

Background Pelvic floor muscle training (PFMT) has emerged as a potential intervention to improve post–total hysterectomy (TH) sexual function. Electromyographic (EMG) biofeedback is an adjunct that may improve outcomes. Aim In this study we aimed to compare the EMG biofeedback–assisted PFMT and PFMT alone for improving sexual function in women after TH. Methods For this prospective study we enrolled women undergoing TH in our hospital between January 2022 and April 2023. Participants were divided according to the treatment they selected: EMG biofeedback–assisted PFMT or PFMT alone. Outcomes The primary study outcome was change in patient sexual function evaluated by use of the Female Sexual Function Index. Secondary outcomes were changes in anxiety and depression evaluated with the Hospital Anxiety and Depression Scale score and pelvic floor muscle strength was evaluated with the Glazer assessment performed from before to after treatment. Results A total of 73 patients were included, with 38 patients treated with Electromyographic biofeedback–assisted pelvic floor muscle training. After treatment, sexual function was significantly improved compared to baseline in all patients (all P  < .001). Compared to patients with pelvic floor muscle training, the changes in total Female Sexual Function Index scores from before to after treatment in patients with Electromyographic biofeedback–assisted pelvic floor muscle training were significantly higher (all P  < .05). There were no significant differences between the 2 groups in the changes in the Glazer score and Hospital Anxiety and Depression Scale scores from before to after treatment (both P  > .05). Clinical Translation The results demonstrate that Electromyographic biofeedback–assisted pelvic floor muscle training may be used to improve the sexual function of patients following TH. Strengths and Limitations This study is limited by its single-center design, small sample size, lack of randomization, and absence of estrogen monitoring in enrolled participants. Conclusions Electromyographic biofeedback–assisted pelvic floor muscle training appears to be more effective than pelvic floor muscle training alone in improving sexual function among patients after total hysterectomy. [ABSTRACT FROM AUTHOR]

Background Pelvic floor muscle training can effectively improve pelvic floor muscle strength and activities; however, its impact on sexual function in women with stress urinary incontinence remains unclear. Aim The study sought to investigate the impact of pelvic floor muscle training on pelvic floor muscle and sexual function in women with stress urinary incontinence. Methods This was a retrospective observational study involving women who visited a urogynecologic clinic at a tertiary medical center. Patients with stress urinary incontinence without pelvic organ prolapse underwent pelvic floor muscle training programs that included biofeedback and intravaginal electrostimulation. Other evaluations included pelvic floor manometry, electromyography, and quality-of-life questionnaires, including the short forms of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire, Urogenital Distress Inventory, and Incontinence Impact Questionnaire. Outcomes Clinical characteristics, vaginal squeezing and resting pressure, maximal pelvic floor contraction, duration of sustained contraction, quality-of-life scores, and sexual function were compared between baseline and after the pelvic floor muscle training programs. Results There were 61 women included in the study. The mean number of treatment sessions was 12.9 ± 6.3, and the mean treatment duration was 66.7 ± 32.1 days. The short forms of the Urogenital Distress Inventory (7.7 ± 3.8 vs 1.8 ± 2.1; P <.001) and Incontinence Impact Questionnaire (5.9 ± 4.3 vs 1.8 ± 2.0; P <.001) scores significantly improved after the pelvic floor muscle training program. In addition, all pelvic floor muscle activities significantly improved, including maximal vaginal squeezing pressure (58.7 ± 20.1 cmH2O vs 66.0 ± 24.7 cmH2O; P =.022), difference in vaginal resting and maximal squeezing pressure (25.3 ± 14.6 cmH2O vs 35.5 ± 16.0 cmH2O; P <.001), maximal pelvic muscle voluntary contraction (24.9 ± 13.8 μV vs 44.5 ± 18.9 μV; P <.001), and duration of contraction (6.2 ± 5.7 s vs 24.9 ± 14.6 s; P <.001). Nevertheless, the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire score demonstrated no significant improvement (28.8 ± 9.7 vs 29.2 ± 12.3; P =.752). Clinical Implications Pelvic floor muscle training programs may not improve sexual function in women with stress urinary incontinence. Strengths and Limitations The strength of this study is that we evaluated sexual function with validated questionnaires. The small sample size and lack of long-term data are the major limitations. Conclusion Pelvic floor muscle training can improve pelvic floor muscle activities and effectively treat stress urinary incontinence; however, it may not improve sexual function. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study is to examine the impact of structured pelvic floor muscle training (PFMT) on pelvic floor muscle (PFM) contraction and the treatment of pelvic organ prolapse (POP) in postpartum women. Methods: Sixty patients who volunteered for a PFMT assessment at 6–8 weeks after delivery were included in this retrospective analysis. For 5 weeks, all patients had structured PFMT, which included supervised daily pelvic muscle contractions, biofeedback therapy, and electrical stimulation. The main outcomes were POP stage assessed by POP quantification (POP-Q), pelvic organ position and hiatus area (HA) assessed by transperineal ultrasound, PFM contraction assessed by Modified Oxford scale (MOS), surface electromyography (EMG), and sensation of PFM graded using visual analog scale (VAS). Results: Structured PFMT was associated with better POP-Q scores in Aa, Ba, C, and D (p values were 0.01, 0.001, 0.017, and 0.001 separately). The bladder neck at rest and maximum Valsalva, the cervix position and HA at maximum Valsalva in transperineal ultrasound were significantly better than before (p values were 0.031, < 0.001, 0.043, and < 0.001 separately). PFM contraction assessed by MOS, EMG, and PFM VAS score were significantly improved (all p values were < 0.001). However, no significant improvement was observed in POP-Q stage. Conclusions: Structured PFMT can increase PFM function in postpartum women but cannot modify the POP-Q stage. Transperineal ultrasonography is a useful method for evaluating therapy efficacy objectively. More randomized controlled trials are needed before definitive conclusions can be drawn about the effect of structured PFMT on POP in postpartum women. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence is highly prevalent in women while pelvic floor muscle training is recommended as the first-line therapy. However, the exact treatment regimen is poorly understood. Also, patients with pelvic floor muscle damage may have decreased muscle proprioception and cannot contract their muscles properly. Other conservative treatments including electromagnetic stimulation are suggested by several guidelines. Thus, the present study aims to compare the effectiveness of electromagnetic stimulation combined with pelvic floor muscle training as a conjunct treatment for urinary incontinence and different treatment frequencies will be investigated. Methods/design: This is a randomized, controlled clinical trial. We will include 165 patients with urinary incontinence from the outpatient center. Participants who meet the inclusion criteria will be randomly allocated to three groups: the pelvic floor muscle training group (active control group), the low-frequency electromagnetic stimulation group (group 1), and the high-frequency electromagnetic stimulation group (group 2). Both group 1 and group 2 will receive ten sessions of electromagnetic stimulation. Group 1 will be treated twice per week for 5 weeks while group 2 will receive 10 days of continuous treatment. The primary outcome is the change in International Consultation on Incontinence Questionnaire–Short Form cores after the ten sessions of the treatment, while the secondary outcomes include a 3-day bladder diary, pelvic floor muscle function, pelvic organ prolapse quantification, and quality of life assessed by SF-12. All the measurements will be assessed at baseline, after the intervention, and after 3 months of follow-up. Discussion: The present trial is designed to investigate the effects of a conjunct physiotherapy program for urinary incontinence in women. We hypothesize that this strategy is more effective than pelvic floor muscle training alone, and high-frequency electromagnetic stimulation will be superior to the low-frequency magnetic stimulation group. [ABSTRACT FROM AUTHOR]

Introduction and hypothesis: Urinary incontinence (UI) is prevalent among older women, but conservative treatment rates remain low due to limited accessibility, despite evidence supporting pelvic floor muscle training (PFMT) efficacy. Group-based approaches, including online options, could offer cost-effective alternatives. Recent evidence supports the feasibility of online group-based PFMT for treating UI in older women. This pilot study now evaluated the clinical effects of this program on the number of leakage episodes per day, additional UI-specific outcomes, and other symptoms and indicators. Methods: Community-dwelling women aged 65 and over, with stress or mixed UI, were recruited. Eligibility was assessed through in-person evaluations conducted by pelvic floor physiotherapists, who instructed participants on pelvic floor muscle contraction using digital palpation. Participants engaged in a 12-week group-based PFMT program with weekly 1-h sessions. Data were collected at three time points: recruitment (PRE1), before the first session (PRE2), and after the program (POST). Participants recorded UI symptoms using 7-day bladder diaries and standardized questionnaires on UI symptoms, quality of life (QoL), UI self-efficacy, and perceived costs. After the program (POST), participants provided feedback on their impression of improvement and satisfaction. Results: Participants reported a significant reduction in their number of leakage episodes per day. Standardized questionnaire scores also supported the positive effects of the program on UI symptoms and QoL, self-efficacy in avoiding leakage and performing PFMT exercises, and monthly costs for continence products. Older women expressed high satisfaction with symptom improvement and the program. Conclusions: Online group-based PFMT improved UI symptoms, QoL, UI self-efficacy, and perceived UI costs among older women. Pragmatic randomized controlled trials are necessary for further validation. [ABSTRACT FROM AUTHOR]

Introduction Current literature is inconclusive as to whether transversus abdominis (TrA) training can provide an additional benefit to pelvic floor muscle (PFM) training in female stress urinary incontinence (SUI). We designed a study to investigate the effect of PFM and TrA training on incontinence parameters. Material and methods 60 females with SUI were randomised to PFM training alone or PFM plus TrA training. They all attended 12 weekly training sessions by a single physical therapist and completed relevant questionnaires at baseline and study completion. Results Both interventions reduced the number of incontinence episodes and improved quality of life (QoL) and sexual function. Women on PFM+TrA training reduced the number of used pads per day (p = 0.007), improved the QoL (p = 0.031) and the sexual lubrication score (p = 0.04), and reported better satisfaction rates compared to PFM alone (66.7% versus 43.3%). A subgroup analysis reported that women with pure SUI benefit more from combined PFM+TrA training compared to PFM alone (p = 0.04). Conclusions TrA add-on to PFM training was similar to PFM training alone in the reduction of incontinence episodes but was superior in reducing the number of pads needed, which suggests a beneficial effect on the severity of incontinence. [ABSTRACT FROM AUTHOR]

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Purpose of research: Stress urinary incontinence (SUI) is a common health problem, especially among women which impairs daily functioning. The purpose of this research is to elucidate the pathophysiology of stress urinary incontinence (SUI), describe its diagnostic methods, summarize current treatments in light of recent studies, and outline examples of new potential therapies. Methods: Databases such as PubMed, Medline, and ResearchGate were searched with particular attention to the current guidelines. Basic results: The primary treatment of SUI is lifestyle modification, including weight reduction. Pelvic floor muscle training (PFMT) is recommended as first-line therapy, reducing the number of incontinence episodes and improving quality of life. Additional methods include electrical stimulation or biofeedback. At later stages of treatment, pharmacological therapy is recommended, mainly using vaginal oestrogens and duloxetine. Conclusions: Non-operative therapies, such as lifestyle modification and PFMT, are effective treatments for SUI. In combination with pharmacotherapy, they significantly improve the quality of life of patients without invasive surgical procedures.

Abstract Background Urinary incontinence symptoms severely affect older people with different body mass index (BMI).To compare the efficacy of the pelvic floor muscle training (PFMT) in patients with post-prostatectomy incontinence with different BMI. Methods Thirty-seven patients with post-prostatectomy incontinence were included. They were divided into group A (BMI ≤ 25,12), group B (26 ≤ BMI ≤ 30,14), and group C (BMI ≥ 31,11) based on difference BMI. Three groups of patients underwent the same Pilates combined with kegel training. Participants were assessed with 1-hour pad test, the number of incontinence episodes, International Consultation on Incontinence Questionnaire and Oxford Grading Scale. Results In the 1-hour pad test, the differences before and after training were statistically significant in all three groups of participants. Group A decreased from 81.83 ± 8.79 to 31.08 ± 5.64 g (P

Abstract Background Stress urinary incontinence (SUI), though a prevalent condition among women, is undertreated in primary care. EHealth with pelvic floor muscle training is an evidence-based alternative to care-as-usual. It is unknown, however, how eHealth usage is related to treatment outcome, and this knowledge is required for general practitioners to implement eHealth in their practice. This study examines the relation between usage of eHealth for SUI and treatment outcomes by examining log data. Baseline factors were also explored for associations with treatment success. Method In this pre-post study, women with SUI participated in “Baasoverjeblaas.nl”, a web-based intervention translated from the Swedish internet intervention "Tät®-treatment of stress urinary incontinence". Usage was based on log data and divided into three user groups (low, intermediate and high). Online questionnaires were sent before, after treatment and at six-months follow-up. The relation between usage and the primary outcome − treatment success (PGI-) − was studied with a binomial logistic regression analysis. Changes in the secondary outcomes − symptom severity (ICIQ-UI SF) and quality of life (ICIQ-LUTSqol) − were studied per user group with linear mixed model analysis. Results Included were 515 users with a mean age of 50.5 years (12.0 SD). The majority were low users (n = 295, 57.3%). Treatment success (PGI-I) was reached by one in four women and was more likely in high and intermediate users than in low users (OR 13.2, 95% CI 6.1–28.5, p

Background: Pelvic floor dysfunction is a widespread, multifactorial disease that progresses slowly with age and occurs in 77% of postmenopausal women.Objective: To evaluate the effectiveness of conservative treatment of pelvic floor dysfunction in women and the possibility of preventing pelvic organ prolapse.Materials and methods: We analyzed literature data (PubMed, eLibrary, Scopus) on treatment and prevention of pelvic floor dysfunction in women using various conservative treatment options.Results: The conservative approach is the only preventive measure and a first-line treatment of pelvic organ prolapse, especially at the disease onset. It involves lifestyle changes, physical therapy, and pessary insertion. Physical therapy includes pelvic floor muscle training with or without biofeedback, vaginal cones, electrical stimulation, etc.Conclusions: Despite the large number of available conservative treatment options, their effectiveness should be further studied, and preventive measures aimed at strengthening pelvic floor muscles should be actively promoted and included in the routine medical use and daily life of women to prevent pelvic organ prolapse.

Background Pregnancy and vaginal delivery are important factors leading to pelvic floor dysfunction (PFD) in women, manifested as pelvic organ prolapse (POP), stress urinary incontinence (SUI), and sexual dysfunction. Postpartum pelvic floor function rehabilitation has become a research hotspot in recent years. Stimulating the pelvic floor muscle groups through active exercise and passive contraction can improve detrusor stability and levator muscle function to prevent and treat PFD. Objective To investigate the clinical value of biofeedback electrical stimulation combined with pelvic floor muscle training (PFMT) therapy in the rehabilitation of pelvic floor function after vaginal delivery through a clinical controlled study. Methods Postpartum women with PFD after delivery implemented in Department of Obstetrics and Gynecology, Beijing Shijitan Hospital Affiliated to Capital Medical University from January 2020 to January 2022 were selected as the research subjects, and divided into the observation group and the control group using a random number table method. The observation group was treated with biofeedback electrical stimulation combined with PFMT, while the control group was treated with PFMT alone. The muscle strength of the pelvic floor class Ⅰ and class Ⅱ muscle fibers, the ratio of SUI and POP level of the two groups before and after treatment; postpartum PFMT situation; scores of Pelvic Floor Dysfunction Questionnaire (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7), and International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form (ICI-Q-SF) before and at 3 and 6 months after the treatment. Results A total of 327 cases were included in the observation group and 343 cases in the control group. After the treatment, the strength recovery of type Ⅰ and Ⅱ muscle fibers in the observation group was better than the control group (P0.05). The proportion of PFMT frequency≥5 times/week in the observation group was higher than that in the control group at 3 months and 6 months after treatment (P

Abstract Background This study aimed to evaluate clinically relevant improvement after conservative self-management of urinary incontinence via a mobile app. It further aimed to establish Minimum Important Differences (MIDs) based on the severity and type of urinary incontinence. Methods Data was collected in a prospective cohort study that evaluated the freely available app Tät®. The app provided pelvic floor muscle training (PFMT) and life-style advice. Non-pregnant, non-postpartum women (≥ 18 years) who downloaded the app to treat urinary incontinence were included, if they completed the Patient Global Impression of Improvement (PGI-I) question at the 3-month follow-up (n = 1,733). Participants answered the International Consultation on Incontinence Questionnaire (ICIQ-UI SF) at baseline and after 3 months. The score change was analysed for correlation (Spearman) with the PGI-I. We then analysed one-way ANOVAs to determine whether there were significant differences between the groups based on the answers to the PGI-I. The MID was set to the mean change of the group that selected the answer “a little better” to the PGI-I question. Results The one-way ANOVA showed significant differences between PGI-I groups (p