Üriner Inkontinans Semptomu Olan Kadınlarda Mesane Eğitimi ile Birlikte Pelvik Taban Kas Eğitiminin Etkinliğinin Araştırılması

Abstract

The aim of this study was to assess and compare the efficacy of bladder training (BT) and combination therapy of bladder training and pelvic floor muscle training (BT+PFMT) on urinary incontinence in women. The primary hypothesis was that BT+PFMT would be more effective than BT alone in improving urinary incontinence. One hundred two patients diagnosed with stress urinary incontinence (n= 49), urgency urinary incontinence (n= 17) and mixed urinary incontinence (n= 36) were randomized to 6-week BT or BT+PFMT program. The primary outcome measure was participant's perception of improvement of urinary incontinence. Other outcome variables included incontinence severity score, pelvic floor muscle strength and endurance, quality of life and urinary diary parameters (number of daily and nocturnal micturition, mean voided volume and number of incontinent episodes). All outcome variables were collected at baseline and at the end of 6th week. At the end of this study, BT was found effective in stress and mixed incontinence but not in urgency incontinence. All types of urinary incontinence showed improvement with BT+PFMT. Compared with BT, BT+PFMT group had significantly better improvement in incontinence severity in all subgroups and greater subjective improvement rates in stress and mixed incontinence subgroups (p< 0.05). In other outcome variables, two treatment groups were similar (p> 0.05). According to these results, combination therapy seems to be more effective than bladder training alone in the treatment of urinary incontinence. However, further studies with larger sample sizes especially in urgency incontinence and studies with longer follow-up periods in all types of urinary incontinence are needed to confirm the superiority of combination therapy.