A comparative analisys of pelvic floor muscle strength in women with stress and urge urinary incontinence

Monica Orsi Gameiro,João Luiz Amaro,Paulo Roberto Kawano,Carlos Roberto Padovani,Eliane Cristina Moreira,Renata Spagnoli Ferrari

doi:10.1590/s1677-55382012000500011

Monica Orsi Gameiro, João Luiz Amaro + Show 4 more

Open Access

https://doi.org/10.1590/s1677-55382012000500011

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Abstract

To assess pelvic floor muscle (PFM) strength in women with stress urinary incontinence (SUI) and urge urinary incontinence (UUI). 51 women were prospectively divided into two groups, according to the symptoms as SUI (G1 = 22) or UUI (G2 = 29). Demographic data, such as number of pads/ 24 hours, number of micturations/ 24 hours and nocturia, delay time of urgent void (i.e., the time period for which an urgent void could be voluntarily postponed), number of parity and vaginal deliveries were obtained using a clinical questionnaire. Objective urine loss was evaluated by 60-min. Pad Test, subjective urine stream interruption test (UST) and visual survey of perineal contraction. Objective evaluations of PFM were performed in all patients (vaginal manometry). Median of age, mean number of pads / 24 hours, nocturia and warning time were significantly higher in UUI comparing to SUI group. During UST, 45.45% in G1 and 3.44%, in G2, were able to interrupt the urine stream (p < 0.001). The 60-min. Pad Test was significantly higher in G2 compared to G1 women (2.7 ± 2.4 vs 1.5 ± 1.9 respectively, p = 0.049). Objective evaluation of PFM strength was significantly higher in the SUI than in the UUI patients. No statistical difference was observed regarding other studied parameters. Pelvic floor muscle weakness was significantly higher in women with UUI when compared to SUI.

Highlights

Stress urinary incontinence (SUI) is considered when involuntary leakage of urine on effort or exertion occurs [1,2]
The daily fluid intake was significantly lower in Urge urinary incontinence (UUI) group than in SUI (Table-1)
The average delay time of urgent void was significantly lower in UUI than in SUI group (Table-1)

Summary

Introduction

Stress urinary incontinence (SUI) is considered when involuntary leakage of urine on effort or exertion occurs [1,2]. Urinary incontinence may involve important psychosocial implications; there is a significant greater proportion of patients (60%) with urge incontinence with previous history of depression than those with SUI (14%) [3]. Pelvic floor muscle (PFM) function evaluation may play an important role in the diagnosis and treatment of female urinary incontinence. Amaro et al reported significant decreased in PFM strength on incontinent women when compared with continent ones [4], showing that the anatomical and functional deteibju | pelvic floor muscle strength in women with stress and urge incontinence riorations of these striated muscles may cause urinary and fecal incontinence. Vaginal delivery causes several degrees of PFM and connective tissue damage [5]. The recovery of these muscles could be therapeutic [6]. Some authors observed a positive correlation between increase in PFM strength and improvement in SUI and quality of life [7,8,9,10]

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