Abstract
Objective: To determine the feasibility of performing a randomized controlled trial comparing Pelvic Floor Muscle Training (PFMT) and behavioral advice only for postpartum SUI. Results: A feasibility study was performed with 207 women in 7-16 weeks postpartum at community postpartum clinics. Women reporting SUI were randomized to an intervention group (n=15), which followed an organized PFMT programme for six weeks and a control group (n=14). Control group was advised on routine postnatal care with behavioral advice. Both groups were assessed for QoL using a validated incontinence-quality of life (I-QOL) questionnaire at recruitment and in six weeks. There were 14% (29/207) of women suffering from SUI amongst the study sample. Before intervention there was no difference between I-QOL score in both groups. There was significant improvement (p<0.001) of I-QOL score in the interventional group (PFMT) compared to the control group (routine care with behavioral advice) after six weeks. Studying QOL improvement with this intervention is feasible for an interventional study. If directly inquired by the healthcare provider, women were willing to report, discuss and seek treatment for SUI. Conclusion: SUI is a common postpartum problem in this urban cohort of Lankan women. These women can be effectively treated improving their QOL with PFMT intervention.
Highlights
SUI can be defined as involuntary urine leakage with coughing, sneezing and/or physical exertion 6
A consecutively recruited sample of 207 postpartum women who had their first childbirth were interviewed at 7-16 weeks after delivery and 29 (14%) of them were suffering from SUI after childbirth
The resultant 29 women were recruited for the feasibility study, 15 women for the intervention (PFMT)
Summary
SUI can be defined as involuntary urine leakage with coughing, sneezing and/or physical exertion 6. When urodynamic studies demonstrate involuntary loss of urine during increased intra-abdominal pressure, but the leakage is not accompanied by a contraction of the detrusor muscle, the condition is termed urodynamic SUI 6. According to Cochrane review published in 2020, there is an uncertainty about the effectiveness of PFMT in women with postpartum SUI 1. SUI has severe impact on life, such as poor QOL, negative effect on sexual and social life 1. This underlines the value of both preventive strategies and treatment interventions and the need for further research. Aforementioned Cochrane review has pointed out the deficiency of studies assessing incontinence-specific QOL among antenatal and postnatal women with UI 1
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