Postpartum Pelvic Floor Muscle Training for Reducing Urinary Incontinence: A Systematic Review of Randomized Control Trials

Abstract

Postpartum urinary incontinence is an increasingly prevalent problem for women, as it affects about one-third of women. The clinical significance of urine incontinence in relation to deficiencies in the active and passive pelvic floor structures is well recognized. Hence, pelvic floor muscle training (PMFT) treatment for urine incontinence is recommended. Several research studies suggest that PFMT prevents and treats pregnancy- and delivery-related urine incontinence. This study aimed to determine the effectiveness of postpartum PFMT for the treatment of urinary incontinence. Randomized control trials reporting the efficiency of PFMT among postpartum women from 2003–2023 were included. Studies including pregnant women or women who underwent any surgical intervention, along with studies describing pharmacological interventions and others apart from PFMT or PFMT with electrostimulation or biofeedback, were excluded. Additionally, studies with insufficient or unclear data regarding pregnancy outcomes were excluded. A Cochrane bias risk assessment tool was utilized to assess the quality of the studies. Final inclusion resulted in 7 studies that recruited 1398 patients. Four of the included trials assessed the endurance and strength of PFMT, and various rates of strength and endurance were observed among participants in both the intervention and control groups. The prevalence of urinary incontinence in comparison to the control group was observed to be lower in the intervention group, which demonstrates the beneficial role of PFMT in the management of urinary incontinence postpartum. There is strong evidence to suggest the effectiveness of PFMT in the management of postpartum urinary incontinence. However, this beneficial role of PFMT is often overlooked or under-described in clinical practice, for which awareness among clinicians and patients is vital. Additionally, awareness and planning for PFMT execution during antenatal visits can also help prevent urinary incontinence postpartum.