Abstract
OBJECTIVES: to assess whether pelvic-floor muscle training associated with biofeedback is more effective in the treatment of women with stress urinary incontinence, when compared to exercise alone. METHODS: a research of articles published in the last 20 years in Lilacs, PubMed and SCIRUS databases, using the descriptors "urinary incontinence, stress" and "biofeedback" was conducted. Randomized clinical trials comparing pelvic-floor muscle training with and without biofeedback were included. RESULTS: the study involved three randomized clinical trials involving 169 patients. A physical therapist was responsible for conducting the treatment using electromyographic or pressure biofeedback, and exercises were performed in the clinic or at home. The assessment methods, treatment times and protocols used were heterogeneous. Statistical analysis and rates of cure/improvement were similar between the groups of articles analyzed. Two studies had a score 8, and the third had 6 points according to PEDro's Scale. CONCLUSIONS: examination of the studies found suggests that adding biofeedback to pelvic-floor muscle training appears not to bring about a significant difference in terms of the success of treatment, when compared to perineal exercises performed in isolation.
Highlights
Stress urinary incontinence (SUI) is defined as the involuntary loss of urine during physical exercise, sneezing or coughing.[1]
It was restricted to female patients, aged over 18 years, who had been diagnosed with stress urinary incontinence
Three randomized clinical trials involving 169 patients in total were chosen for more detailed analysis: Berghmans et al.,[16] Morkved et al.,[17] e Aukee et al.[18] (Figure 1)
Summary
Stress urinary incontinence (SUI) is defined as the involuntary loss of urine during physical exercise, sneezing or coughing.[1] In practical terms, SUI can occur as a result of hypermobility of the bladder neck and proximal urethra or by sphincter failure. As it is considered an anatomical incontinence, the main structures that can be damaged in hypermobility of the bladder neck are the pelvic-floor muscles, the endopelvic fascia and the ligaments.[2]. Some studies point to evidence that exercises involving the perineal muscles, electrostimulation, the use of vaginal cones and biofeedback are effective in treating this disorder.[6,7,8,9]
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