Vaginal Cones Research Articles

Perineal Rehabilitation in Pelvic Floor Dysfunction: The Benefits of Vaginal Cone Training

Pelvic floor dysfunctions (PFD) are prevalent conditions that affect millions of women worldwide, encompassing a range of issues severely affecting women's quality of life. Pelvic floor muscle strength and function are fundamental to the management and prevention of PFD, and pelvic rehabilitation is a non-invasive approach that effectively improves symptoms, restores function, and prevents complications. This study aimed to evaluate the impact of pelvic floor muscle training program using weighted vaginal cones, on pelvic floor muscle function and quality of life in women with pelvic floor dysfunction (PFD). Fifty-four women aged 26-62 years, with different type of urinary incontinence, cystocele, and prolapse participated in this pre-post intervention comparative analysis. Pelvic floor muscle function was assessed using the PC test, which measures strength, endurance and fatigability, while the impact on patients' quality of life was assessed with the Pelvic Floor Impact Questionnaire - Short Form 7 (PFIQ-7). A three-month vaginal cone training regimen was implemented, with as-sessments conducted before the intervention (T0), one month later (T1), and three months later (T2). Data analysis showed a change with significant differences between the PC test score values at the level of each parameter and at each assessment (p<0.05, ES=0.254-511). The scores for bladder and urinary problems Urinary Impact Questionnaire (UIQ-7) significantly de-creased from 38.901 ± 1.268 at T0 to 29.366 ± 2.493 at T2 (W = 1082.000, p < 0.001, ES=0.570). In contrast, the scores for vaginal or pelvic problems (POPIQ-7) showed a slight, insignificant decrease from 12.699 ± 1.128 at T0 to 10.499 ± 2.362 at T2 (W = 278.000, p = 0.800, ES=0.053). fVaginal cone training significantly improves pelvic floor mus-cle function and reduces urynary symptoms in women with PFD.

Evaluation of Videos Related to Vaginal Cone Usage on YouTube as an Online Information Source.

The aim of this study is to examine the quality and content characteristics of educational videos on the use of vaginal cones published on YouTube. Video searches were conducted on the YouTube website using the keyword "usage of vaginal cones". A total of 52 videos were included in the current study. Modified DISCERN (mDISCERN) and Journal of the American Medical Association (JAMA) scales were used to evaluate the reliability of the videos, and the Global Quality Scale (GQS) was used for quality and usefulness. As a result of the content analysis conducted, it was observed that 29 videos were classified as having "poor content" and 23 as "rich content." When we examined the sources of the videos (n = 52), it was found that the majority (58%, n = 30) were produced by nonhealth care sources (medical companies and nonhealth professionals). With statistical significance in mDISCERN and GQS (p = 0.014, p = 0.036), physiotherapists were found to have the highest average scores (4.11 ± 1.05, 3.44 ± 0.73) whereas doctors ranked second in the average standard deviation (3.09 ± 1.04, 2.82 ± 0.98). In JAMA, medical companies were found to have the highest average score with statistical significance (p = 0.015) at 3.4 ± 0.74, followed by doctors at 3 ± 1, and physiotherapists at 2.89 ± 0.78 when averages were analyzed. It is clearly evident that there is a need for higher quality and more reliable vaginal cone content database on YouTube. It is important for patients to be guided by health care professionals and informed about quality content criteria in order to access quality, reliable, and useful information.

Conservative Interventions for Urinary Incontinence on Postpartum Women: A Systematic Review and Meta-Analysis.

Urinary incontinence (UI) is common in postpartum women and can lead to a reduced quality of life and withdrawal from fitness and exercise activities. Conservative management interventions such as pelvic floor muscle training (PFMT), use of vaginal cones, and biofeedback have been recommended as first-line treatment. We aimed to explore the effects of conservative interventions on UI rate, severity, and incontinence-specific quality of life in postpartum women with UI. Nine databases were searched from inception to August 2022: PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, Wanfang, China National Knowledge Infrastructure, China Biological Medicine, and VIP Journal Integration Platform. Randomized controlled trials examining the effects of conservative interventions on postpartum UI were included. Initial searches produced 1839 results, of which 17 studies were eligible. All included studies had a low to moderate risk of bias. Supervised PFMT and use of a vaginal cone were more effective than individual PFMT in decreasing rates of UI (odds ratio, 0.29; 95% CI, 0.14-0.61). Individual PFMT combined with acupuncture (mean difference, -1.91; 95% CI, -2.46 to -1.37) or electroacupuncture and supervised PFMT combined with moxibustion were more effective than individual supervised PFMT alone in improving the severity of symptoms. Furthermore, electrical stimulation and biofeedback combined with acupoint stimulation or core training were more effective than electrical stimulation and biofeedback alone. For improving the incontinence-specific quality of life, supervised PFMT was more efficacious than individual PFMT; electrical stimulation and biofeedback plus core training were more beneficial than electrical stimulation and biofeedback alone. Supervised PFMT and use of a vaginal cone were more beneficial in decreasing rates of UI compared with individual PFMT. Superior effects in decreasing UI severity may be achieved by combining PFMT or electrical simulation and biofeedback with other therapies. Electrical stimulation and biofeedback plus core training, as well as supervised PFMT, are most effective in improving incontinence-specific quality of life. Further research is required to provide more evidence on the efficacy of these therapies.

Recommendations of Clinical Practice Guidelines for the treatment of urinary incontinence in women: A methodological survey

Objective: This study described and analysed key recommendations from Clinical Practice Guidelines (CPGs) concerning urinary incontinence (UI) treatment in women. Materials and methods: We carried out searches in the following databases: MEDLINE, EMBASE, Web of Science, Virtual Health Library, among others. The reviewers, in duplicate and independently, selected the documents and extracted the data. The quality assessment of the guidelines was carried out, in triplicate, using the Appraisal of Guidelines REsearch and Evaluation (AGREE II) instrument. Results: Six CPGs were selected for analysis. Pelvic Floor Muscle Training (PFMT) is the primary treatment for UI, with adjunctive therapies (biofeedback, vaginal cones, dynamic lumbopelvic stabilisation, and electrical stimulation) recommended alongside PFMT. Discrepancies among CPG were noted in recommendations for drug treatments and invasive procedures, suggesting the need for individualised approaches. When conservative non-pharmacological treatments failed, drugs are recommended. Mid-urethral slings were endorsed, with alternatives like colposuspension or autologous rectus fascial slings considered when mid-urethral slings were unsuitable. Botulinum toxin type A was suggested for urge UI patients unresponsive to conservative therapy. Conclusion: UI treatment must prioritise the conservative non-pharmacological therapies and progressing to invasive options, as necessary. These evidence-based findings aim to guide patients, healthcare professionals, and policy managers in effectively managing UI. Level of evidence: Not applicable

Conservative Treatment Options to Prevent and Manage Pelvic Floor Dysfunction in Women

Background: Pelvic floor dysfunction is a widespread, multifactorial disease that progresses slowly with age and occurs in 77% of postmenopausal women.Objective: To evaluate the effectiveness of conservative treatment of pelvic floor dysfunction in women and the possibility of preventing pelvic organ prolapse.Materials and methods: We analyzed literature data (PubMed, eLibrary, Scopus) on treatment and prevention of pelvic floor dysfunction in women using various conservative treatment options.Results: The conservative approach is the only preventive measure and a first-line treatment of pelvic organ prolapse, especially at the disease onset. It involves lifestyle changes, physical therapy, and pessary insertion. Physical therapy includes pelvic floor muscle training with or without biofeedback, vaginal cones, electrical stimulation, etc.Conclusions: Despite the large number of available conservative treatment options, their effectiveness should be further studied, and preventive measures aimed at strengthening pelvic floor muscles should be actively promoted and included in the routine medical use and daily life of women to prevent pelvic organ prolapse.

Accuracy and Reliability of Different Approaches for the Assessment of Pelvic Floor Muscle Strength: A Systematic Review.

There had been various methods employed for the evaluation of pelvic floor muscle (PFM) strength. The aim of the study was to do a systemic review of these methods for a better understanding of these techniques and to find the best appropriate method. A systemic review of the literature was done using three databases that included: PubMed, Scopus and Web of Science using the keywords "pelvic floor anatomy" and "functional anatomy of pelvic floor muscles" from 1985 to 2022. All the studies involved were analyzed for the methodologies used by the researcher, advantages, disadvantages, and the conclusion of the study. A total of 1,876 studies were found, out of which only 64 met the criteria of inclusion. In these studies, seven methods were used for the determination of PFM strength. These methods included: clinical palpation, perineometer, electromyography, dynamometer, ultrasonography, magnetic resonance imaging, and vaginal cones. The PFM cannot be calculated accurately using any one measuring technique. There is therefore no "gold standard" approach to PFM assessment. However, combining these methods will result in the best outcomes. According to the literature review, the most often employed procedures were digital palpation, perineometry, and Ultrasonography (USG).

Current State of Non-surgical Devices for Female Stress Urinary Incontinence.

The purpose of this review is to summarize and assess the current non-surgical devices for the treatment of stress urinary incontinence (SUI). Devices for SUI can generally be divided into two categories. One category is the augmentation of pelvic floor muscle training (PFMT), wherein devices such as vaginal cones, intravaginal biofeedback, and electrical or magnetic stimulation are used to strength the pelvic floor musculature, though none are more effective than traditional PFMT. The second category of devices mechanically occludes the outlet and includes incontinence pessaries, intravaginal occlusion devices, and urethral plugs and patches. While these are palliative rather than curative, they share similar rates of improvement in leakage. A number of novel devices exist for the treatment and management of SUI. Though no single device has been shown to be more effective than PFMT alone, they may be beneficial for women who have difficulty isolating their pelvic floor muscles, desire accountability, or prefer technology-based engagement. Outlet occlusion devices are less comfortable for the patient, but remain an option for women who do not desire surgery.

Commercially Available Home Pelvic Training Devices for the Treatment of Pelvic Floor Disorders: A Systematic Review and Meta-analysis.

To assess the clinical efficacy of commercially available pelvic muscle training devices on the treatment of pelvic floor disorders. We searched MEDLINE, Web of Science, and ClinicalTrials.gov through April 2020. We included observational cohort studies and randomized trials. Case reports, case series, and conference poster presentations were excluded. Studies using vaginal weights or cones and those conducted in the peripartum periods were also excluded. A total of 294 studies were screened. Twenty-six studies were included in the qualitative analysis, and 15 studies were eligible for meta-analyses. Study characteristics and quality were recorded for each study. Meta-analysis showed a large positive effect of commercially available pelvic floor training devices on pelvic floor muscle strength by both objective and subjective measures. Meta-analysis of objective measures showed a reduction of 1.2 pads per day (P<.01), 1.3 incontinence episodes per day, (P<.01) and 11 g on 24-hour pad test (P<.01). Meta-analysis of subjective measures showed a reduction in UDI-6 (Urogenital Distress Inventory, Short Form) scores by 25.1 points (P<.01) and in IIQ-7 scores (Incontinence Impact Questionnaire, Short Form) by 14.1 points (P=.01). There was an increase in I-QOL (Incontinence Quality of Life) scores by 16.8 points (P<.01). The minimal important difference was met for the UDI-6 and I-QOL but not for the IIQ-7. We were unable to perform meta-analysis to evaluate whether pelvic floor training devices are as effective as traditional supervised pelvic floor physical therapy. Commercially available home pelvic floor training devices are effective in increasing strength of pelvic floor muscles and in the treatment of pelvic floor disorders.

Effectiveness of physiotherapeutic techniques in urinary incontinence: a review of the literature

Introduction and purpose : Urinary incontinence is a common condition characterized by involuntary urine leakage from urethra. It particularly affects elderly women and is a serious medical, social and economic problem. As a result of recently observed population ageing, the incidence of this anomaly is expected to rise. Due to multifactorial etiology, several types of incontinence are distinguished. Proper diagnostic procedures lead to diagnosis confirmation and allow appropriate therapeutic intervention. Both conservative and surgical methods are used in management of urine incontinence. In addition to pharmacological therapy, physiotherapeutic methods have an important meaning in conservative approach. The aim of this article is a review presenting the results of recent studies on the effectiveness of physiotherapy procedures in treatment of various types of urine incontinence. Description of the state of knowledge: In the study 33 articles which published physiotherapy techniques in 2004-2021 regarding the role of physiotherapeutic methods in the treatment of urinary incontinence were analyzed. The results of studies assessing the effectiveness of physiotherapy techniques (acupuncture, behavioral therapy, yoga, magnetic stimulation, pelvic floor muscle training, vaginal cones, vibration therapy, kinesiotheraphy techniques, stimulation) in reducing the severity of urinary incontinence symptoms and improving the quality of patients’ life were presented on the basis of analyzed literature. Conclusions: Physiotherapy is an effective method of treatment of urinary incontinence and it supports other types of therapy. Therapy should be interdisciplinary approached and the choice of physiotherapeutic methods should be dependent on the individual needs of the patient.

Efficacy of vaginal weights in pelvic floor dysfunction: A systematic review and meta-analysis

Pelvic floor dysfunction (PFD) affects women's quality of life because the pelvic floor muscles are unable to contract and relax properly. Kegel exercise is the first line of treatment for PFD, while vaginal cones with weights have recently been used for pelvic floor strengthening. When compared to alternative treatments, various studies have evaluated the effectiveness of vaginal weights or cones in treating PFD. However, there are controversial conclusions reached when the effectiveness of vaginal weights is compared in various ways. The purpose of this study was determine the effectiveness of vaginal weights compared with other interventions in reducing the symptoms of PFD. Using various databases, an extensive literature search was conducted, and a randomised control trial examining the usefulness of vaginal weights in PFD was identified. PRISMA guidelines were used to synthesize the data. The risk of bias tools were used to assess the quality of the selected studies. Results suggest that vaginal cones are effective in treating PFD. However, when it was compared with other treatment modalities, no significant differences were found. Hence, the results are equivocal and cannot be generalized.

Pelvic Floor Muscle Training for Urinary Incontinence with or without Biofeedback or Electrostimulation in Women: A Systematic Review.

To determine the effectiveness of pelvic floor muscle training (PFMT) with or without biofeedback or electrostimulation in reducing urinary incontinence and pelvic floor muscle con-traction in non-pregnant women with urinary incontinence. Methods: The following electronic databases were searched: PubMed, Cochrane Central, ClinicalTrials.gov, EU Clinical Trials Register, and sources from NICE, FDA, EMA, and SMC (articles only in English, 2000–2021). Search terms were: urinary incontinence, pelvic floor muscle training or exercises, biofeedback, electrostimulation. We used the PRISMA statement (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) for this systematic review. Relevant articles were selected, data were extracted, and quality was assessed. Data were extracted in predesigned form, followed by narrative synthesis. Results: Following the search, 15 RCTs were retrieved using the strict inclusion and exclusion criteria, assessing 2441 non-pregnant women with urinary incontinence. Of the 15 studies, 7 were low risk, 5 were medium risk, and 3 were high-risk studies. Of the 2441 patients, 970 were in PFMT, 69 were in extracorporeal magnetic innervation (ExMi) or with PFMT + BF, 30 were in electrostimulation (ES), 21 were in whole body vibration training (WBVT), 23 were in pelvic floor muscle + abdominal muscle therapy (PFM + AMT), 326 were in PFMT + biofeedback, 93 were in vaginal cones (VC), 362 were in PFMT + education, 318 were in education, and 229 were in control groups. The most often measures employed were pad tests, bladder diary, and questionnaire on the quality of life. Stress, urge and mixed urinary incontinence were studied. In all RCT, PFMT significantly reduced urinary incontinence, essentially SIU and MUI, when compared with the control group before and after treatment. Overall, out of 997 PFMT or PFMT + education patients, 504 patients (50.5%) showed improvement in urinary incontinence, and 218 became continent (21.8%) (negative pad test). In total, 62% of patients significantly reduced their urinary incontinence or cured it and improved their pelvic floor muscle contraction. All other physiotherapist techniques also significantly reduced urinary leakages, e.g., vaginal cones, biofeedback, ExMI, and WBVT when compared with the control group. There were no significant differences between these methods in reducing the severity of urinary incontinence. Conclusion: PFMT alone or with bio-feedback or electrostimulation was effective in reducing urinary incontinence and improving pelvic floor muscle contraction. PFMT when compared with other interventions such as bio-feedback, VC, and WBVT did not show significant differences but was superior to the control group. RCT studies with similar parameters used for measuring the outcomes need to be included.

The effect of pelvic floor exercises performed with EMG biofeedback or a vaginal cone on incontinence severity, pelvic floor muscle strength, and quality of life in women with stress urinary incontinence: a randomized, 6-month follow-up study.

The objective was to assess the effectiveness of pelvic floor exercises performed with electromyographic (EMG) biofeedback or a vaginal cone on incontinence severity, muscle strength, social activity level, quality of life, treatment success, and treatment satisfaction in women with stress urinary incontinence (SUI). This prospective, randomized study included 40 female patients diagnosed with SUI. Patients were randomly divided into two groups as the group receiving pelvic floor muscle exercise (PFME) with a vaginal cone at home (n = 20) and the group receiving PFME with EMG biofeedback in the hospital (n = 20). The measurement of urinary incontinence severity with a 1-h pad test, assessment of social activity with the social activity index (SAI), assessment of incontinence-specific quality of life, manual measurement of pelvic floor muscle strength, and the assessment of treatment satisfaction were performed in the pre-treatment period and post-treatment at 3 and 6 months. In intragroup analyses, an improvement was observed in both groups in the pad test, muscle strength, SAI, quality of life, and treatment satisfaction measurement compared with the pre-treatment period (p < 0.05). No significant difference was found between the groups in terms of assessment parameters in intergroup analyses during follow-up (p > 0.05). It was concluded that both EMG biofeedback assisted PFME and PFME with a vaginal cone had curative effects on incontinence in patients with SUI. We believe that both protocols can be used as acceptable and effective conservative therapy methods in the treatment of women with SUI considering their preference.

Physiotherapeutic Approach in Stress Urinary Incontinence with Prolapsed Uterus: A Case Report

The International Continence Society (ICS) describes incontinence as an objectively demonstrable loss of urine which is not voluntary and that is a social and/or sanitary issue. The complaint of leakage of urine, which is not voluntary on an effort made, on exertion, on sneezing or while coughing is described as Stress urinary incontinence (SUI). The intra-abdominal increases as the effort or exertion increases, and the urethral sphincter is not capable to sustain a pressure greater than the pressure applied on the urinary bladder. Eventually, leakage of urine occurs during the daily activities like lifting, laughing, jumping, while sneezing or coughing. In women, stress urinary incontinence is most common category of incontinence of urine. Even though it isn’t a lethal illness. SUI has a number of negative effects on women's quality of life, including restricting social interaction and relationship and the personal relationships but also physical activity. Cystocele is the weakness of pubocervical fascia, which makes the urinary bladder to descend downwards and backwards against the anterior wall of the vagina. If this is a not taut then it will protrude. In more extreme cases a pouch of bladder sets up which holds on to the residual urine. The conservative treatment, a nonsurgical therapy, includes ameliorating the living standards, urinary bladder training, pelvic floor muscle exercises and strengthening. Kegel exercises are the most effective form of strengthening muscles of pelvic floor in addition are a noninvasive therapy and the use of vaginal weights or cones are not included. The rehabilitation and strengthening muscles of pelvic floor is facilitated and promote urine storage. The combination of Kegel’s exercise along with other interventions for a span of six weeks has shown a significant improvement in the symptoms.

Auto-rééducation pour le traitement de l’incontinence urinaire féminine : revue de la littérature

Literature review on the home-based options for the conservative management of stress urinary incontinence including biofeedback and weighted vaginal cones.. Research was conducted in the Cochrane Library and Pubmed to find articles, published until March 2020, dealing with the conservative management of incontinence. A total of 9 randomized controlled trials were included, 4 concerning biofeedback and 5 concerning vaginal cones. Most of them highlighted the superiority of these three methods compared to the absence of treatment but were not superior compared to the pelvic floor muscles training in the clinic setting. Home-based devices for female stress urinary incontinence is a safe and effective treatment for female urinary incontinence. It has not shown superiority to physiotherapist-guided pelvic floor muscle reinforcement and needs more evidence to gain its place as a first line therapeutic option.

Stress Urinary Incontinence I: Nonsurgical Management

Conservative management of stress urinary incontinence (SUI) is generally offered as first-line treatment. Such treatment options include behavioral therapy, pelvic floor muscle therapy, vaginal devices, pharmacologic therapy, and urethral bulking agents. Weight loss management is an example of an effective behavioral strategy in obese patients. Pelvic floor physical therapy alone or under the supervision of skilled providers can significantly improve SUI; however, long-term effects are harder to maintain. Pessaries, vaginal cones, and vaginal inserts have been widely used for treatment of SUI and are beneficial in patients who are motivated to use them. Currently in the United States, there is no FDA-approved medication for the treatment of SUI. Conversely, the European Union has approved and used duloxetine. Urethral bulking agents are indicated for patients with intrinsic sphincter deficiency and sometimes used in patients who are not able to undergo surgical procedures for SUI or who have failed said procedures. Three materials are currently FDA approved for urethral bulking in the United States. Many options exist for the nonsurgical management of SUI. This review contains 5 tables and 47 references Key words: Stress Urinary Incontinence, conservative treatment, urethral bulking, pelvic floor exercises, incontinence pessaries.

A network meta-analysis protocol of conservative interventions for urinary incontinence in postpartum women.

Background:Postpartum urinary incontinence (PPUI) is a common urological condition in women after childbirth. Due to the side effects of surgical and pharmacological therapies, the patients and physicians alike express a strong preference for conservative approaches on PPUI, such as pelvic floor muscle training, biofeedback, electrical stimulation, bladder training, vaginal cones and acupuncture. Application of these conservative approaches should be guided by high quality evidence, yet their comparative effectiveness has not been well documented. Therefore, the network meta-analysis aims to compare, rank and summarize all available studies to determine which conservative intervention is more effective for PPUI.Methods:In this present study, qualified English and Chinese studies will be searched in PubMed, Scopus, EMBASE, The Cochrane Library, Web of Science, VIP Database, Wanfang Database, Chinese Biomedical Literature Database and China National Knowledge Infrastructure. All eligible randomized controlled trails (RCTs) of conservative interventions for PPUI will be included. R software 3.61 (R Foundation for Statistical Computing, Vienna, Austria) will be applied to synthesize data and conduct network meta-analysis. I2 statistic and Z test will be used to assess heterogeneity and inconsistency, respectively.Results:Ethical approval is not required for this existed literature based meta-analysis. The findings of this research will be disseminated through a recognized journal.Conclusion:The findings of this study will provide ranking evidence for clinicians and patients to choose a more appropriate conservative therapy on PPUI.Trial registration number:PROSPERO CRD42020168042

Development of an anatomic intravaginal device and comparison with a conventional vaginal cone regarding their effectiveness in pelvic floor muscle perception and strength: randomized clinical test

The weakness and lack of perception of the perineal musculature and pelvic floor cause a series of emotional and social problems that can affect the social quality of life. This muscular structure is responsible for maintaining the support of the internal organs and participating in the maintenance of the urinary and fecal continence, as well as allowing coitus and childbirth. The objective of this study was evaluating the maximum pressure during the contraction of the perineal musculature and the performance of the pelvic floor muscles after using both the anatomical intravaginal device and the conventional vaginal cone. For this purpose, 30 women were selected and randomly and equally divided into 3 groups: Group I, control; Group II, used the conventional vaginal cone; and Group III, used the anatomically shaped intravaginal device, developed in order to accomplish the research. The volunteers in Groups II and III were respectively submitted to a protocol with the vaginal cone and the intravaginal device, and, after the use, they were assessed in order to verify their maximum pressure and the capacity of pelvic floor contraction. The analysis of the data showed a statistically significant difference, concerning the evaluated parameters, in the group that used the anatomically shaped intravaginal device. The anatomical intravaginal device, developed in this study, was more effective than the conventional vaginal cone regarding the improvement of the maximum perineal contraction pressure, local perception, and muscular performance.

Comparative study of effect of vaginal cones as a biofeedback device and pelvic floor exercises in rural females with urinary incontinence

Background: The international continence society defines urinary incontinence (UI) as a situation in which involuntary urine loss is a hygienic or social issue and can be demonstrated objectively. Due to culture of silence, Indian females with urinary issues are quietly suffering from symptoms even when their symptoms trigger great discomfort and hamper regular activities. In India, there are limited research dealing with the effect of UI among rural females. Aim: The aim of the study was to determine the effect of vaginal cones and perineometer as a biofeedback device in rural females with UI. Objective: The objective of the study was to compare the effect of vaginal cones along with perineometer as a biofeedback device versus pelvic floor exercise in rural females with UI. Procedure: A comparative study included 45 participants aged 45–70 years as per the inclusion criteria which were divided into two groups: Group A was treated with vaginal cones and perineometer, whereas Group B was given Kegel exercises. Pre- and postreadings of questionnaire for female UI diagnosis and perineometer were taken. Results: The analysis of the result showed a significant improvement in Group A as compared to Group B. Conclusion: The present study concluded that a combined effect of vaginal cones and perineometer with biofeedback device showed a more significant result than pelvic floor muscle strength training (Kegel exercise).

Eficácia dos cones vaginais no fortalecimento do assoalho pélvico na incontinência urinária feminina pós- menopausa: estudo de casos

INTRODUÇÃO: A incontinência urinária (IU), pode afetar ambos os sexos, porém apresenta alta prevalência no sexo feminino, sendo as mulheres, na terceira idade, as mais acometidas. A IU afeta a qualidade de vida (QV), pois causa desconforto, redução da autoconfiança, alteração do comportamento, interferência na sexualidade, no convívio social, na saúde física e emocional. OBJETIVO: Avaliar o uso de cones vaginais no fortalecimento do assolho pélvico (AP) em mulheres com incontinência urinaria pós-menopausa. MÉTODOS: Estudo quantitativo, de delineamento observacional exploratório do tipo estudo de casos, realizado com 2 mulheres inscritas para tratamento de IU. Foi realizado a aplicação do questionário International Consultation on Incontinense Questionnaire (ICIQ-SF) e avaliação funcional do AP por meio do perineômetro, antes e após 10 sessões, realizadas 3 vezes por semana, durante 45 minutos, através de um programa de tratamento com uso de cones vaginais e cinesioterapia, associando aos exercícios de Kegel. RESULTADOS: Quanto ao ICIQ-SF, a paciente 1, na avaliação pontou o escore de 10 pontos (muito grave) e na reavaliação 2 (leve impacto). A paciente 2, inicialmente pontuou 9 (grave impacto) e após o tratamento, 1 (leve impacto).. Na avaliação da contração muscular a paciente 1 obteve 40 sauers (normal) e passou para 44 (bom). A paciente 2 passou de 16 sauers (regular) para 28 (normal). CONCLUSÃO: Os cones vaginais beneficiaram mulheres com incontinência urinário de esforço, fortalecendo os músculos do assoalho pélvico, proporcionando melhora na qualidade de vida.

The impact of vaginal cone therapy on stress urinary incontinence compared with transobturator tape.

Objective:To emphasize the efficiency of vaginal cone (VC) therapy in stress urinary incontinence (SUI) through a comparison with transobturator tape (TOT).Materials and Methods:A prospective randomized controlled study was conducted at the Etlik Zübeyde Hanım Maternity and Women Hospital during a one year study period. Forty women were allocated into two equal groups; those treated with VCs for a 3 month period, and women who underwent TOT procedures. These women were followed up at 6 weeks and 6 months after the treatments. Subjective cure was assessed using Wagner’s Quality of Life Questionnaire. Objective cure was evaluated through a cough stress and pad test results.Results:Maternal demographic features were comparable among groups. We observed improvement in pad weight test among groups when compared with the pretreatment state (p=0.015, p=0.005). Although the subjective cure rate was similar in both groups at the 6th week and 6th month follow up (65% vs. 75%; 75% vs. 80%) (p>0.05), the objective cure rate was significantly higher in the TOT group than in the VC group, as expected (10% vs. 80%; 30% vs. 75%) (p<0.05).Conclusion:The main treatment of SUI is surgery; however, VC could be offered as an alternative treatment for women who refuse surgery, those at high risk for surgery or it could be used temporarily before surgery.