[Antenatal perineal rehabilitation in patients with stress urinary incontinence during pregnancy: preliminary study]

To evaluate the results of antenatal perineal rehabilitation (APR) in patients complaining of stress urinary incontinence (SUI) during pregnancy.

Ten patients complaining of SUI during pregnancy participated in a standardizedAPR program. A phone investigation was carried late after delivery to evaluate patient satisfaction, improvement of SUI and effect of this therapeutic approach on sexual function and pelvic floor stability. The patients were invited to respond to two quality of life and symptom questionnaires (ISP, QIP). Results obtained were compared with those of a control group of 10 patients who did not present SUI during pregnancy, and who did not participate in APR, but took part in a conventional program of postnatal perineal rehabilitation (PPR). The groups were matched for age, BMI, parity and obstetrical history. Delivery modalities (instrumental deliveries and episiotomy rate) were analyzed in both groups.

The rate of satisfaction with perineal rehabilitation were 10/10 and 7/10 for the APR and the PPR respectively. Delivery modalities were not different in the APR group. Four of the 10 patients who presented SUI during pregnancy had persistent SUI 14 months after childbirth. One of the 10 patients who did not present SUI during pregnancy presented SUI 22 months after the childbirth.

This study provides incentive to conduct a prospective study to demonstrate that antenatal perinealrehabilitation is an effective way to reduce the risk of persistent SUI after childbirth. Although these preliminary results have to be confirmed by larger series, this management scheme can be proposed.