Long-term effect of pelvic floor exercises on female urinary incontinence

In order to assess the permanent effect of pelvic floor exercises on female stress incontinence, 76 incontinent women, referred for incontinence surgery, underwent a 3-month exercise programme conducted by an experienced physiotherapist. The patients were followed up for 1 year. At the last assessment 30% were cured and 17% improved. Altogether 47% avoided surgery. No relapses were seen during the follow-up period. Patients with mild incontinence benefited from intensified training, since 72% could expect to be cured, while patients with severe incontinence and no immediate effect did not benefit from further exercises. Patients with a positive hormone status and those with normal weight had a significantly higher cure rate. The subjective results were confirmed by the 24-h pad test. Anal pressure profilometry was a valid method for instruction and objective control of pelvic floor function. It was concluded that pelvic floor exercises should precede surgery, since exercises had a permanent effect in half of the patients.