The role of biofeedback in Kegel exercise training for stress urinary incontinence

This study examined the effectiveness of teaching pelvic floor exercises with use of bladder-sphincter biofeedback compared to training with verbal feedback based on vaginal palpation in 24 women with stress urinary incontinence. Verbal feedback training consisted of instructing the patient to squeeze the vaginal muscles around the examiner's fingers and providing her with verbal performance feedback. Biofeedback patients received visual feedback of bladder pressure, abdominal (rectal) pressure, and external anal sphincter activity. The biofeedback group improved the strength and selective control of pelvic floor muscles; the verbal feedback group did not. Both groups significantly reduced the frequency of incontinence. The biofeedback group averaged 75.9% reduction in incontinence, significantly greater than the 51.0% reduction shown by the verbal feedback group. Twelve of 13 patients in the biofeedback group improved by 60% or better. Six patients in the verbal feedback group improved by 68% or better, and five were less than 30% improved.