Pelvic Floor Muscle Training by Telehealth to Treat Female Stress Urinary Incontinence: A Randomized Clinical Trial

Providing pelvic floor muscle training (PFMT) via telehealth is challenging as it depends on patients learning how to contract their pelvic floor muscles (PFMs) without in-person assessments. Our hypothesis is that PFMT performed via telemedicine is effective at treating stress urinary incontinence (SUI) in patients who were considered capable of performing PFM contraction through instructions and self-palpation.

A single-center, randomized, and controlled clinical trial, involving 50 women with SUI who received either PFMT (n = 26) or educational approach (n = 24) by teleconsultation, and were evaluated at baseline and after 12-week therapy. Primary outcome was the severity of SUI (International Consultation on Incontinence Questionnaire Short Form [ICIQ-SF]). Secondary outcomes were urinary symptoms, quality of life, patient satisfaction, frequency of online sessions, and adherence to home exercise sets. Student's t, Mann-Whitney U, and Chi-squared tests were used, with a 5% cut-off for significance.

Significant reduction in the severity of SUI was observed in the PFMT compared with the educational group (mean ICIQ-SF score 6.2 ± 2.7 and 12.5 ± 3.2 respectively, p < 0.001]. We observed differences among the groups in favor of the PFMT group regarding the number of episodes of urine leakage (p = 0.024), number of pads (p = 0.001), satisfaction with the treatment (p < 0.001), self-efficacy (p < 0.001), and quality of life (social embarrassment[ n = 0.048). Attendance at online sessions was similar in the two groups; and the home adherence was a mean 18 sets per month.

Pelvic floor muscle training performed via telehealth showed improvement in the urinary symptoms, patients' satisfaction, and quality of life, and is an option for SUI management in women.