Utility of Pelvic Floor Therapy and Behavioral Interventions in the Neurogenic Lower Urinary Tract Dysfunction...

Neurogenic lower urinary tract dysfunction (NLUTD) describes a wide range of symptoms depending on neurologic diagnosis and the resulting bladder and sphincter dysfunction. This narrative review is designed to address the question regarding which NLUTD population benefits most from pelvic floor therapy and behavioral interventions, and how to deliver these therapies.

Most NLUTD treatment guidelines encourage least-invasive, low-risk therapies like behavioral therapy (BT) and pelvic floor muscle therapy (PFMT)/pelvic floor physical therapy (PFPT), but they are often underutilized because of a multitude of reasons. Studies show that PFMT along with electrostimulation or biofeedback to facilitate understanding of the pelvic floor activity, may offer significant improvement in urinary symptoms and quality of life in certain NLUTD populations.

Education, adherence support, and supervised exerciseappear to enhance outcomes. Finally, evidence suggests that telerehabilitation-based PFMT is feasible, effective and associated with higher adherence and satisfaction compared with home exercise alone.