Pelvic Floor Muscle Training Combined with Biofeedback Therapy for Stress Urinary Incontinence in Postmenopausal...

To evaluate the effectiveness of pelvic floor muscle training (PFMT) combined with biofeedback therapy for stress urinary incontinence (SUI) in postmenopausal women and to explore multidimensional changes in symptoms, urine leakage, pelvic floor muscle function, imaging parameters, and urethral dynamics.

This single-center retrospective controlled study included 168 postmenopausal women with SUI treated between January 2021 and December 2023 with a 12-week follow-up. The control group received conventional PFMT (n = 82), and the combined group received PFMT plus EMG biofeedback training (n = 86). Primary outcomes were changes in ICIQ-SF and 1-h pad test leakage. Secondary outcomes included pelvic floor EMG parameters, Oxford scale grade, transperineal ultrasound indices, urethral pressure/LPP parameters, and adverse events.

At week 12, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score showed a statistically significantly greater reduction in the combined group compared to controls (mean difference [MD] 2.6 points; 95% confidence interval [CI] 1.8-3.4; p < 0.001), although this inter-group difference did not reach the predefined minimal clinically important difference (MCID) of 4 points. Pad-test leakage decreased by a mean of 21.8 g in the combined group vs. 12.7 g in controls (MD 9.1 g; 95% CI 5.4-12.8; p < 0.001). The combined group showed larger gains in maximum voluntary contraction (MVC) (+11.7 vs. +6.3 µV) and greater reductions in bladder neck mobility (-5.8 vs. -2.8 mm) (all p < 0.01). Urethral dynamics showed modest improvements favoring the combined intervention. No severe adverse events occurred.

PFMT combined with biofeedback leads to greater short-term (12-week) reductions in objective urine leakage and improved muscle function compared with PFMT alone. However, the incremental benefit in subjective symptom scores, while statistically significant, did not meet the threshold for minimal clinical importance.