NEW YORK (Reuters Health) -
In pregnant women, pelvic floor
muscle training for bladder-control problems, though beneficial
initially, is ineffective over the long term, research shows.

Stress-related urinary incontinence “is a risk factor for
long-term leakage but not necessarily enough to require
surgery,” Dr. Robert M. Freeman from Derriford Hospital,
Plymouth, UK told Reuters Health. Performing exercises before
delivery designed to strengthen the pelvic floor muscles “does
not seem to give good long-term results, and this is probably
due to poor compliance,” Freeman noted.

The findings are based on 230 women who participated in two
studies of the effectiveness of pelvic floor muscle training
for preventing stress urinary incontinence after pregnancy.

At 3 months after pregnancy, significantly fewer women who
performed pelvic floor muscle exercises reported post-delivery
urinary incontinence, compared with women who did not perform
these exercises (19 percent versus 33 percent).

Eight years later, however, urinary incontinence was
reported by a similar percentage of women in the pelvic floor
muscle training group and the control group (35 percent and 39
percent, respectively).

More than two-thirds of the women in the training group
reported that they still performed pelvic floor muscle training
at 8 years, and more than a third said they were performing the
exercises at least twice a week.

Despite these reports, the investigators say, incontinence
rates did not differ between those performing pelvic floor
exercises at least twice weekly and those performing the
exercises less frequently.

“We are concerned that a lot of the evidence for both
(before delivery and after delivery) pelvic floor muscle
training suggests poor long-term effect,” Freeman said. “We
believe that compliance is the major issue, and this can only
be improved by education.”

SOURCE: BJOG: An International Journal of Obstetrics and
Gynaecology, July 2008.