Effect of Pelvic Floor Muscle Strengthening Exercises on Urinary Incontinence in Women after Uterus Removal Surgery

Abstract

Background. Hysterectomy (HT) is a very common procedure in which the uterus is removed surgically. The extent and type of HT surgery may vary, but the surgical intervention itself is a risk factor for the development of postoperative urinary incontinence regardless of the extent and type of surgery (Skorupska, Miotla, Kubik–Komar, Rechberger, Adamiak–Godlewska & Rechberger, 2016). Techniques for preventing urinary incontinence include maintaining proper weight, limiting the number of children, making lifestyle adjustments, and educating to perform pelvic floor muscle (PFM) training exercises correctly (Habib & Chaudhary, 2016). However, there is still a lack of research on how PFM training can be combined with other interventions (Silantyeva, et al., 2019), and different authors presernt conflicting results.

Aim. The purpose was to evaluate the effect of pelvic floor muscle strengthening exercises on urinary incontinence in women after uterus removal surgery.

Methods. The first group of subjects received biofeedback and usual physical therapy (BF + UT), while the second group of patients received only usual therapy (UT). All subjects were assessed for perceived pain, PFM strength, quality of life associated with urinary incontinence, and overall quality of life, before and after exposure. Pain intensity and PFM stregth were additionally assessed after 5 and 10 days.

Results. After exposure, there was a significant increase in outcome in the BF + UT group – PFM strength, and quality of life associated with urinary incontinence compared to the UT group. Perceived pain and overall quality of life outcomes did not differ between groups (p > 0,05).

Conclusion. Usual therapy combined with biofeedback is more effective in increasing pelvic floor muscle strength, and quality of life related to urinary incontinence, in terms of behavior, than usual therapy alone.

Keywords: hysterectomy, pelvic floor muscle, pelvic floor muscle training, urinary incontinence, physical therapy.