Incontinence improves in older women after intensive pelvic floor muscle training: An assessor-blinded randomized controlled trial§


  • Conflicts of interest: None.

  • Linda Brubaker led the review process.

  • §

    Author contributions: MG designed the study with contributions from MS and KB. MS coordinated the study and analyzed the data under the supervision of MG. MB and MC assisted with recruitment and screening of participants. All authors reviewed drafts of the manuscript. MG is guarantor. Janet Chase conducted the blinded assessments. Melinda Cooper, Judy Sincock, Elizabeth Hampel, Libby Oldfield, and Debbie Herz conducted the exercise classes. Jeromy Anglim assisted with data analysis.



To test the hypotheses that high intensity pelvic floor muscle training (PFMT) is effective in relief of stress urinary incontinence in community dwelling older women, and that intense PFMT improves stress urinary incontinence more than bladder training (BT) in this population.


A two-center, assessor-blinded randomized controlled trial of 20 weeks duration with two active intervention arms: PFMT and BT. Assessments and interventions were undertaken at two metropolitan tertiary hospitals. Participants were community dwelling women over 65 years of age with urodynamic stress incontinence. Primary outcome measure was urinary leakage during a cough stress test. Secondary outcome measures included symptoms and bother (ICIQ-UI SF), participant global perception of change, leakage episodes (7-day accident diary), degree of “bother” (VAS) and health related quality of life (AQoL).


Eighty-three Caucasian women, 71.8 (SD 5.3) years participated in the study. Both groups improved over the intervention period; however, the PFMT group reported significantly lower amounts of leakage on the stress test [PFMT median 0.0 g, 95% CI: 0.2–0.9; BT median 0.3 g, 95% CI: 0.2–1.7, P = 0.006], improved symptoms and bother [PFMT mean 5.9, 95% CI: 4.8–7.1; BT group mean 8.5, 95% CI: 7.1–9.9 and greater perception of change [PFMT 28 (73.6%); BT 12 (36.4%) (P = 0.002)] after 5 months than the BT group.


High intensity PFMT is effective in managing stress urinary incontinence and is more effective than BT in healthy older women. Neurourol. Urodynam. 30:317–324, 2011. © 2011 Wiley-Liss, Inc.