Mickey Karram led the peer-review process as the Associate Editor responsible for the paper.
Original Clinical Article
Article first published online: 28 MAR 2013
Copyright © 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 32, Issue 5, pages 449–454, June 2013
How to Cite
Dumoulin, C., Martin, C., Elliott, V., Bourbonnais, D., Morin, M., Lemieux, M.-C. and Gauthier, R. (2013), Randomized controlled trial of physiotherapy for postpartum stress incontinence: 7-year follow-up. Neurourol. Urodyn., 32: 449–454. doi: 10.1002/nau.22330
Disclosure: Chantale Dumoulin was supported by a New investigator fellowship from the Fonds de la Recherche en Santé du Québec (FRSQ) and the Canadian Institute for Health Research (CIHR).
Conflict of interest: none.
- Issue published online: 18 JUN 2013
- Article first published online: 28 MAR 2013
- Manuscript Accepted: 12 SEP 2012
- Manuscript Received: 27 APR 2012
- Canadian Institute for Health Research (CIHR)
- University of Montreal research allocation
- pelvic floor;
- stress urinary incontinence
To estimate the long-term effect of intensive, 6-week physiotherapy programs, with and without deep abdominal muscle (TrA) training, on persistent postpartum stress urinary incontinence (SUI).
The study was a single-blind randomized controlled trial. Fifty-seven postnatal women with clinically demonstrated persistent SUI 3 months after delivery participated in 8 weeks of either pelvic floor muscle training (PFMT) (28) or PFMT with deep abdominal muscle training (PFMT + TrA) (29). Seven years post-treatment, 35 (61.4%) participants agreed to the follow-up; they were asked to complete a 20-min pad test and three incontinence-specific questionnaires with an assessor blinded to each participant's group assignment.
Of the 35 (61.4%) who agreed to the follow-up: 26 (45.6%) took the 20-min pad test (12 PFMT and 14 PFMT + TrA) and 35 (61.4%) completed the questionnaires (18 PFMT and 17 PFMT + TrA). The baseline clinical characteristics of the follow-up and non-follow-up participants were not significantly different; nor did they differ between PFMT and PFMT + TrA participants enrolled in the follow-up study. At 7 years, the pad test scores for the PFMT group did not differ statistically from those of the PFMT + TrA group. When combining both treatment groups, a total of 14/26 (53%) follow-up participants were still continent according to the pad test.
The addition of deep abdominal training does not appear to further improve the outcome of PFM training in the long term. However, benefits of physiotherapy for postpartum SUI, although not as pronounced as immediately after the initial intervention, is still present 7 years post-treatment. Neurourol. Urodynam. 32: 449–454, 2013. © 2013 Wiley Periodicals, Inc.