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Physiotherapy for female stress urinary incontinence: a multicentre observational study


Correspondence: Ms Patricia Neumann, Pelvic Floor Rehabilitation and Continence Clinic, 32 Kensington Road, Rose Park, South Australia 5067, Australia. Email:


Background: No previous data are available on the effectiveness of physiotherapy management of urinary stress incontinence with relevance to the Australian health system.

Aims: To evaluate Australian ambulatory physiotherapy management of stress urinary incontinence.

Methods: Observational multicentre clinical study of physiotherapy management of female stress urinary incontinence between February 1999 and October 2000, with 1-year follow-up. Outcome measures were a stress test and a 7-day diary of incontinent episodes (pretreatment and at every visit) and a condition-specific quality of life (QoL) questionnaire (pre- and post-treatment). Subjects were followed-up 1 year after treatment by questionnaire with a 7-day diary, QoL questionnaire, and assessment of subjective outcome, subjective cure, satisfaction and need for surgery.

Results: Of the 274 consenting subjects, 208 completed an episode of physiotherapy care consisting of a median (IQ range) of five (four to six) visits. At the end of the episode, 84% were cured and 9% improved on stress testing, whilst 53% were cured and 25% improved according to the 7-day diary. Mean volume of urine loss on stress testing reduced from 2.4 (2.5) mL to 0.1(0.4) mL after treatment. There was a significant improvement in all QoL domains. Median (interquartile range) incontinent episodes per week were reduced from five (three to 11) to zero (zero to two) (P < 0.05) after treatment and to one (zero to four) at 1 year (P < 0.05). At 1 year, approximately 80% of respondents had positive outcomes on all outcome measures.

Conclusions: Physiotherapy management in Australian clinical settings is an effective treatment option for women with stress urinary incontinence.