Wednesday, July 1, 2009

Pelvic Floor Muscle Retraining Can Reduce Urinary Incontinence in Late Pregnancy and Post Partum Women in the first 12 months

Urinary Incontinence (UI) is a common female pelvic health problem and physical therapy is the most commonly recommended first line therapy for it. About 1/3 of women have UI. It is usually recommended for Mixed UI (Stress and Urge) and less commonly for Urge Incontinence alone. Pelvic Floor Muscle (PFM) retraining is usually done over 5 -12 sessions in order to adequately localize the correct muscles to train and reinforce therapy and adherence.

There are no adverse effects of doing PFM retraining. Overall, it is most beneficial when individually taught to the individual woman who is immediate post-natal but at high risk for incontinence (urinary or fecal), such as after instrument delivery, vaginal delivery after a large baby, or a third degree perineal tear.

If women perform PFM training during pregnancy or just after birth what are the findings:

In women without UI who have never given birth yet, or those with only one birth, PFM reduce UI in late pregnancy (34 weeks or more pregnant), immediate post partum (up to 12 weeks), and even up to 3-6 months after birth.

In women with UI at baseline, PFM retraining did lower UI in late pregnancy but did not show lasting effects into the post partum period.

So for all you soon-to-be new moms or those with only one child who do NOT have UI, start doing those Kegels about 2 months before the baby is due to help cut down on UI after birth.

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