Listed in Issue 133


HAY-SMITH and DUMOULIN, Department of Women’s and Children’s Health, DSM, University of Otago, PO Box 913, Dunedin, New Zealand, have reviewed (51 references) pelvic floor muscle training for urinary incontinence in women.


Pelvic floor muscle training is the most commonly used physical therapy treatment for women with stress urinary incontinence. The aim of this study was to determine the effects of pelvic floor muscle training for women with urinary incontinence in comparison to no treatment, placebo or sham treatments, or other inactive control treatments.


The Cochrane Incontinence Group Specialised Trials Register was searched. Randomized or quasi-randomized trials in women with urinary incontinence were included. Trials were independently assessed for eligibility and methodological quality. Data were extracted then cross-checked. Formal meta-analysis was not undertaken because of study heterogeneity.


13 trials involving 714 women met the inclusion criteria, but only 6 trials (403 women) contributed data to the analysis. Most studies were at moderate to high risk of bias, based on the trial reports. There was considerable variation in interventions used, study populations, and outcome measures. Women who did pelvic floor muscle training were more likely to report they were cured or improved than women who did not. Pelvic floor muscle training women also experienced about one fewer incontinence episodes per day. Of the few adverse effects reported, none were serious. The trials that suggested greater benefit recruited a younger population and recommended a longer training period.


The review provides some support for the widespread recommendation that pelvic floor muscle training be included in first-line conservative management programmes for women with urinary incontinence.


Hay-Smith EJ, Dumoulin C. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews (1) : CD005654, 2006.

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