Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting? - Abstract

INTRODUCTION AND HYPOTHESIS: Pelvic floor muscle training (PFMT) is the recommended first-line treatment for women with urinary incontinence (UI).

Success rates are variable and dependent on a number of factors. The development of an incontinence treatment motivation questionnaire (ITMQ) provides us with a tool to assess patient self-motivation with respect to PFMT and UI. The aim of this study was to determine the effect of women's self-motivation to perform PFMT on outcome.

METHODS: Women with stress predominant UI completed an ITMQ and a 24-h pad test and then underwent a 12-week course of supervised PFMT. At the end of their treatment they completed a patient global impression of improvement questionnaire (PGI-I) and a second 24-h pad test. The PGI-I scores and the difference in pad test weight correlated with the ITMQ according to Spearman's correlation coefficient.

RESULTS: Sixty-five women were recruited. Thirty-two (49 %) patients perceived themselves as having improved, 28 women (43 %) did not experience any change in symptoms and 5 women (8 %) felt that their symptoms deteriorated following treatment. When correlating the PGI-I with the ITMQ, 3 of the 5 domains: MQS1 (positive attitude for treatment; p = 0.003), MQS3 (frustration of living with incontinence; p = 0.002) and MQS4 (desire for treatment; p = 0.002) correlated significantly with outcome. Desire for treatment was the only domain to correlate with change in pad weight (p = 0.001).

CONCLUSION: Self-motivation is essential in order to determine improved success rates with PFMT.

Written by:
Vella M, Nellist E, Cardozo L, Mastoroudes H, Giarenis I, Duckett J.   Are you the author?
Department of Urogynaecology, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9 RS, UK.

Reference: Int Urogynecol J. 2013 May 24. Epub ahead of print.
doi: 10.1007/s00192-013-2115-x


PubMed Abstract
PMID: 23702666

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