Impact of at-home self-rehabilitation of the perineum on pelvic floor function in patients with stress urinary incontinence: Results from a prospective study using three-dimensional ultrasound

Pelvic floor muscle training (PFMT) is the first step of treatment for stress urinary incontinence (SUI). Patients must perform self-retraining exercises of the perineal muscles at home in order to maintain the benefit of the physiotherapy.

The aim of this study is to assess the benefit of a perineal electro-stimulator, using three-dimensional ultrasound, during this home-care phase.

A longitudinal prospective study was conducted between May 2012 and May 2013. All patients with de novo SUI benefited from PFMT followed by a self-maintenance of perineal rehabilitation at home with the Keat(®) Pro system. The primary endpoint was the biometric of the levator ani and it was assessed by three-dimensional perineal ultrasound at inclusion, after conventional rehabilitation and at the end of the study after self-rehabilitation.

Ten patients were included. All patients (100%) showed a clinical improvement of SUI. The quality of life was significantly improved after PFMT vs. inclusion (P=0. 014) and after self-rehabilitation vs. after PFMT (P=0. 033). Levator ani muscles were significantly thicker after conventional rehabilitation than at baseline (P=0. 004) and significantly thicker after self-rehabilitation than after PFMT (P=0. 009).

Conducting self-rehabilitation in addition to conventional PFMT objectively improves the perineal muscle building achieved after conventional rehabilitation.

Journal de gynecologie, obstetrique et biologie de la reproduction. 2015 Aug 27 [Epub ahead of print]

G Legendre, A Gonzalves, J-M Levaillant, D Fernandez, F Fuchs, H Fernandez

Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France; Service de gynécologie-obstétrique, CHU d'Angers, 49933 Angers cedex, France. Service de gynécologie-obstétrique, CHU d'Angers, 49933 Angers cedex, France. , Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France. , Cabinet de sage-femmes, 47, avenue Aristide-Briand, 92350 Le Plessis-Robinson, France. , Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France. , Service de gynécologie-obstétrique, hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, 78, avenue du Général-Leclerc, 94276 Le Kremlin-Bicêtre cedex, France.

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