A randomized, single-blinded
study is always a challenging task. The difficulties in our study were the
recruitment and compliance of patients with the treatment and the long-term
follow-up (12 months). We knew that the 24 h pad test was better than the 1 h
test for the evaluation of the treatment of female urinary incontinence (UI), despite the fact that the latter had
been approved by the International Continence Society. The 1 h pad test
permitted us to standardize and ensure the quality of results.
After recruitment, some
patients presented difficulties in perinea exercises due to the old habits of
contracting the pelvic floor muscles (PFM) to maintain continence. These
patients demanded the full support of a physiotherapist involved in this work.
The weekly meetings between
the physiotherapist and patients proved to be important to improve the
understanding of problems related to urinary incontinence (UI) and to encourage
patients to make more comprehensive and stronger commitments to treatment.
It was pertinent to point out
that the two different types of non-surgical management of UI increased the
patients' motivation resulting in a significant and quick improvement in the
symptoms of patients undergoing such treatments.
The weighted vaginal cone (WVC)
proved to be efficient in strengthening the PFM fast, and might be recommended
before the surgical approach to UI in order to maximize the results. The perinea
exercises were also effective to treat UI showing its importance in maintaining
the strength of female PFM.
Female urinary incontinence is
better assisted when a motivated, sensitive multi-professional team is able to
provide the best physic-psychological support. Clinical treatment of female UI
is recommended less frequently than surgical procedure; therefore, further
randomized trials are very important to evaluate the best options of clinical
management of UI.
Resource:
- http://www.medicalnewstoday.com/articles/188230.php
