Does Perinatal Period Pelvic Floor Muscle Exercises Affect Urinary Incontinence? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Aim: Pelvic floor dysfunction (PFD) consists of urinary incontinence (UI), anal incontinence, pelvic organ prolapses, and sexual dysfunction. This study aimed to conduct a systematic compilation and meta-analysis of randomized controlled studies examining urinary incontinence symptom severity and quality of life of pelvic floor muscle exercises performed on women during pregnancy, birth, and postpartum period. Method: Databases, including PubMed, Cochrane Library, and Web of Science, were scanned using MeSH-based keywords. Only randomized controlled trials (RCT) were included. The data were analyzed using the Review Manager computer program (Version 5.3). Results: Pooled standardized differences in incontinence mean (SMD) between pre-intervention groups were -0.09 (95% CI: [-0.018, -0.00], p=0.04). Initially, the exercise group had lower average scores in UDI-6 (mean difference (MD) =-3.32 [-4.61-2.03], p<0.00001). MD was higher after exercise (MD = -2.85 [-3.10 -2.61], p<0.00001). There was little evidence of a difference in quality of life between the intervention and control groups as measured by ICIQ-SF. Initially, the exercise group had lower average scores on ICIQ-SF (MD = -0.07 [-0.21-0.08], p=0.37). MD was higher after exercise (MD = -0.06 [-0.16-0.04], p=0.45, but there was no statistically significant difference. Conclusion: Evidence has shown an effect of pelvic floor muscle training on urinary incontinence and quality of life in the postpartum period in primiparous women. However, high-quality randomized controlled studies are needed.

Keywords

• Pregnancy
• postpartum
• urinary incontinence
• quality of life
• pelvic floor exercise

Perinatal Dönemde Pelvik Taban Kas Egzersizleri Üriner İnkontinansı Etkiler mi? Randomize Kontrollü Çalışmaların Sistematik İncelenmesi ve Meta-Analizi

Abstract

Amaç: Pelvik taban disfonksiyonu (PTD), idrar kaçırma (İK), anal inkontinans, pelvik organ prolapsusu ve cinsel işlev bozukluğundan oluşur. Bu çalışmada gebelik, doğum ve doğum sonrası dönemde kadınlara uygulanan pelvik taban kas egzersizlerinin üriner inkontinans semptom şiddeti ve yaşam kalitesini inceleyen randomize kontrollü çalışmaların sistematik derlemesi ve meta-analizinin yapılması amaçlandı. Yöntem: PubMed, Cochrane Library ve Web of Science gibi veri tabanları, MeSH tabanlı anahtar kelimeler kullanılarak tarandı. Yalnızca randomize kontrollü çalışmalar (RKÇ) dahil edildi. Veriler Review Manager bilgisayar programı (Sürüm 5.3) kullanılarak analiz edildi. Bulgular: Müdahale öncesi gruplar arasında inkontinans ortalamasında birleştirilmiş standartlaştırılmış farklar -0,09 idi (%95 GA: [-0,018, -0,00], p=0,04). Başlangıçta, egzersiz grubunun UDI-6'da ortalama puanları daha düşüktü (MD =-3.32 [-4.61-2.03], p<0.00001). MD egzersiz sonrasında daha yüksekti (MD = -2,85 [-3,10 -2,61], p<0,00001). ICIQ-SF ile ölçülen müdahaleler ve kontrol grupları arasında yaşam kalitesinde bir fark olmadığını gösteren çok az kanıt vardı. Başlangıçta egzersiz grubunun ICIQ-SF'de ortalama puanları daha düşüktü (MD = -0,07 [-0,21-0,08], p=0,37). MD egzersiz sonrası daha yüksekti (MD = -0,06 [-0,16-0,04]; p=0,45 ancak istatistiksel olarak anlamlı bir fark yoktu. Sonuç: Kanıtlar, ilk doğum yapan kadınlarda pelvik taban kas eğitiminin idrar kaçırma ve postpartum dönemde yaşam kalitesi üzerinde etkili olduğunu göstermiştir. Ancak yüksek kalitede randomize kontrollü çalışmalara ihtiyaç vardır.

Keywords

• Gebelik
• doğum sonrası
• idrar kaçırma
• yaşam kalitesi
• pelvik taban egzersizi

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