Effectiveness of physiotherapeutic techniques in urinary incontinence: a review of the literature
DOI:
https://doi.org/10.12775/JEHS.2022.12.08.015Keywords
urinary incontinence, physiotherapeutic methods, rehabilitationAbstract
Introduction and purpose : Urinary incontinence is a common condition characterized by involuntary urine leakage from urethra. It particularly affects elderly women and is a serious medical, social and economic problem. As a result of recently observed population ageing, the incidence of this anomaly is expected to rise. Due to multifactorial etiology, several types of incontinence are distinguished. Proper diagnostic procedures lead to diagnosis confirmation and allow appropriate therapeutic intervention. Both conservative and surgical methods are used in management of urine incontinence. In addition to pharmacological therapy, physiotherapeutic methods have an important meaning in conservative approach. The aim of this article is a review presenting the results of recent studies on the effectiveness of physiotherapy procedures in treatment of various types of urine incontinence.
Description of the state of knowledge: In the study 33 articles which published physiotherapy techniques in 2004-2021 regarding the role of physiotherapeutic methods in the treatment of urinary incontinence were analyzed. The results of studies assessing the effectiveness of physiotherapy techniques (acupuncture, behavioral therapy, yoga, magnetic stimulation, pelvic floor muscle training, vaginal cones, vibration therapy, kinesiotheraphy techniques, stimulation) in reducing the severity of urinary incontinence symptoms and improving the quality of patients’ life were presented on the basis of analyzed literature.
Conclusions: Physiotherapy is an effective method of treatment of urinary incontinence and it supports other types of therapy. Therapy should be interdisciplinary approached and the choice of physiotherapeutic methods should be dependent on the individual needs of the patient.
References
Kopańska M, Torices S, Czech J, Koziara W, Toborek M, Dobrek M. Urinary incontinence in women: biofeedback as an innovative treatment method. Therapeutic Advances in Urology. 2020; 12: 1-12
Weidner AC, Barber MD, Markland A, Rahn DD, Hsu Y, Mueller ER, Jakus-Waldman S, Dyer KY, Warren LK, Gantz MG, Meikle S. Perioperative Behavioral Therapy and Pelvic Muscle Strengthening Do Not Enhance Quality of Life After Pelvic Surgery: Secondary Report of a Randomized Controlled Trial. Phys Ther. 2017 Nov 1;97(11):1075-1083. doi: 10.1093/ptj/pzx077. PMID: 29077924; PMCID: PMC6075557.
Zygmunt R, Kozioł S, Hładki W, Golec J. Wpływ fizjoterapii na nietrzymanie moczu u kobiet. Ostry Dyżur. 2017, 10(3): 77-83;
Fiodorenko-Dumas Ż, Paprocka-Borowicz M. Postępowanie fizjoterapeutyczne w nietrzymaniu moczu. Medycyna Ogólna i Nauki o Zdrowiu. 2014; 20(1): 12-16;
Vaughan CP, Burgio KL, Goode PS, Juncos JL, McGwin G, Muirhead L, Markland AD, Johnson TM 2nd. Behavioral therapy for urinary symptoms in Parkinson's disease: A randomized clinical trial. Neurourol Urodyn. 2019 Aug;38(6):1737-1744. doi: 10.1002/nau.24052. Epub 2019 Jun 11. PMID: 31187552; PMCID: PMC6660386.
Purc D, Rasała A. Metody leczenia nietrzymania moczu. European Journal of Medical Technologies. 2015; 3(8): 29-38;
Witkoś J, Wróbel P, Błońska- Fajfrowska B. Wysiłkowe nietrzymanie moczu u kobiet jako problem medyczny, społeczny, psychologiczny i ekonomiczny – ocena zakresu wiedzy studentów kończących kierunki medyczne. Rehabilitacja medyczna. 2017; 21(1): 11-19;
Diokno AC, Newman DK, Low LK, Griebling TL, Maddens ME, Goode PS, Raghunathan TE, Subak LL, Sampselle CM, Boura JA, Robinson AE, McIntyre D, Burgio KL. Effect of Group-Administered Behavioral Treatment on Urinary Incontinence in Older Women: A Randomized Clinical Trial. JAMA Intern Med. 2018 Oct 1;178(10):1333-1341. doi: 10.1001/jamainternmed.2018.3766. PMID: 30193294; PMCID: PMC6233747.
Silay K, Akinci S, Ulas A, Yalcin A, Silay YS, Akinci MB, Dilek I, Yalcin B. Occult urinary incontinence in elderly women and its association with geriatric condition. Eur Rev Med Pharmacol Sci. 2016;20(3):447-51. PMID: 26914118.
Komesu YM, Schrader RM, Ketai LH, Rogers RG, Dunivan GC. Epidemiology of mixed, stress, and urgency urinary incontinence in middle-aged/older women: the importance of incontinence history. Int Urogynecol J. 2016;27(5):763-772. doi:10.1007/s00192-015-2888-1
Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women [published correction appears in Nat Rev Dis Primers. 2017 Nov 16;3:17097]. Nat Rev Dis Primers. 2017;3:17042. Published 2017 Jul 6. doi:10.1038/nrdp.2017.42
Grzybowska ME, Wydra D & Smutek J. Analysis of the usage of continence pads and help-seeking behavior of women with stress urinary incontinence in Poland. BMC women's health, 2015; 15, 80
Hu JS, Pierre EF. Urinary Incontinence in Women: Evaluation and Management. Am Fam Physician. 2019;100(6):339-348.
Kubiak K, Husejko J, Gajos M, Wysocka M. Menagement of stress incontinence in older women. Journal of Education, Health and Sport. 2019; 9(5), 209-220.
Mota RL. Female urinary incontinence and sexuality. Int. Braz. J. Urol.,2017; 43, 20–28.
Borowicz AM, Wieczorowska-Tobis K. Metody fizjoterapeutyczne w leczeniu nietrzymania moczu. Gerontol. Pol. 2010, 18(3), str. 114–119.
Finazzi-Agrò E, Petta F, Sciobica F, Pasqualetti P, Musco S, Bove P. Percutaneous tibial nerve stimulation effects on detrusor overactivity incontinence are not due to a placebo effect: a randomized, double-blind, placebo controlled trial. J Urol. 2010;184(5):2001-2006. doi:10.1016/j.juro.2010.06.113
Schreiner L, dos Santos TG, Knorst MR, da Silva Filho IG. Randomized trial of transcutaneous tibial nerve stimulation to treat urge urinary incontinence in older women. Int Urogynecol J. 2010;21(9):1065-1070. doi:10.1007/s00192-010-1165-6
Alves PG, Nunes FR, Guirro EC. Comparison between two different neuromuscular electrical stimulation protocols for the treatment of female stress urinary incontinence: a randomized controlled trial. Rev Bras Fisioter. 2011;15(5):393-398. doi:10.1590/s1413-35552011005000010
Pereira VS, Bonioti L, Correia GN, Driusso P. Efectos de la electroestimulación superficial en las mujeres mayores con incontinencia urinaria de esfuerzo: estudio piloto aleatorio controlado [Effects of surface electrical stimulation in older women with stress urinary incontinence: a randomized controlled pilot study]. Actas Urol Esp. 2012;36(8):491-496. doi:10.1016/j.acuro.2011.11.016
Chêne G, Mansoor A, Jacquetin B, Mellier G, Douvier S, Sergent F, Aubard Y, Seffert P. Female urinary incontinence and intravaginal electrical stimulation: an observational prospective study. Eur J Obstet Gynecol Reprod Biol. 2013 Sep;170(1):275-80. doi: 10.1016/j.ejogrb.2013.06.011. Epub 2013 Jul 5. PMID: 23830965.
Correia GN, Pereira VS, Hirakawa HS, Driusso P. Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence: randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2014;173:113-118. doi:10.1016/j.ejogrb.2013.11.023
Kolb G, Kolb E, Richmond C & Hanson C. Surface-Applied Electrical Muscle Stimulation for Self-administered Treatment of Female Stress Urinary Incontinence. Journal of Women's Health Physical Therapy, 2019; 43(4), str. 188–193.
Hwang UJ, Lee MS, Jung SH, Ahn SH, Kwon OY. Which pelvic floor muscle functions are associated with improved subjective and objective symptoms after 8 weeks of surface electrical stimulation in women with stress urinary incontinence?. Eur J Obstet Gynecol Reprod Biol. 2020;247:16-21. doi:10.1016/j.ejogrb.2020.02.008
Schreiner L, Nygaard CC, Dos Santos TG, Knorst MR, da Silva Filho IG. Transcutaneous tibial nerve stimulation to treat urgency urinary incontinence in older women: 12-month follow-up of a randomized controlled trial. Int Urogynecol J. 2021;32(3):687-693. doi:10.1007/s00192-020-04560-6
Chisholm L, Delpe S, Priest T, Reynolds WS. Physical Activity and Stress Incontinence in Women. Curr Bladder Dysfunct Rep. 2019;14(3):174-179. doi:10.1007/s11884-019-00519-6
Mishra GD, Hardy R, Cardozo L, Kuh D. Body weight through adult life and risk of urinary incontinence in middle-aged women: results from a British prospective cohort. Int J Obes (Lond). 2008;32(9):1415-1422. doi:10.1038/ijo.2008.107
Lee AH, Hirayama F. Physical activity and urinary incontinence in older adults: a community-based study. Curr Aging Sci. 2012;5(1):35-40
Poświata A, Socha T, & Opara J. Prevalence of stress urinary incontinence in elite female endurance athletes. Journal of human kinetics, 2014; 44, 91–96.
Nygaard IE, Shaw JM, Bardsley T, Egger MJ. Lifetime physical activity and female stress urinary incontinence. Am J Obstet Gynecol. 2015;213(1):40.e1-40.e10. doi:10.1016/j.ajog.2015.01.044
Chu CM, Khanijow KD, Schmitz KH, Newman DK, Arya LA, Harvie HS. Physical Activity Patterns and Sedentary Behavior in Older Women With Urinary Incontinence: an Accelerometer-based Study. Female Pelvic Med Reconstr Surg. 2019;25(4):318-322. doi:10.1097/SPV.0000000000000552
Mazur-Bialy AI, Kołomańska-Bogucka D, Nowakowski, C, & Tim S. Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy. Journal of clinical medicine. 2020; 9(4), 1211.
Tantawy SA, Elgohary HMI, Abdelbasset WK, Kamel DM. Effect of 4 weeks of whole-body vibration training in treating stress urinary incontinence after prostate cancer surgery: a randomised controlled trial. Physiotherapy. 2019;105(3):338-345. doi:10.1016/j.physio.2018.07.013
Lauper M, Kuhn A, Gerber R, Luginbühl H, Radlinger L. Pelvic floor stimulation: what are the good vibrations?. Neurourol Urodyn. 2009;28(5):405-410. doi:10.1002/nau.20669
Luginbuehl H, Lehmann C, Gerber R, Kuhn A, Hilfiker R, Baeyens JP, Radlinger L. Continuous versus intermittent stochastic resonance whole body vibration and its effect on pelvic floor muscle activity. Neurourol Urodyn. 2012 Jun;31(5):683-7. doi: 10.1002/nau.21251. Epub 2012 Mar 6. PMID: 22395850.
Farzinmehr A, Moezy A, Koohpayehzadeh J, Kashanian M. A Comparative Study of Whole Body Vibration Training and Pelvic Floor Muscle Training on Women's Stress Urinary Incontinence: Three- Month Follow- Up. J Family Reprod Health. 2015;9(4):147-154.
Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005654. doi: 10.1002/14651858.CD005654.pub4. PMID: 30288727; PMCID: PMC6516955.
Sung VW, Borello-France D, Newman DK, Richter HE, Lukacz ES, Moalli P, Weidner AC, Smith AL, Dunivan G, Ridgeway B, Nguyen JN, Mazloomdoost D, Carper B, Gantz MG; NICHD Pelvic Floor Disorders Network. Effect of Behavioral and Pelvic Floor Muscle Therapy Combined With Surgery vs Surgery Alone on Incontinence Symptoms Among Women With Mixed Urinary Incontinence: The ESTEEM Randomized Clinical Trial. JAMA. 2019 Sep 17;322(11):1066-1076. doi: 10.1001/jama.2019.12467. PMID: 31529007; PMCID: PMC6749544.
Burgio KL, Kraus SR, Johnson TM 2nd, Markland AD, Vaughan CP, Li P, Redden DT, Goode PS. Effectiveness of Combined Behavioral and Drug Therapy for Overactive Bladder Symptoms in Men: A Randomized Clinical Trial. JAMA Intern Med. 2020 Mar 1;180(3):411-419. doi: 10.1001/jamainternmed.2019.6398. PMID: 31930360; PMCID: PMC6990866.
Fiodorenko-Dumas Z, Paprocka-Borowicz M. Postępowanie fizjoterapeutyczne w nietrzymaniu moczu. Medycyna Ogólna i Nauki o Zdrowiu. 2014;20(49)(1).
Dannecker C, Wolf V, Raab R, Hepp H, Anthuber C. EMG-biofeedback assisted pelvic floor muscle training is an effective therapy of stress urinary or mixed incontinence: a 7-year experience with 390 patients. Arch Gynecol Obstet. 2005;273(2):93-97. doi:10.1007/s00404-005-0011-4
Hirakawa T, Suzuki S, Kato K, Gotoh M, Yoshikawa Y. Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence. Int Urogynecol J. 2013;24(8):1347-1354. doi:10.1007/s00192-012-2012-8
Aydın Sayılan A, Özbaş A. The Effect of Pelvic Floor Muscle Training On Incontinence Problems After Radical Prostatectomy. Am J Mens Health. 2018;12(4):1007-1015. doi:10.1177/1557988318757242
Weber-Rajek M, Radzimińska A, Strączyńska A, Podhorecka M, Kozakiewicz M, Perkowski R, Jarzemski P, Kędziora-Kornatowska K, Goch A. A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women. Clin Interv Aging. 2018;13:2473-2480
https://doi.org/10.2147/CIA.S176588
Wallis MC, Davies EA, Thalib L, Griffiths S. Pelvic static magnetic stimulation to control urinary incontinence in older women: a randomized controlled trial. Clin Med Res. 2012;10(1):7-14. doi:10.3121/cmr.2011.1008
Weber-Rajek M, Radzimińska A, Strączyńska A, Podhorecka M, Kozakiewicz M, Perkowski R, Jarzemski P, Kędziora-Kornatowska K, Goch A. A randomized-controlled trial pilot study examining the effect of extracorporeal magnetic innervation in the treatment of stress urinary incontinence in women. Clin Interv Aging. 2018 Dec 4;13:2473-2480. doi: 10.2147/CIA.S176588. PMID: 30584287; PMCID: PMC6287547.
Weber-Rajek M, Strączyńska A, Strojek K, Piekorz Z, Pilarska B, Podhorecka M, Sobieralska-Michalak K, Goch A, Radzimińska A. Assessment of the Effectiveness of Pelvic Floor Muscle Training (PFMT) and Extracorporeal Magnetic Innervation (ExMI) in Treatment of Stress Urinary Incontinence in Women: A Randomized Controlled Trial. Biomed Res Int. 2020 Jan 16;2020:1019872. doi: 10.1155/2020/1019872. PMID: 32016111; PMCID: PMC6988664.
Huang AJ, Jenny HE, Chesney MA, Schembri M, Subak LL. A group-based yoga therapy intervention for urinary incontinence in women: a pilot randomized trial. Female Pelvic Med Reconstr Surg. 2014;20(3):147-154. doi:10.1097/SPV.0000000000000072
Huang AJ, Chesney M, Lisha N, Vittinghoff E, Schembri M, Pawlowsky S, Hsu A, Subak L. A group-based yoga program for urinary incontinence in ambulatory women: feasibility, tolerability, and change in incontinence frequency over 3 months in a single-center randomized trial. Am J Obstet Gynecol. 2019 Jan;220(1):87.e1-87.e13. doi: 10.1016/j.ajog.2018.10.031. Epub 2018 Oct 26. PMID: 30595143; PMCID: PMC6314206.
Nicosia FM, Lisha NE, Chesney MA, Subak LL, Plaut TM, Huang A. Strategies for evaluating self-efficacy and observed success in the practice of yoga postures for therapeutic indications: methods from a yoga intervention for urinary incontinence among middle-aged and older women. BMC Complement Med Ther. 2020;20(1):148. Published 2020 May 14. doi:10.1186/s12906-020-02934-3
Parkkinen A, Karjalainen E, Vartiainen M, Penttinen J. Physiotherapy for female stress urinary incontinence: individual therapy at the outpatient clinic versus home-based pelvic floor training: a 5-year follow-up study. Neurourol Urodyn. 2004;23(7):643-648. doi:10.1002/nau.20065
Castro RA, Arruda RM, Zanetti MR, Santos PD, Sartori MG, Girão MJ. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo). 2008;63(4):465-472. doi:10.1590/s1807-59322008000400009
Newman DK, Borello-France D, Sung VW. Structured behavioral treatment research protocol for women with mixed urinary incontinence and overactive bladder symptoms. Neurourol Urodyn. 2018;37(1):14-26. doi:10.1002/nau.23244
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