An Objective Assessment of Physiotherapy for Female Genuine Stress Incontinence

Sixty women with genuine stress incontinence were consecutively assigned to one of four physiotherapy groups who were treated for 6 weeks by either (1) pelvic floor exercises (PFE) in hospital; (2) PFE and faradism; (3) PFE and interferential therapy; (4) PFE at home. Assessment before and after treatment was by 7-day bladder charts, urethral pressure profiles and perineometry. Approximately two-thirds of the hospital-treated patients (groups 1, 2 and 3) experienced marked or moderate subjective improvement and at 6 months, 27% were dry or almost dry. There was little difference in outcome between groups 1, 2 and 3 but hospital-based therapy was more effective than home treatment. Statistical analyses showed that there were significant improvements in the objective indices measured in the 45 hospital-treated patients. Successful treatment was more likely in younger patients, in those with lesser degrees of genuine stress incontinence and those who had had no previous pelvic floor surgery.