Pelvic floor muscle training for prevention and treatment of urinary and fecal incontinence in antenatal and postnatal women: a short version Cochrane review.

BACKGROUND: Pelvic floor muscle training (PFMT) is commonly recommended during pregnancy and after birth both for prevention and the treatment of incontinence.

OBJECTIVES: Effect of pelvic floor muscle training compared to usual antenatal and postnatal care on incontinence.

SEARCH METHODS: Cochrane Incontinence Group Specialized Register; handsearching (searched February 7, 2012); the references of relevant articles.

SELECTION CRITERIA: Randomized or quasi-randomized controlled trials in pregnant or postnatal women having pelvic floor muscle training (PFMT) versus no PFMT or standard care.

DATA COLLECTION AND ANALYSIS: Duplicate trial assessment, selection and data abstraction.

RESULTS: Twenty-two trials involving 8,485 women. Continent pregnant women (prevention) who had intensive antenatal PFMT were less likely to report urinary incontinence up to 6 months after delivery (risk ratio (RR) 0.71, 95% CI 0.54-0.95). Incontinent postnatal women (treatment) who received PFMT were less likely to report urinary incontinence 12 months after delivery (RR 0.60, 95% CI 0.35-1.03). In a mixed population (women with and without incontinence symptoms in late pregnancy or after delivery), PFMT did not reduce incontinence rates after delivery.

AUTHORS' CONCLUSIONS: For women who are continent during pregnancy, PFMT may prevent urinary incontinence up to 6 months after delivery. The extent to which mixed prevention and treatment approaches to PFMT in the postnatal period are effective is less clear that is, offering advice on PFMT to all pregnant or postpartum women whether they have incontinence symptoms or not. There was little evidence about long-term effects for either urinary or fecal incontinence.