Kegel exercises with a guidebook for stress urinary incontinence treatment

Authors

  • Surahman Hakim Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Budi Iman Santoso Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia; Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Harrina Erlianti Rahardjo Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Urology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Siti Setiati Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Widjajalaksmi Kusumaningsih Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Joedo Prihartono Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
  • Nurhadi Ibrahim Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Physiology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Wresti Indriatmi Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department of Dermatology and Venerology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Erwinanto Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia

DOI:

https://doi.org/10.13181/mji.oa.247142

Keywords:

exercise therapy, guidebook, pelvic floor, urinary stress incontinence

Abstract

BACKGROUND Stress urinary incontinence (SUI) is uncontrollable urine leakage when intra-abdominal pressure increases. Behavioral therapy with Kegel exercise is currently the best conservative management recommendation for treating SUI patients. This study aimed to investigate the success of supervised Kegel exercises using the Kegel exercises guidebook in women with SUI.

METHODS This quasi-experimental study involved both groups being taught the same regiment of Kegel exercises, but the intervention group was given the Kegel exercises guidebook. After 12 weeks, the compliance, subjective, and objective success rates were evaluated through the patient’s notes, Urinary Distress Inventory-6, Incontinence Impact Questionnaire-7, perineometer, and pad test.

RESULTS Patients with a higher level of education had lower compliance to Kegel exercises (p = 0.01; odds ratio [OR] 0.38; 0.18–0.79). No significant difference was observed in the subjective symptom improvement between the two groups. The intervention group had a significantly higher success rate based on objective success by analyzing the 1-hour pad test results. The intervention group was also more adherent (p<0.001; OR 4.78; 2.51–9.0).

CONCLUSIONS Patients who received the Kegel exercises guidebook were more compliant and more objectively successful than those who did not receive the manuals.

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References

Falah-Hassani K, Reeves J, Shiri R, Hickling D, McLean L. The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis. Int Urogynecol J. 2021;32(3):501-52. Erratum in: Int Urogynecol J. 2021;32(6):1607.

https://doi.org/10.1007/s00192-020-04622-9

Saboia DM, Firmiano ML, Bezerra KC, Vasconcelos JA Neto, Oriá MO, Vasconcelos CT. Impact of urinary incontinence types on women's quality of life. Rev Esc Enferm USP. 2017;51:e03266. https://doi.org/10.1590/s1980-220x2016032603266

Lee UJ, Feinstein L, Ward JB, Kirkali Z, Martinez-Miller EE, Matlaga BR, et al. Prevalence of urinary incontinence among a nationally representative sample of women, 2005-2016: findings from the Urologic Diseases in America Project. J Urol. 2021;205(6):1718-24. https://doi.org/10.1097/JU.0000000000001634

Fakhrizal E, Priyatini T, Santoso B, Junizaf, Moegni F, Djusad S, et al. Prevalence and risk factors of persistent stress urinary incontinence at three months postpartum in Indonesian women. Med J Indones. 2016;25(3):163-70. https://doi.org/10.13181/mji.v25i3.1407

Pizzol D, Demurtas J, Celotto S, Maggi S, Smith L, Angiolelli G, et al. Urinary incontinence and quality of life: a systematic review and meta-analysis. Aging Clin Exp Res. 2021;33(1):25-35. https://doi.org/10.1007/s40520-020-01712-y

Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean women. Sci Rep. 2021;11(9054). https://doi.org/10.1038/s41598-021-88740-4

Cross D, Waheed N, Krake M, Gahreman D. Effectiveness of supervised Kegel exercises using bio-feedback versus unsupervised Kegel exercises on stress urinary incontinence: a quasi-experimental study. Int Urogynecol J. 2023;34(4):913-20. https://doi.org/10.1007/s00192-022-05281-8

Dumoulin C, Cacciari LP, Hay-Smith EJ. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10(10):CD005654. https://doi.org/10.1002/14651858.CD005654.pub4

World Health Organization. Regional Office for the Western Pacific. The Asia-Pacific perspective: redefining obesity and its treatment [Internet]. Sydney: Health Communications Australia; 2000. Available from: https://iris.who.int/handle/10665/206936.

Skorupska K, Grzybowska ME, Kubik-Komar A, Rechberger T, Miotla P. Identification of the Urogenital Distress Inventory-6 and the Incontinence Impact Questionnaire-7 cutoff scores in urinary incontinent women. Health Qual Life Outcomes. 2021;19(1):87. https://doi.org/10.1186/s12955-021-01721-z

McLean L, Varette K, Gentilcore-Saulnier E, Harvey MA, Baker K, Sauerbrei E. Pelvic floor muscle training in women with stress urinary incontinence causes hypertrophy of the urethral sphincters and reduces bladder neck mobility during coughing. Neurourol Urodyn. 2013;32(8):1096-102. https://doi.org/10.1002/nau.22343

Fan HL, Chan SS, Law TS, Cheung RY, Chung TK. Pelvic floor muscle training improves quality of life of women with urinary incontinence: a prospective study. Aust N Z J Obstet Gynaecol. 2013;53(3):298-304. https://doi.org/10.1111/ajo.12075

Celiker Tosun O, Kaya Mutlu E, Ergenoglu AM, Yeniel AO, Tosun G, Malkoc M, et al. Does pelvic floor muscle training abolish symptoms of urinary incontinence? A randomized controlled trial. Clin Rehabil. 2015;29(6):525-37. https://doi.org/10.1177/0269215514546768

Kharaji G, ShahAli S, Ebrahimi-Takamjani I, Sarrafzadeh J, Sanaei F, Shanbehzadeh S. Supervised versus unsupervised pelvic floor muscle training in the treatment of women with urinary incontinence - a systematic review and meta-analysis. Int Urogynecol J. 2023;34(7):1339-49. https://doi.org/10.1007/s00192-023-05489-2

Hay-Smith J, Herderschee R, Dumoulin C, Herbison P. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women: an abridged Cochrane systematic review. Eur J Phys Rehabil Med. 2012;48(4):689-705. https://doi.org/10.1002/14651858.CD009508

Alouini S, Memic S, Couillandre A. Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women: a systematic review. Int J Environ Res Public Health. 2022;19(5):2789. https://doi.org/10.3390/ijerph19052789

Kargar Jahromi M, Talebizadeh M, Mirzaei M. The effect of pelvic muscle exercises on urinary incontinency and self-esteem of elderly females with stress urinary incontinency, 2013. Glob J Health Sci. 2014;7(2):71-9. https://doi.org/10.5539/gjhs.v7n2p71

Bø K, Hilde G. Does it work in the long term?--A systematic review on pelvic floor muscle training for female stress urinary incontinence. Neurourol Urodyn. 2013;32(3):215-23. https://doi.org/10.1002/nau.22292

Elnegaard S, Pedersen AF, Sand Andersen R, Christensen RD, Jarbøl DE. What triggers healthcare-seeking behaviour when experiencing a symptom? Results from a population-based survey. BJGP Open. 2017;1(2):bjgpopen17X100761. https://doi.org/10.3399/bjgpopen17X100761

Ten Kate J, Koster W, Van der Waal J. "Following your gut" or "questioning the scientific evidence": understanding vaccine skepticism among more-educated Dutch parents. J Health Soc Behav. 2021;62(1):85-99. https://doi.org/10.1177/0022146520986118

Sugaya K, Owan T, Hatano T, Nishijima S, Miyazato M, Mukouyama H, et al. Device to promote pelvic floor muscle training for stress incontinence. Int J Urol. 2003;10(8):416-22. https://doi.org/10.1046/j.1442-2042.2003.00659.x

Asklund I, Nyström E, Sjöström M, Umefjord G, Stenlund H, Samuelsson E. Mobile app for treatment of stress urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2017;36(5):1369-76. https://doi.org/10.1002/nau.23116

Dumoulin C, Hay-Smith J, Frawley H, McClurg D, Alewijnse D, Bo K, et al. 2014 consensus statement on improving pelvic floor muscle training adherence: International Continence Society 2011 State-of-the-Science Seminar. Neurourol Urodyn. 2015;34(7):600-5. https://doi.org/10.1002/nau.22796

Navarro-Brazález B, Vergara-Pérez F, Prieto-Gómez V, Sánchez-Sánchez B, Yuste-Sánchez MJ, Torres-Lacomba M. What influences women to adhere to pelvic floor exercises after physiotherapy treatment? A qualitative study for individualized pelvic health care. J Pers Med. 2021;11(12):1368. https://doi.org/10.3390/jpm11121368

Reed P, Osborne LA, Whittall CM, Emery S. Impact of patient motivation on compliance and outcomes for incontinence. Physiotherapy. 2021;113:100-6. https://doi.org/10.1016/j.physio.2020.10.003

Eynon M, Foad J, Downey J, Bowmer Y, Mills H. Assessing the psychosocial factors associated with adherence to exercise referral schemes: a systematic review. Scand J Med Sci Sports. 2019;29(5):638-50. https://doi.org/10.1111/sms.13403

Kubanek J, Snyder LH, Abrams RA. Reward and punishment act as distinct factors in guiding behavior. Cognition. 2015;139:154-67. https://doi.org/10.1016/j.cognition.2015.03.005

Published

2024-07-24

How to Cite

1.
Hakim S, Santoso BI, Rahardjo HE, Setiati S, Kusumaningsih W, Prihartono J, Ibrahim N, Indriatmi W, Erwinanto. Kegel exercises with a guidebook for stress urinary incontinence treatment. Med J Indones [Internet]. 2024Jul.24 [cited 2024Nov.19];33(2):80-7. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/7142

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Clinical Research
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