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Postnatal pelvic floor muscle training for the treatment of urinary incontinence

Näytönastekatsaukset
Minna Törnävä and Aleksi Raudasoja
31.3.2026

Level of evidence: C

Pelvic floor muscle training during the postpartum period may decrease urinary incontinence episodes.

A Cochrane review «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 measured the impact of pelvic floor muscle training on urinary incontinence after giving birth. The pooled evidence of three trials (n = 696) suggested an uncertain decrease in self-reported urinary incontinence (risk ratio 0.55 [0.29 to 1.07]). In the same review, two trials measured the impact of PFMT on prevention or treatment of postnatal urinary incontinence and suggested a decrease in self-reported urinary incontinence (risk ratio 0.54 [0.44 to 0.66]) in short term (under three months) follow up.

The level of evidence was downgraded due to study limitations and imprecision.

Table 1. Description of the included studies.
Reference Study type Population Intervention and comparison Outcomes Risk of bias
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 SR/MA Postnatal women Pelvic floor muscle training (PFMT) during pregnancy vs no intervention/usual care Urinary incontinence High
Table 2. Additional comments for included studies.
Reference Comments
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 The PFMT programs and control conditions varied considerably and were often poorly described. In this review, the comparison group in the two most influential trials, which had the greatest impact on the pooled assessment, received standard care (which may have included PFMT), complicating the evaluation.
Risk of bias:
  • No blinding.
  • The largest trial providing most patients for the primary analysis (outcome 1) had uncertain allocation concealment.
  • Large dropout rate of over 20%.

Results

Table 3. Outcome 1: Self-reported urinary incontinence late postnatal period (> 6-12 months).
Reference Number of studies and number of patients (I/C) Follow-up time Absolute number of events (%) I Absolute number of events (%) C Risk Ratio
M-H, Random (95% CI)
Level of evidence: low
The quality of evidence is downgraded due to study limitations, and imprecision.
I=intervention; C=comparison; CI=confidence interval
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 3 (341/355) 6-12 months 188 (55%) 257 (72%) 0.55 (0.29, 1.07)
Table 4. Table 4. Outcome 2: Self-reported urinary incontinence early postnatal period (0-3 months).
Reference Number of studies and number of patients (I/C) Follow-up time Absolute number of events (%) I Absolute number of events (%) C Risk Ratio
M-H, Fixed (95% CI)
Level of evidence: low
The quality of evidence is downgraded due to study limitations and imprecision.
I=intervention; C=comparison; CI=confidence interval
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic fl...»1 2 (194/127) 3 months 70 (36%) 65 (51%) 0.54 (0.44, 0.66)

References

  1. Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5):CD007471 «PMID: 32378735»PubMed