Effectiveness of pelvic floor muscle strength training to prevent and treat urinary incontinence in postpartum primiparous women: a systematic review

Abstract

Objectives: To analyse the effectiveness of active physiotherapy of the pelvic floor as a method of prevention and treatment in primiparous postpartum women.

Methods: Pubmed (MEDLINE), SCOPUS, Web of Science (WOS), CINAHL Complete, and PEDro databases were searched to identify clinical trials that included primiparous postpartum women that compared the effects of physiotherapy active of the pelvic floor in the postpartum and also, that the degree of urinary incontinence be measured. Data extraction was carried out by two of the authors in a Microsoft Excel sheet, using a third author in case of discrepancy or doubt.

Results: A total of 5 studies were selected including 444 primiparous postpartum women, 222 of whom received active physiotherapy of the pelvic floor. The results were very heterogeneous, two of the studies did not find significant differences between both groups, one study shows a clear improvement in the intervention group, and in the other studies, a significant intragroup improvement was found post-intervention. There is no significant difference in muscle resistance and strength (P < 0.05), but if it is applied combined with biofeedback there is a clear improvement (P = 0.001). With respect to urinary symptoms there is an improvement in the intervention group (P < 0.05).

Conclusions: This systematic review indicates that pelvic floor muscle training (PFMT) is an effective intervention to prevent and treat urinary incontinence in postpartum women. PFMT in improving pelvic floor strength and reducing urinary incontinence symptoms.