VAGINAL WEIGHTS

vaginal weights and pelvic muscle therapy

For women who don't achieve satisfactory results with primary behavioral interventions for urodynamic stress or mixed incontinence, pelvic muscle therapy can improve measures of pelvic muscle function. However, these improvements do not necessarily translate into significant improvements in urinary symptoms, according to a report in the November issue of BJU.

pelvic muscle therapy and vaginal weights therapy have been suggested to improve urinary stress incontinence, the authors explain, but the studies investigating their efficacy have had various shortcomings.

Dr. Kate S. Williams from University of Leicester, UK, and colleagues compared pelvic muscle muscle and vaginal weights therapy with standard primary care in women who had completed standard primary behavioral intervention that included advice on fluid intake, caffeine intake, bladder reeducation, pelvic muscle awareness and weight loss.

Of the 238 women who began the trial, 231 were available for follow-up after 3 months. The subjects were all women older than 40 years.

All three groups of women experienced reductions in the mean incontinence episode frequency, the authors report, but there were no significant differences among the groups.

Similarly, the report indicates, self-reported outcomes at 3 months and improvement in outcomes over the study period did not differ among the three groups after adjusting for baseline status.

Improvements in pelvic muscle function were significantly better in the pelvic muscle therapy group than in the vaginal weights therapy and control groups, the researchers note, and there were no differences between the vaginal weights therapy and control groups.

The groups did not differ statistically in their quality of life, individual perception of their problem, or satisfaction with current symptoms for the rest of their life, the report indicates.

"Women with urinary stress incontinence and mixed urinary incontinence, even after initial primary treatment, can benefit from further pelvic muscle therapies," the authors conclude, "but pelvic muscle therapy is not significantly better than vaginal weights therapy or pelvic muscle awareness (control) in reducing urinary symptoms."

"Any improvement is likely to be related to the time spent with the therapist and the motivation and support they provide," the investigators add. "The importance of the therapeutic relationship providing motivation and support should not be underestimated in the provision of pelvic muscle therapy."

In prospective, comparing the effectiveness of pelvic muscle exercises with vaginal weights
in combination of these two techniques produced greater improvement in urinary incontinence.