OBJECTIVE: The aim of this study was to compare the effectiveness of multimo da l supervised physiotherapy programs with the absence of treatment among women wi th persistent postnatal stress urinary incontinence. METHODS: This was a single -blind randomized controlled trial. Sixty-four women with stress urinary incon tinence were randomly assigned to 8 weeks of either multimodal pelvic floor reha bilitation (n = 21), multimodal pelvic floor rehabilitation with abdominal muscl e training (n = 23), or control non-pelvic floor rehabilitation (n = 20). The p rimary outcome measure consisted of a modified 20-minute pad test. The secondar y outcome measures included a Visual Analog Scale describing the perceived burden of incontinence, the Uro genital Distress Inventory, the Incontinence Impact Questionnaire, and pelvic fl oor muscle function measurements. RESULTS: Two patients dropped out, leaving 62 for analysis. At follow-up, more than 70%of the women in the treatment groups (14/20 in the pelvic floor and 17/23 in the pelvic floor plus abdominal group) w ere continent on pad testing compared with 0%of women in die control group. Sco res on the pad test, Visual Analog Scale, Urogenital Distress Inventory, and Inc ontinence Impact Questionnaire improved significantly in both treatment groups ( all P < .002), whereas no changes were observed in the control group. Pelvic flo or muscle function, however, did not improve significantly in either active grou p. CONCLUSION: Multimodal supervised pelvic floor physiotherapy is an effective treatment for persistent postnatal stress urinary incontinence.
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