Effect of adding pelvic floor muscle training to weight loss intervention on urinary incontinence in overweight women: a randomized controlled trial
Prof Sameh GHROUBIa, Dr Wafa ELLEUCHa, Dr Saoussan MAHERSIa, Prof Habib FEKIb, Prof Mohamed Habib ELLEUCHa
a Service de Médecine Physique et de Réadaptation, CHU Habib Bourguiba, Sfax, Tunisie, et Unité de recherche de l’évaluation des pathologies de l’appareil locomoteur UR12ES18, université de Sfax, b Service de médecine préventive. CHU Hedi Chaker, Sfax, Tunisie
Objective: Our objective was to study the effect of the association of weight loss intervention and pelvic floor muscle training (PFMT) on unirary incontinence (UI) in obese women.
Methods: This prospective study included 107 obese women with urinary incontinence (UI) randomized into three groups: G1 including women who underwent a training program with a low calorie diet, G2 women who underwent the same training associated to a PFMT and G3 women without any therapeutic intervention. An evaluation was realised a week before the beginning and after 12 months.
Results: A reduction of the BMI (body mass index) was noted in G1 and G2 (p<0.001). 66% of women in G1 and 85.3% of women in G2 reported that their condition improved. The score of PFM strength was significantly improved only in G2 (p<0.001). Only in the two first group, we noted a significant reduction in the number of voiding and of leakages per day (p<0.001), a significant amelioration in the 24-hour pad test (p<0.001) and a significant improvement of the Urinary Disability Measure (UHM) and the score of quality of life (p<0,001). The improvement of all these parameters was more important in G2 (p < 0.001).
Discussion: There are studies that report the effect of either weight loss intervention or PFMT for treating female UI [1, 2]. However, there is no study that reveals whether or not there were additional effects of adding weight loss intervention to PFMT for UI in obese women. This work shows that the best management for UI in obese women must include weight loss intervention and PFMT with making women aware of their floor pelvic muscles.
However, the limited nature of follow-up beyond the end of treatment means that the long-term outcomes of use of PFMT or weight loss intervention remain uncertain.
1-Vissers D et al.The effect of non-surgical weight loss interventions on urinary incontinence in overweight women: a systematic review and meta-analysis.Obes Rev. 2014;15:610-7.
2-Dumoulin C et al. Pelvic Floor Muscle Training Versus no Treatment, or Inactive Control Treatments, for Urinary Incontinence in Women. Neurourol Urodyn. 2015 May 21. [Epub ahead of print]
Keywords : urinary incontinence, obese women, training program, pelvic floor muscle training, weight loss