A 10-year follow-up after Kegel pelvic floor muscle exercises for genuine stress incontinence.

Abstract

To determine the outcome 10 years after an individual course of pelvic floor muscle (PFM) exercises for genuine stress incontinence. Postal questionnaires were sent to 52 women who had undergone PFM training 10 years earlier, and their medical files were reviewed. The main outcome measures were the patients' self-assessment of therapy outcome, the frequency of PFM exercises at home, and the demand for surgery after physiotherapy. Forty-five women (87%; mean age 61 years) were suitable for analysis. On completing the course of PFM exercises, physiotherapy had been apparently successful in 24 (53%), and considered to have failed in 21 women (47%). Sixteen of the 24 successful patients remained satisfied with their urinary continence when reassessed 10 years later; two women had undergone surgery (8%). In the group where physiotherapy initially failed, five women (24%) who had not had surgery claimed to be much improved; 13 women (62%) had undergone surgery. Overall, women in whom the conservative treatment of stress incontinence had produced an improvement over the 10 years had practised PFM exercises more regularly (76%) than the others (55%; not significant). However, an active voluntary PFM contraction before a sudden intra-abdominal pressure rise ('perineal lock') appeared to be responsible for most of the success. When PFM training is initially successful, there is a 66% chance that the favourable results will persist for at least 10 years.