How important is the timing and duration of pelvic floor muscle training for preventing postpartum urinary incontinence? a meta-analysis.

BACKGROUND

Postpartum urinary incontinence (PUI) is a common condition that significantly impairs the quality of life for women who have given birth. This meta-analysis aimed to systematically evaluate how the timing and duration of pelvic floor muscle training (PFMT) influence the prevention of PUI.

METHODS

To identify relevant studies examining the role of PFMT in preventing PUI, a thorough literature search was conducted across multiple databases up to February 20, 2025. These databases included PubMed, Embase, Web of Science, ClinicalTrials.gov, OVID, Cochrane Library, Wanfang, CNKI, and Weipu. The search aimed to locate randomized controlled trials (RCTs) that specifically assessed PFMT's impact on PUI prevention. The meta-analysis was subsequently performed using RevMan 5.4 software to synthesize and analyze the collected data.

RESULTS

The meta-analysis included 11 RCTs that collectively involved 2778 parturient women, of whom 1495 received PFMT interventions. The pooled results demonstrated that PFMT significantly reduced the incidence of PUI (p < 0.001). Subgroup analyses revealed that PFMT significantly decreased the risk of urinary incontinence at both 3 months (p < 0.001) and 6 months postpartum (p < 0.001). However, PFMT did not significantly affect urinary incontinence immediately after childbirth (p = 0.69). No significant differences were observed in the improvement of urinary incontinence when comparing the initiation of PFMT during mid-to-late pregnancy versus postpartum or when considering PFMT durations of 3 months or less versus more than 3 months (all p > 0.05).

CONCLUSION

PFMT implemented during pregnancy and the postpartum period effectively reduces the incidence of PUI. Significant benefits of PFMT have been observed at both 3 and 6 months postpartum, indicating its efficacy across different time frames. However, given the limitations in the quality and sample sizes of the included RCTs, further investigation with large-scale, high-quality studies is warranted to more comprehensively elucidate the role of PFMT in managing PUI.