[The effect of pelvic floor exercise on stress urinary incontinence].

Several randomised controlled trials have shown that pelvic floor muscle exercise has resulted in a 60-70% improvement or cure rate from stress incontinence. The aim of the present study was to assess whether these methods could be put into general use in a physiotherapy clinic in primary health care. 36 women, all with a diagnoses of stress urinary incontinence, mean age 49 (range 25-67 years), participated in the study. Before treatment they underwent vaginal examination to ensure there was proper pelvic floor muscle contraction. Pelvic floor muscle strength was assessed by vaginal pressure measurement. Urinary leakage was registered on a 13-item "leakage index", using a 5-point graded scale (1 = never leakage to 5 = always leakage). The women attended a six-month pelvic floor muscle exercise programme, training in groups led by a physiotherapist, and exercising at home with three series of 8-12 contractions a day. 12 patients reported to be cured, and 12 reported a significant improvement (67% in all). Five patients achieved some improvement, whereas in another five there was no change. None became worse. It is concluded that pelvic floor muscle exercises, under the guidance of trained physiotherapists, may be just as effective in clinical practice as in randomised controlled trials.