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Management of Stress Urinary Incontinence With Surface Electromyography–Assisted Biofeedback in Women of Reproductive Age

MT Rett, PT, MS, is a PhD student in the Department of Obstetrics and Gynecology, School of Medicine, Universidade Estadual de Campinas (UNICAMP), Campinas, São Paulo, Brazil
JA Simoes, MD, PhD, is Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, UNICAMP, Caixa Postal 6181, 13084-971 Campinas, São Paulo, Brazil
V Herrmann, MD, PhD, is Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, UNICAMP
CLB Pinto, MD, PhD, is Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, UNICAMP
AA Marques, PT, PhD, is Director of the Physiotherapy Section, Department of Obstetrics and Gynecology, School of Medicine, UNICAMP
SS Morais is Statistician, Department of Obstetrics and Gynecology, School of Medicine, UNICAMP

Address all correspondence to Dr Simoes at: jsimoes{at}caism.unicamp.br

Background and Purpose: Although surgery has been widely accepted as the treatment of choice for stress urinary incontinence (SUI), there has recently been an increased interest in the conservative management of this condition. The aims of this study were to test the ability of a biofeedback-assisted pelvic-floor muscle exercise (PFME) program to affect symptoms of SUI in premenopausal women and to evaluate a training program that might lead to successful outcomes in a relatively limited number of sessions.

Subjects: Twenty-six women with SUI were treated with PFME with surface electromyography (sEMG)–assisted biofeedback. All participants were of reproductive age and were treated individually for 12 sessions.

Methods: Results were evaluated with a 7-day voiding diary, a 1-hour pad test, pelvic-floor muscle strength measurements, sEMG amplitudes, a leakage index, and a quality-of-life questionnaire. These variables were compared before and after the intervention.

Results: The frequency of urine loss, the occurrence of nocturia, and the number of pads required decreased significantly after the intervention. Objective cure was found in 61.5% of women. There was a significant improvement in the quality of life, in pelvic-floor muscle strength, and in the sEMG amplitudes of all contractions throughout the intervention.

Discussion and Conclusion: A relatively short-term intervention of PFME with sEMG-assisted biofeedback appeared to be helpful in relieving symptoms of SUI in premenopausal women and represents a reasonable conservative management option.

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