Long-term failure of pelvic floor musculature exercises in treatment of genuine stress incontinence.

This report evaluates the motivation of a group of patients to continue a program of pelvic floor musculature exercises as conservative therapy for genuine stress incontinence. Fourteen women with urodynamically documented genuine stress incontinence had subjective improvement; nine of them showed objective improvement after 4 weeks of supervised pelvic floor musculature exercises. These patients were questioned 5 years later as to continence status, performance of pelvic floor musculature exercises, and subsequent surgery for incontinence. Ten of 14 patients responded: four have had anti-incontinence surgery and remain continent; five have not had surgery, do not perform pelvic floor musculature exercises, and continue to have stress incontinence. One patient continues to perform pelvic floor musculature exercises and has stress incontinence with a full bladder. Thus, only one patient out of 10 remained sufficiently motivated to perform pelvic floor musculature exercises after 5 years, even though all patients in this series had improvement after a 4-week course of supervised exercises.