An intensive programme for pelvic floor muscle exercises: short- and long-term effects on those with stress urinary incontinence.

Pelvic floor muscle exercises for the treatment of stress urinary incontinence were reported 45 years ago. However, few studies have been made on the long-term outcome and clinical effects in elderly people. We put 123 incontinent women on an intensive exercise programme for 8 weeks and followed them for more than 12 months; 15 patients were over 65 years old and 108 under 65 years old. Self-reported success rates, i.e., cure or a reduction of > 50% of the original severity, were prospectively assessed in the 2 groups immediately and a mean of 28 months (12-52) after the training. Predictive parameters for an immediate and a long-term success were assessed. The intensive programme depended on patients being motivated, patient education, correct muscle contractions, and the keeping of treatment diaries for 8 weeks. Urine loss evaluated objectively and bothersome scores in 6 activities assessed subjectively improved only in the younger adult group. However, vaginal contractile strength increased in both groups. The immediate success rate was 20% and 40% for the elderly and the adults, respectively. Twenty eight months later, the success rate was 27% for the aged and 40% for the adults with 6 patients becoming continent by surgery. Both the short- and long-term success rates were similar in the 2 groups (p < 0.05). 95% of the patients stated that the intensive training was valuable and that they would recommend the training to friends suffering from stress incontinence. Contractile strength of the vagina can be used to predict the immediate treatment outcome, but there are no parameters for predicting the long-term success. In conclusion, the intensive programme of pelvic floor muscle exercises is an effective treatment option for not only for the young adults but also for elderly people suffering from stress incontinence.