Perceived benefits are crucial for maintaining adherence to pelvic floor muscle training (PFMT). However, the timeline for expected responses and the factors influencing PFMT effectiveness remain unclear. Our study aimed to (1) determine when older women with urinary incontinence (UI) can expect a clinically important reduction in leakage from PFMT, and (2) identify factors associated with the time needed to achieve this reduction.
This is a pooled analysis from a randomized controlled trial supporting the non-inferiority of group-based versus individual PFMT. Participants included 362 older women with stress or mixed UI following a structured 12-week PFMT program, delivered in group sessions or individually. Primary Outcomes: Time to achieve minimal (50%) and incremental (70%) clinically important differences in weekly incontinence episodes were assessed using Kaplan-Meier estimates.
Factors that potentially influenced treatment response, including age, body mass index, parity, comorbidities, UI duration, severity and type, pelvic floor strength, and PFMT delivery mode were analysed using ordinal logistic regression.
A total of 328 (91%) women provided usable leakage report data. Median minimal and incremental clinically important differences were achieved by the 4th and 6th weeks of treatment. Improvements continued until the last treatment session. Age, UI duration, severity, pelvic floor strength, and group-based intervention were related to later treatment response.
In older women with stress or mixed urinary incontinence, a clinically significant reduction in leakage can be achieved by the 4th week of PFMT. Early PFMT intervention and post-treatment exercise adherence favours optimal outcomes.
NCT02039830.
International urogynecology journal. 2025 Dec 17 [Epub ahead of print]
Licia P Cacciari, Mélanie Morin, Marie-Hélène Mayrand, Chantale Dumoulin
Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, Canada., School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke and Research Center of the Centre Hospitalier de l'Université de Sherbrooke, Sherbrooke, Canada., Departments of Obstetrics and Gynecology and Social and Preventive Medicine, Université de Montréal and Research Center of the Centre Hospitalier de l'Université de Montréal, Montréal, Canada., School of Rehabilitation, Faculty of Medicine, Université de Montréal and Research Center of the Institut Universitaire de Gériatrie de Montréal, Montréal, Canada. .