Muscles in the pelvic floor are important in controlling the flow of urine. These muscles help support organs in the pelvic area like the bladder and help to stop the flow of urine. Like any muscles, these pelvic floor muscles can weaken over time or after an injury. One result of this weakening can be urinary incontinence, or unwanted leakage of urine. Incontinence is common in women after the stress of childbirth. Fortunately, a little exercise can help strengthen these muscles and improve urinary function. Pelvic floor muscle training has been shown to help control symptoms in women who have incontinence already.
Researchers from the United Kingdom reviewed previous trials to see if pelvic floor muscle training in early pregnancy could reduce the risk of developing urinary incontinence after giving birth. The review, published in the Cochrane Database, found that pelvic floor muscle training during pregnancy does appear effective at decreasing the risk of urinary incontinence after childbirth.
The systematic review included 22 randomized trials with 8,485 women who were pregnant or had recently given birth. The trials compared pelvic floor muscle training to no training or standard care for prevention of urinary incontinence. Some women had signs of urinary incontinence at the beginning of the trial.
The review found that women who had no urinary incontinence at the beginning of the study and who did pelvic floor muscles exercises during pregnancy had a decreased incidence of urinary incontinence in:
- The first 12 weeks after birth
- The first 3-6 months after birth
There was no clear benefit with the pelvic floor muscle training in preventing incontinence while the women were still pregnant. Also, there was not enough information to assess benefits more than 6 months after birth.
A systematic review is considered a reliable form of research by pooling several smaller studies. A larger pool of participants increases the chances that the results of the review are true. This review was also made up of randomized control trials which are also considered very reliable forms of research. Overall, several studies have shown that pelvic floor exercises can help reduce urinary incontinence. This review adds that starting these exercise before symptoms show up may help prevent incontinence.
Pelvic floor exercises are a safe activity with no known side effects. They can be done at any point in life but may be most beneficial during and after pregnancy when the pelvic area is stressed. The exercises may be started once symptoms appear but using them in people at high risk may prevent incontinence from even starting. If you are pregnant, discuss these exercises with your doctor.
Boyle R, Hay-Smith EJ, Cody JD, Mørkved S.
Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women.
Cochrane Database Syst Rev. 2012 Oct 17;10:CD007471
Last reviewed March 2013 by Brian Randall, MD
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