Stress Incontinence: Exercise Works Best

Electronic Stimulation Offers No Benefit Over Kegel Exercises Alone

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July 15, 2003 -- A new study shows exercising the right muscles can significantly improve stress incontinence, but electrical stimulation -- used for more than 50 years -- offers no added benefit.

Researchers say the key to maximizing results is to make sure you work closely with your doctor. The research is in the July 16 issue of TheJournal of the American Medical Association.

Stress Incontinence Affects Millions

Stress incontinence is a common malfunction of the bladder mostly seen in women. It is the involuntary loss of urine when you put pressure on your abdomen through activities such as sneezing, laughing, or exercising. Weak or torn bladder muscles along the pelvic floor are often the culprits. This can happen because of pregnancy or loss of estrogen that occurs at menopause.

Doctors often recommend pelvic floor (Kegel) exercises and pelvic floor electrical stimulation as a way to strengthen bladder muscles. Electrical stimulation has been widely used in the medical community since 1952, according to the researchers.

The researchers studied 200 women aged 40 to 78 for eight weeks. They divided them into three groups.

  • Those with only clinic-based behavioral training (behavior training includes home exercises, bladder control strategies, and self-monitoring with bladder diaries)
  • Those with behavioral training plus home electrical stimulation
  • Those who used self-help books and did behavioral training on their own (comparison group)

The Key to Success

Results showed that there was little difference between the first two groups. Kegel exercises alone or in combination with electrical stimulation reduced episodes of incontinence by about 70%. The group that toughed it out alone had only a 53% reduction.

"The results suggest that behavioral training for stress incontinence is optimally implemented in the clinic in which clinicians can ensure that patients are exercising the correct muscles and can encourage patients to persist with their efforts long enough for training to yield results," researchers say.

But the researchers add that electrical stimulation is still a good option. Electrical stimulation can be useful in teaching pelvic floor muscle contraction to women who cannot identify or contract these muscles voluntarily because of extreme weakness, researchers say.

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SOURCES: The Journal of the American Medical Association, July 2003. News release, The Journal of the American Medical Association.
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