Biofeedback training in female stress urinary incontinence

Purpose: Biofeedback training is frequently used for treating stress urinary incontinence. The aim of this surveillance study is to clarify important questions in clinical practice. These include questions as to (1) the duration of exercise periods required to best possibly strengthen the pelvic floor; (2) differences between the left and the right part of the pelvic floor from the outset; and (3) biofeedback training leading to an improved coordination. Methods: 92 women, with an age range of 17 years to 80 years averaging at 52 years, took part in the conducted study of first grade stress urinary incontinence. The treatment was executed daily using a standardised biofeedback home-training treatment for 15 minutes. In total the training lasted either: less than 30 days, 30 to 60 days, 60 to 90 days, or more than 90 days. All relevant data were collected within the training session and analysed thereafter. The activity of each half of the pelvic floor musculature was measured in advance of each therapy session by means of surface electromyography (s EMG). Results: An increase of the pelvic floor musculature activity of three units (p <= 0.03) over an average training period of 67 days was achieved by all patients. An enhanced muscular strength of the pelvic floor i.e. by eight units was realised by women with less developed pelvic floor musculature (p <= 0.0001). Prior to the therapie 24 women featured a stronger developed left pelvic floor and 25 women a stronger developed right pelvic floor side, The subsequent training resulted in an averaged difference of both parts of the pelvic floor musculature. Conclusion: Since continuing the therapy sessions does not result in advanced pelvic floor muscle strength optimal biofeedback training can be achieved within 90 days. The strength of the pelvic floor often differs as was demonstrated in 49 out of 92 cases conducted. Biofeedback training reduced the differences between both sides of the pelvic floor.