Urinary Incontinence in Women: Modern Methods of Physiotherapy as a Support for Surgical Treatment or Independent Therapy

Urinary incontinence (UI) is a common health problem affecting quality of life of nearly 420 million people, both women and men. Pelvic floor muscle (PFM) training and other physiotherapy techniques play an important role in non-surgical UI treatment, but their therapeutic effectiveness is limited to slight or moderate severity of UI. Higher UI severity requires surgical procedures with pre- and post-operative physiotherapy. Given that nearly 30%–40% of women without dysfunction and about 70% with pelvic floor dysfunction are unable to perform a correct PFM contraction, therefore, it is particularly important to implement physiotherapeutic techniques aimed at early activation of PFM. Presently, UI physiotherapy focuses primarily on PFM therapy and its proper cooperation with synergistic muscles, the respiratory diaphragm, and correction of improper everyday habits for better pelvic organ support and continence. The purpose of this work is a systematic review showing the possibilities of using physiotherapeutic techniques in the treatment of UI in women with attention to the techniques of PFM activation. Evidence of the effectiveness of well-known (e.g., PFM training, biofeedback, and electrostimulation) and less-known (e.g., magnetostimulation, vibration training) techniques will be presented here regarding the treatment of symptoms of urinary incontinence in women.

Study of posterior vaginal wall prolapses and correlation with bowel function

Background: This study’s objectives were to describe symptoms related to bowel symptoms in women with prolapse and to compare these symptoms as per the grading of posterior vaginal prolapse.Methods: Descriptive study, 63 women answered questionnaire for assessment of bowel function and were subjected to physical examination according to the International Continence Society’s system for grading uterovaginal prolapse.Results: The distribution of pelvic organ support by overall POPQ stage was 6.4%stage 1,21%stage 2, 50% stage 3, and 23% stage 4. Women were asked to rate the extent to which they were bothered by their bowel function on a scale of 1 to 10, with 1 being not at all and 10 being extremely. Thirty-six women (58%) reported 1 to 4, 18 (29%) reported 5 to 7, and 8 (13%) reported greater than 8. According to the furthest extent of posterior vaginal prolapse at point Bp, 22 (15.5%) were in stage 0, 46 (32.4%) were in stage I, 50 (35.2%) were in stage II, 23 (16.2%) were in stage III, and 1 (0.7%) was in stage IV. Ninety-two percent of women reported having bowel movements at least every day. When asked whether straining was required for them to have a bowel movement, 67% reported never or rarely,3% reported sometimes,1.6%) reported always. When asked whether they ever needed to help stool come out by pushing with a finger in the vagina or rectum, 77.0% reported never or rarely, 15.1% reported sometimes, (5.6%) reported usually, and (1.6%) reported always. No women had fecal incontinence, there were no clinically significant associations between any of the questions related to bowel function and severity of posterior vaginal prolapse.Conclusions: Women with uterovaginal prolapse frequently have symptoms related to bowel dysfunction but this is not associated with the severity of posterior vaginal prolapse.