Does it work in the long term?—A systematic review on pelvic floor muscle training for female stress urinary incontinence
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Aims: There is level 1, grade A evidence that pelvic floor muscle training (PFMT) is effective in treatment of stress urinary incontinence (SUI), but long‐term outcome has been questioned. The aim of this systematic review was to evaluate the long‐term outcome of PFMT for female SUI. Methods: Computerized search on PubMed up to year 2012 was undertaken with the search strategy: pelvic floor AND (urinary incontinence OR stress urinary incontinence) AND (training OR exercise OR physical activity) AND (follow‐up OR long‐term). Limitations were: humans, female, clinical trial, English, and adults. Inclusion criteria were: studies on SUI using PFMT with or without biofeedback as the intervention, follow‐up period of ≥1 year. Exclusion criteria were studies using electrical stimulation alone and studies in the peripartum period. Results: Nineteen studies were included (1,141 women followed between 1 and 15 years). Statistical meta‐analysis was not performed due to high heterogeneity. Only two studies provided follow‐up interventions. Losses to follow‐up during the long‐term period ranged between 0% and 39%. Long‐term adherence to PFMT varied between 10% and 70%. Five studies reported that the initial success rate on SUI and MUI was maintained at long‐term. Long‐term success based on responders to the original trial varied between 41% and 85%. Surgery rates at long term varied between 4.9% and 58%. Conclusions: Short‐term outcome of PFMT can be maintained at long‐term follow‐up without incentives for continued training, but there is a high heterogeneity in both interventional and methodological quality in short‐and long‐term pelvic floor muscle training studies. Neurourol. Urodynam. 32: 215–223, 2013. © 2012 Wiley Periodicals, Inc.
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In that systematic review, only two studies provided follow-up incentives for continuous PFMT, and long-term adherence to PFMT varied between 10% and 70%.
“Only two studies provided follow-up incentives for continuous PFMT during follow-up and long-term adherence to PFMT varied between 10% and 70%.”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [93]
A systematic review of the long-term effect of PFMT for SUI/MUI identified 19 studies with follow-up ranging from 1 to 15 years.
“In a systematic review of long-term effect of PFMT for SUI/MUI 19 studies with follow-up ranging from 1–15 years were found [93].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [93]
For exercise training there are additional long-term study challenges such as non-adherence to maintenance training.
“For exercise training there are additional challenges such as non-adherence to maintenance training [93, 94].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [93]
Long-term studies of any intervention face general challenges from loss to follow-up, co-interventions, treatment switching and competing events.
“There are general challenges to long-term studies of any intervention due to loss-to follow-up, co-interventions, treatment switching and competing events [93, 94].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [93]
Few long-term studies of stress urinary incontinence have evaluated the results after treatment with pelvic floor muscle training.
“Few long‐term studies of SUI have evaluated the results after treatment with PFMT.”
From Self‐management of stress urinary incontinence via a mobile app: two‐year follow‐up of a randomized controlled trial (2017) · cites this paper as [20]
A systematic review reported a surgery rate of 4.9-58% after pelvic floor muscle training for stress urinary incontinence.
“A systematic review concluded that the long‐term success (defined as one year or more after treatment) of PFMT, was between 41 and 85%, with a surgery rate of 4.9–58% 20.”
From Self‐management of stress urinary incontinence via a mobile app: two‐year follow‐up of a randomized controlled trial (2017) · cites this paper as [20]
A systematic review concluded that the long-term success (defined as one year or more after treatment) of pelvic floor muscle training was between 41 and 85%.
“A systematic review concluded that the long‐term success (defined as one year or more after treatment) of PFMT, was between 41 and 85%, with a surgery rate of 4.9–58% 20.”
From Self‐management of stress urinary incontinence via a mobile app: two‐year follow‐up of a randomized controlled trial (2017) · cites this paper as [20]
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- Authors
- Bø, K., & Hilde, G.
- Affiliations
- Norwegian School of Sport Sciences (NO)
- Corresponding author
- Bø, Kari
- Venue
- Neurourology and Urodynamics
- Publisher
- Wiley
- Published
- 2012-07-27
- Volume
- 32
- Issue
- 3
- Pages
- 215-223
- ISSN
- 0733-2467 (ISSN-L)
- 1520-6777
- OpenAlex
- W2150604826
- Cited by
- 146
- References
- 50
- Citations by year
- 2026: 13 · 2025: 15 · 2024: 14 · 2023: 7 · 2022: 7 · 2021: 9 · 2020: 19 · 2019: 13 · 2018: 8 · 2017: 13 · 2016: 6 · 2015: 6 · 2014: 12 · 2013: 3
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Neurourology and Urodynamics (publishedVersion)
- PubMed (publishedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Keywords
- pelvic floor muscle training, stress urinary incontinence, female urinary incontinence, long-term outcomes, medication adherence, biofeedback, surgical rates, loss to follow-up
- MeSH terms
- Adult, Aged, Urinary Bladder, Female, Humans, Middle Aged, Patient Compliance, Time Factors, Urinary Incontinence, Stress, Urodynamics, Treatment Outcome, Pelvic Floor, Evidence-Based Medicine, Recovery of Function, Physical Therapy Modalities, Young Adult
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