Effect of adding biofeedback to pelvic floor muscle training to treat urodynamic stress incontinence

OBJECTIVE: To compare the effect of individual pelvic floor muscle training with and without biofeedback in women with urodynamic stress incontinence METHODS: The study was a single, blind, randomized trial. All women completed 6 months of pelvic floor muscle training comprising three sets of ten contractions three times per day, supervised by a physical therapist. One group trained with a biofeedback apparatus at home, the other without biofeedback. The primary outcome measures were pad test with standardized bladder volume and self-report of severity. RESULTS: A total of 103 women were randomized, and data from 94 women were analyzed. Mean age (range) was 46.6 (30-70) years, and mean (range) duration of symptoms was 9.7 (1-25) years. Seventy women had urodynamic stress incontinence alone, and 24 women reported additional urge symptoms. Women training with and without biofeedback showed a statistically significant reduction in leakage on pad test (P < .01) after 6 months of pelvic floor muscle training. Objective cure (2 g or less of leakage) in the total group was 58% in women training with and 46% in women training without biofeedback, and in the subgroup of women with urodynamic stress incontinence alone, 69% in women training with and 50% in women training without biofeedback. There was no statistically significant difference between the groups posttreatment in any outcome measure. CONCLUSION: Cure rate was high, and the reduction in urinary leakage after treatment was statistically significant in both groups. However, there was no statistically significant difference in the effect of individual pelvic floor muscle training with and without biofeedback. (C) 2002 by The American College of Obstetricians and Gynecologists.