Urinary incontinence and strengthening of pelvic muscles to improve quality of life in women
Main Article Content
Abstract
Introduction. Urinary incontinence (UI) is a social problem that is faced in a higher percentage of women with an affectation ratio of 1:4 suffering from UI. A UI is the involuntary loss of urine, affecting the productivity and quality of life of those who suffer from it, accompanied by depression, anxiety, and an increase in lower urinary tract infections. It is estimated that between 25% and 45% of the factors in women are due to aging, pregnancy, and vaginal births; The types of urinary incontinence are: stress urinary incontinence (SUI), urgency urinary incontinence (UUI) and mixed urinary incontinence (MUI). Work to strengthen the pelvic floor muscles (PFM) has become a first-line conservative treatment for rehabilitation against this pathology. Aim. Explain the generalities of Urinary Incontinence, and the influence of strengthening the pelvic floor muscles and how it intervenes in the quality of life of women. Methodology. A narrative review of the literature was carried out, in the first instance a search was carried out in the databases; PubMed (69), Embase (407), Pedro (25) and Trip (0), finding a total of 501 articles, of which a first selection was made by title with the keywords “exercise and training and incontinence and quality of life”, 10 articles were respectively selected to carry out this study. Results and Conclusion: Strengthening the pelvic floor muscles is necessary to reduce episodes of urinary incontinence. Group-directed programs generate better benefits and results compared to individual work, due to the joint support between groups of women, improving quality of life. In a total of 2,449 women who underwent surgery in the studies reviewed, strengthening the pelvic floor, both in groups and individually, obtained results at 6 and 12 weeks, the intervention was conducted between 2 to 3 times a week with a duration of 40 to 50 minutes per session. General area of study: Physiotherapy. Specific study area: Pelvic floor. Type of study: Original articles.
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Sánchez Gadvay, A. E., Barreno Gadvay, A. D., Orozco Orozco, A. S., & Vallejo Chinche, S. del P. (2025). Urinary incontinence and strengthening of pelvic muscles to improve quality of life in women. Anatomía Digital, 8(1.1), 47-63. https://doi.org/10.33262/anatomiadigital.v8i1.1.3319
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Articulos de revisión bibliográfica
References
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8. Bezerra LO, de Oliveira MCE, da Silva Filho EM, Vicente da Silva HK, Menezes de Oliveira GF, da Silveira Gonçalves AK, et al. Impact of pelvic floor muscle training isolated and associated with game therapy on mixed urinary incontinence: a randomized controlled trial. Games Health Journal. [Internet]. 2021 [citado 26 de Enero de 2025]; 10(1): 43-49. Disponible en: https://doi.org/10.1089/g4h.2019.0207
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10. Ptak M, Ciećwież S, Brodowska A, Starczewski A, Nawrocka-Rutkowska J, Diaz-Mohedo E, et al. The effect of pelvic floor muscles exercise on quality of life in women with stress urinary incontinence and its relationship with vaginal deliveries: a randomized trial. BioMed Research International [Internet]. 2019 [citado 26 de enero de 2025]; 2019: 5321864. Disponible en: https://doi.org/10.1155/2019/5321864
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13. Ptak M, Ciećwież S, Brodowska A, Szylińska A, Starczewski A, Rotter I. The effect of selected exercise programs on the quality of life in women with grade 1 stress urinary incontinence and its relationship with various body mass indices: a randomized trial. BioMed Research International [Internet]. 2020 [citado 26 de Enero de 2025]; 1205281. Disponible en: https://doi.org/10.1155/2020/1205281
14. Vaughan C, Markland A. Urinary incontinence in woman. Annals of internal medicine [Internet]. 2020 [citado 26 de Enero de 2025]; 172(3): ITC17-ITC32. Disponible en: https://www.acpjournals.org/doi/abs/10.7326/AITC202002040
15. García E, Ávila V, López J, Matínez A, Rubio J. What pelvic floor muscle training load is optimal minimizing urine loss in woman with stress urinary incontinence? A systematic review of a meta-analysis. International Journal of Environmental Research and Public Health [Internet]. 2019 [citado 26 de Enero de 2025]; 16(22):4358. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887794/
16. Luginbuelh H, Lehmann C, Baeyens J, Kuhn A, Radlinger L. Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence: a randomized controlled trial. International Urogynecology Journal [Internet]. 2021 [citado 26 de Enero de 2025]; 16: 524. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647572/
17. Johannessen H, Frøshaug B, Lysåker P, Salvesen K, Lukasse M, Mørkved S, et al. Regular antenatal exercise including pelvic floor muscle training reduces urinary incontinence three months postpartum – follow-up of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica [Internet]. 2021 [citado 26 de Enero de 2025]; 100(2): 294-301. Disponible en: https://doi.org/10.1111/aogs.14010
18. Ehsani F, Sahebi N, Shanbehzadeh S, Masoud A, ShahAli S. Stabilization exercises affect function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study. International Urogynecology Journal [Internet]. 2020 [citado 26 de Enero de 2025]; 31(1): 197-204. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31016337/
19. Fitz F, Giménez M, de Azevedo Ferreira L, Perreira M, Tezelli M, Castro R. Pelvic floor muscle training for female stress urinary incontinence: a randomized control trial comparing home and outpatient training. International Urogynecology Journal [Internet]. 2019 [citado 26 de Enero de 2025]; 31(5): 989-998. Disponible en: https://doi.org/10.1007/s00192-019-04081-x
20. Cacciari L, Morin M, Mayrand M, Tousignant M, Abrahamowicz M, Dumoulin C. Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women. Neurourology and urodynamics [Internet]. 2021 [citado 26 de Enero de 2025]; 40(1): 245-255. Disponible en: https://doi.org/10.1002/nau.24542
21. Khrorasani F, Ghaderi F, Bastani P, Sarbakhsh P, Berghmans B. The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress, urinary incontinence, and low back pain: a randomized controlled trial. International Urogynecology Journal [Internet]. 2020 [citado 26 de Enero de 2025]; 31(11): 2301-2307. Disponible en: https://doi.org/10.1007/s00192-020-04284-7
22. Lausen A, Marsland L, Head S, Jackson J, Lausen B. Modified pilates as an adjunct to standard physiotherapy care for urinary incontinence: a mixed methods pilot for a randomized controlled trial. BMC Women's Health [Internet]. 2018 [citado 26 de Enero de 2025]; 18(16). Disponible en: https://doi.org/10.1186/s12905-017-0503-y
23. Gluppe S, Engh M, Bø K. What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review and meta- analysis. Brazialian Journal of Physical Therapy [Internet]. 2021 [citado 26 de Enero de 2025]; 25(6): 664-675. Disponible en: https://doi.org/10.1016/j.bjpt.2021.06.006
24. Yang Z, Wang J. Differential effects of social influence sources on self-reported music piracy. Decision Support System [Internet]. 2015 [citado 26 de Enero de 2025]; 69:70-81. Disponible en: https://doi.org/10.1016/j.dss.2014.11.007
2. Dumoulin C, Morin M, Danieli C, Cacciari L, Mayrand M, Tousignant M, et al. Group-based vs individual pelvic floor muscle training to treat urinary incontinence in older women. JAMA Internal Medicine [Internet]. 2020 [citado 26 de enero de 2025]; 180(10):1284-1293. Disponible en: https://revistamedicasinergia.com/index.php/rms/article/view/1066
3. Salazar D, Aguilar L, Gonzalez F. Fisiopatología y tratamiento de la incontinencia urinaria en mujeres. Revista Médica Sinergia [Internet]. 2023 [citado 26 de enero de 2025]; 8(6): e1066. Disponible en: https://doi.org/10.31434/rms.v8i6.1066
4. Nieto E, Camacho J, Dávila V, Ledo M, Moriano P, Pérez M, et al. Epidemiología e impacto de la incontinencia urinaria en mujeres de 40 a 65 años en un área sanitaria de Madrid. Atención Primaria [Internet]. 2003 [citado 26 de enero de 2025]; 32(7): 410-414. Disponible en: https://doi.org/10.1016/s0212-6567(03)70758-6
5. Chiang H, Susaeta R, Valdevenito R, Rosenfeld R, Finsterbusch C. Incontinencia urinaria. Revista Médica de Clínica Las Condes [Internet]. 2013 [citado 26 de Enero de 2025]; 24(2): 219-227. Disponible en: https://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-pdf-S0716864013701536
6. Martín C, Carnero M. Prevalencia y factores asociados a incontinencia urinaria en el área de salud de Valladolid. Enfermería Global [Internet]. 2020 [citado 26 de enero de 2025]; 19(57): 390-412. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412020000100012&lng=es
7. Rodríguez R, Álvarez E, Salas L, González A. Estudio de la prevalencia de incontinencia urinaria y sus factores de riesgo en nuestro medio. Clínica e Investigación en Ginecología y Obstetricia [Internet]. 2007 [citado 26 de enero de 2025]; 34(4): 128-136. Disponible en: https://www.elsevier.es/es-revista-clinica-e-investigacion-ginecologia-obstetricia-7-articulo-estudio-prevalencia-incontinencia-urinaria-sus-13108247
8. Bezerra LO, de Oliveira MCE, da Silva Filho EM, Vicente da Silva HK, Menezes de Oliveira GF, da Silveira Gonçalves AK, et al. Impact of pelvic floor muscle training isolated and associated with game therapy on mixed urinary incontinence: a randomized controlled trial. Games Health Journal. [Internet]. 2021 [citado 26 de Enero de 2025]; 10(1): 43-49. Disponible en: https://doi.org/10.1089/g4h.2019.0207
9. Torres M, Meldara A. Fisioterapia de suelo pélvico: Manual para la prevención y el tratamiento en la mujer, en el hombre y en la infancia [Internet]. Editorial Médica Panamericana; 2022 [citado 26 de enero de 2025]. Disponible en: https://www.amazon.com/-/es/Fisioterapia-del-suelo-p%C3%A9lvico-book/dp/8491104534
10. Ptak M, Ciećwież S, Brodowska A, Starczewski A, Nawrocka-Rutkowska J, Diaz-Mohedo E, et al. The effect of pelvic floor muscles exercise on quality of life in women with stress urinary incontinence and its relationship with vaginal deliveries: a randomized trial. BioMed Research International [Internet]. 2019 [citado 26 de enero de 2025]; 2019: 5321864. Disponible en: https://doi.org/10.1155/2019/5321864
11. Gómez M, Castaño JC, Saldarriaga E. Trastornos de la contracción de los músculos del piso pélvico femenino. Urología Colombiana [Internet]. 2015 [citado 26 de enero de 2025]; 24 (1): 35-43. Disponible en: https://www.elsevier.es/es-revista-urologia-colombiana-398-articulo-trastornos-contraccion-musculos-del-piso-S0120789X15000106
12. Gretchen I. Urinary incontinence. Primary care: clinics in office practice [Internet]. 2019 [citado 26 de enero de 2025]; 46(2): 233-242. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0095454319300077?via%3Dihub
13. Ptak M, Ciećwież S, Brodowska A, Szylińska A, Starczewski A, Rotter I. The effect of selected exercise programs on the quality of life in women with grade 1 stress urinary incontinence and its relationship with various body mass indices: a randomized trial. BioMed Research International [Internet]. 2020 [citado 26 de Enero de 2025]; 1205281. Disponible en: https://doi.org/10.1155/2020/1205281
14. Vaughan C, Markland A. Urinary incontinence in woman. Annals of internal medicine [Internet]. 2020 [citado 26 de Enero de 2025]; 172(3): ITC17-ITC32. Disponible en: https://www.acpjournals.org/doi/abs/10.7326/AITC202002040
15. García E, Ávila V, López J, Matínez A, Rubio J. What pelvic floor muscle training load is optimal minimizing urine loss in woman with stress urinary incontinence? A systematic review of a meta-analysis. International Journal of Environmental Research and Public Health [Internet]. 2019 [citado 26 de Enero de 2025]; 16(22):4358. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6887794/
16. Luginbuelh H, Lehmann C, Baeyens J, Kuhn A, Radlinger L. Involuntary reflexive pelvic floor muscle training in addition to standard training versus standard training alone for women with stress urinary incontinence: a randomized controlled trial. International Urogynecology Journal [Internet]. 2021 [citado 26 de Enero de 2025]; 16: 524. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647572/
17. Johannessen H, Frøshaug B, Lysåker P, Salvesen K, Lukasse M, Mørkved S, et al. Regular antenatal exercise including pelvic floor muscle training reduces urinary incontinence three months postpartum – follow-up of a randomized controlled trial. Acta Obstetricia et Gynecologica Scandinavica [Internet]. 2021 [citado 26 de Enero de 2025]; 100(2): 294-301. Disponible en: https://doi.org/10.1111/aogs.14010
18. Ehsani F, Sahebi N, Shanbehzadeh S, Masoud A, ShahAli S. Stabilization exercises affect function of transverse abdominis and pelvic floor muscles in women with postpartum lumbo-pelvic pain: a double-blinded randomized clinical trial study. International Urogynecology Journal [Internet]. 2020 [citado 26 de Enero de 2025]; 31(1): 197-204. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31016337/
19. Fitz F, Giménez M, de Azevedo Ferreira L, Perreira M, Tezelli M, Castro R. Pelvic floor muscle training for female stress urinary incontinence: a randomized control trial comparing home and outpatient training. International Urogynecology Journal [Internet]. 2019 [citado 26 de Enero de 2025]; 31(5): 989-998. Disponible en: https://doi.org/10.1007/s00192-019-04081-x
20. Cacciari L, Morin M, Mayrand M, Tousignant M, Abrahamowicz M, Dumoulin C. Pelvic floor morphometrical and functional changes immediately after pelvic floor muscle training and at 1‐year follow‐up, in older incontinent women. Neurourology and urodynamics [Internet]. 2021 [citado 26 de Enero de 2025]; 40(1): 245-255. Disponible en: https://doi.org/10.1002/nau.24542
21. Khrorasani F, Ghaderi F, Bastani P, Sarbakhsh P, Berghmans B. The Effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress, urinary incontinence, and low back pain: a randomized controlled trial. International Urogynecology Journal [Internet]. 2020 [citado 26 de Enero de 2025]; 31(11): 2301-2307. Disponible en: https://doi.org/10.1007/s00192-020-04284-7
22. Lausen A, Marsland L, Head S, Jackson J, Lausen B. Modified pilates as an adjunct to standard physiotherapy care for urinary incontinence: a mixed methods pilot for a randomized controlled trial. BMC Women's Health [Internet]. 2018 [citado 26 de Enero de 2025]; 18(16). Disponible en: https://doi.org/10.1186/s12905-017-0503-y
23. Gluppe S, Engh M, Bø K. What is the evidence for abdominal and pelvic floor muscle training to treat diastasis recti abdominis postpartum? A systematic review and meta- analysis. Brazialian Journal of Physical Therapy [Internet]. 2021 [citado 26 de Enero de 2025]; 25(6): 664-675. Disponible en: https://doi.org/10.1016/j.bjpt.2021.06.006
24. Yang Z, Wang J. Differential effects of social influence sources on self-reported music piracy. Decision Support System [Internet]. 2015 [citado 26 de Enero de 2025]; 69:70-81. Disponible en: https://doi.org/10.1016/j.dss.2014.11.007