NEW YORK (Reuters Health) - In pregnant women, pelvic floor muscle training for bladder-control problems, though beneficial initially, is ineffective over the long term, research shows.

Stress-related urinary incontinence "is a risk factor for long-term leakage but not necessarily enough to require surgery," Dr. Robert M. Freeman from Derriford Hospital, Plymouth, UK told Reuters Health. Performing exercises before delivery designed to strengthen the pelvic floor muscles "does not seem to give good long-term results, and this is probably due to poor compliance," Freeman noted.

The findings are based on 230 women who participated in two studies of the effectiveness of pelvic floor muscle training for preventing stress urinary incontinence after pregnancy.

At 3 months after pregnancy, significantly fewer women who performed pelvic floor muscle exercises reported post-delivery urinary incontinence, compared with women who did not perform these exercises (19 percent versus 33 percent).

Eight years later, however, urinary incontinence was reported by a similar percentage of women in the pelvic floor muscle training group and the control group (35 percent and 39 percent, respectively).

More than two-thirds of the women in the training group reported that they still performed pelvic floor muscle training at 8 years, and more than a third said they were performing the exercises at least twice a week.

Despite these reports, the investigators say, incontinence rates did not differ between those performing pelvic floor exercises at least twice weekly and those performing the exercises less frequently.

"We are concerned that a lot of the evidence for both (before delivery and after delivery) pelvic floor muscle training suggests poor long-term effect," Freeman said. "We believe that compliance is the major issue, and this can only be improved by education."

SOURCE: BJOG: An International Journal of Obstetrics and Gynaecology, July 2008.

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