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Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting?

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Abstract

Introduction and hypothesis

Pelvic floor muscle training (PFMT) is the recommended first-line treatment for women with urinary incontinence (UI). Success rates are variable and dependent on a number of factors. The development of an incontinence treatment motivation questionnaire (ITMQ) provides us with a tool to assess patient self-motivation with respect to PFMT and UI. The aim of this study was to determine the effect of women’s self-motivation to perform PFMT on outcome.

Methods

Women with stress predominant UI completed an ITMQ and a 24-h pad test and then underwent a 12-week course of supervised PFMT. At the end of their treatment they completed a patient global impression of improvement questionnaire (PGI-I) and a second 24-h pad test. The PGI-I scores and the difference in pad test weight correlated with the ITMQ according to Spearman’s correlation coefficient.

Results

Sixty-five women were recruited. Thirty-two (49 %) patients perceived themselves as having improved, 28 women (43 %) did not experience any change in symptoms and 5 women (8 %) felt that their symptoms deteriorated following treatment. When correlating the PGI-I with the ITMQ, 3 of the 5 domains: MQS1 (positive attitude for treatment; p = 0.003), MQS3 (frustration of living with incontinence; p = 0.002) and MQS4 (desire for treatment; p = 0.002) correlated significantly with outcome. Desire for treatment was the only domain to correlate with change in pad weight (p = 0.001).

Conclusion

Self-motivation is essential in order to determine improved success rates with PFMT.

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Funding

No external funding was obtained.

Conflicts of interest

The authors report no conflicts of interest concerning this study.

Ethical approval

Kent Research Ethics Committee UK. REC no. 10/H1101/65

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Authors and Affiliations

  1. Department of Urogynaecology, Kings College Hospital NHS Foundation Trust, Denmark Hill, London, SE5 9 RS, UK

    M. Vella, E. Nellist, L. Cardozo, H. Mastoroudes & I. Giarenis

  2. Department of Obstetrics and Gynaecology, Medway NHS Foundation Trust, Windmill Road, Gillingham, Kent, ME7 5NY, UK

    J. Duckett

  3. King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    M. Vella

Authors
  1. M. Vella
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  2. E. Nellist
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  3. L. Cardozo
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  4. H. Mastoroudes
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  5. I. Giarenis
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  6. J. Duckett
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Correspondence to M. Vella.

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Vella, M., Nellist, E., Cardozo, L. et al. Does self-motivation improve success rates of pelvic floor muscle training in women with urinary incontinence in a secondary care setting?. Int Urogynecol J 24, 1947–1951 (2013). https://doi.org/10.1007/s00192-013-2115-x

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  • DOI: https://doi.org/10.1007/s00192-013-2115-x

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