Abstract
Biofeedback is a method of pelvic floor rehabilitation using a surface electrode inserted into the vagina and a catheter in the rectum. Forty women with genuine urinary stress incontinence were randomized to compare the efficacy of physiotherapy and physiotherapy in combination with biofeedback. The effect of the treatment was determined by a standardized pad-weighing test. Long-term status was determined using a questionnaire after 2–3 years. Thirty-four women completed the treatment. The study showed a statistically significant better improvement in the biofeedback group. The long-term effect in the biofeedback group seemed better and the patients were more motivated for training afterwards.
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EDITORIAL COMMENT: These authors have enhanced our knowledge of physiotherapy and biofeedback in this well done study. Its design is prospective and randomized, with objective measurements of urine loss using a standardized format at 1 and 3 months. Further subjective follow-up provided the information that those trained with biofeedback were better off and that a greater proportion continued to do Kegel exercises at the mean of 2.5 years later. We need further information regarding how to predict which patients are going to repond to this type of therapy. In the non-responder group a great deal of time and effort is being wasted, owing to the personnelintensive nature of this type of therapy. Although we are not told of the parity of these patients, presumably many are multiparous, as evidenced by some who could not contract their pelvic floor at all prior to therapy. Are these the non-responders whose pelvic floors were permanently damaged during childbirth? Should all patients have pudendal motor terminal latency studies to rule out pelvic floor neuropathy, as it is unlikely that these patients will respond? These are unanswered questions and this editor would like to encourage investigators to carry this type of study further, to define who is likely to benefit from this therapy.
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Glavind, K., Nøhr, S.B. & Walter, S. Biofeedback and physiotherapy versus physiotherapy alone in the treatment of genuine stress urinary incontinence. Int Urogynecol J 7, 339–343 (1996). https://doi.org/10.1007/BF01901111
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DOI: https://doi.org/10.1007/BF01901111