Stress Incontinence Research Paper
Stress Incontinence and Pelvic Floor Exercises During Pregnancy
Rigzin Kundo
PBISN
Abstract
The aim of this paper is to is to find out whether pelvic floor muscle exercises (PFME) help to reduce stress incontinence during pregnancy or not. This paper also defines stress incontinence, and explains how it effects on the quality of life of pregnant women. Sangsawang and
Serisathien (2012) and Sahakian and Woodward (2012) focus on the pelvic floor muscle exercise (PFME) to decrease severity of stress incontinence during pregnancy. However,
Kocaoz, Talas, Atabekoglu (2010) focus on the prevalence of urinary incontinence during pregnancy and ways to assess its influence on the quality of life.
Stress Incontinence …show more content…
and Pelvic Floor Exercises During Pregnancy Stress incontinence is defined as the leakage of urine while sneezing or coughing or moving. Stress incontinence is one of the most common forms of urinary incontinence faced by pregnant women today. In pregnancy, stress incontinence is one of the major problems. Stress incontinence occurs in pregnant women because there is increase in intra-abdominal pressure from the growing uterus and fetal weight on pelvic floor muscles throughout pregnancy and also there is hormonal change in estrogen, progesterone and relaxin, and eventually lead to decrease in strength and function of urethral sphincter and detrusor muscles of pelvic floor muscles (Sangsawang and Serisathien, 2012, p.1998)
Stress incontinence is not life threatening but it can have negative impact on the quality of life of women. Most women are distressed from the constant feeling of dampness, malodor and discomfort r/t irritation from the urinary incontinence (Kocaoz, Talas, Atabekoglu, 2010,
p.3315). Sometimes, the level of distress from constant dampness gets so severe that these women choose themselves to isolate from society and live alone. Although stress incontinence is not a fatal disease but negligence on its prevention and treatment during pregnancy can lead to permanent urinary incontinence later in life and also may have adverse effects on quality of their life. The stress incontinence needs to be treated and prevented during pregnancy otherwise it may lead to permanent incontinence in postpartum (Sangsawang and Serisathien, 2012, p.1998).
Pelvic floor muscle exercises (PFME) is the only first line non-invasive treatment for stress incontinence. Studies have found that a 6 weeks pelvic floor muscle exercise programme is effective at relieving stress incontinence.
The purpose of this paper is to examine whether pelvic floors exercises help to reduce stress incontinence in pregnant women or not. Let us assume that pelvic floor exercises do help to reduce stress incontinence in pregnant women. The hypothesis can be tested using the following two studies of research. Let us assume Sahakian and Woodward (2012)- the first study research and Sangsawang and Serisathie (2012)- the second study research. Sahakian and Woodward (2012) demonstrate the literature critique of the impact of pelvic floor exercises on urinary stress incontinence in postnatal women The literature critiques were obtained by conducting research on 162 papers that were taken from four different databases.
Initially there were 162 papers that were analyzed, but out of them only 7 studies were
selected as those studies met all the criteria. Among them, six of the participants were placed either in pelvic floor muscle exercise intervention or a control group ( Sahakian, Woodward, 2012,
p.S12). On the other hand, Sangsawang and Serisathien (2012) examine the effects of pelvic floor muscle exercise (PFME) programme on stress urinary incontinence in pregnant women by conducting research on seventy pregnant women. In this research, the participants were pregnant women and they were selected if they met the following criteria- 18 years and above, gestational age of 20-30 weeks and expectation of single live fetus, atleast one involuntary loss of urine during pregnancy, moderate or severe stress urinary incontinence and pre-pregnancy BMI of <30 kg/m2. (Sangsawang and Serisathie ,2012, p.1999).
In the first research study, the participants were required to perform 8-12 contractions twice daily. The participants those who were active in their performance of pelvic floor muscle exercises, they had better improvement in their strength of pelvic floor muscles on stress incontinence. But those participants who had minimal input, the studies reported no any impact of pelvic floor muscle exercise on stress incontinence. This indicates that for the effectiveness of pelvic floor muscles on stress incontinence, there should be daily adequate input and correct
PFME, otherwise it will be waste of energy.
In this research, vaginal palpation and observation of perineum were analyzed (Sahakian,
Woodward, 2012, p.S12). This analysis was the indicator for the performance of the correct pelvic floor muscle exercises. Those participants who fail to perform the analysis of vaginal palpation and observation of perineum, they were always in doubt of whether their performance of PFME was correct or not. As a result, they always fail to have good performance of PFME and their performance of PFME couldn’t bring any significant change in the pelvic floor muscle on stress incontinence during pregnancy. In the second research, the participants were instructed to repeat total of 40 sets of PFME daily at least 5 days per week for a complete period of 6 weeks
(Sangsawang and Serisathie ,2012, p.2000). However, in this research vaginal palpation wasn’t performed but it encouraged participants to identify correct pelvic muscle to contract by stop- testing, which means to stop flow of urine for a second or two, relax and finish emptying without straining (Sangsawang and Serisathie ,2012, p.2000). This research proves the notion that correct pelvic muscle to contract will result in improving the efficiency and strength of pelvic floor muscles. In the first research, four out of seven studies displayed significant improvement in stress incontinence in postnatal women who were placed in pelvic floor muscle exercise during pregnancy (Sahakian, Woodward, 2012, p.S12). It is unclear from the study why only
4 studies have significant improvement in stress incontinence during pregnancy while the other
3 studies could not. On the other hand, the participants who followed the 6 week pelvic floor muscle exercise programme was effective in relieving stress urinary incontinence.
However, in the second research, those women who had already received treatment for stress urinary incontinence and didn’t have sufficient knowledge of Thai language were excluded from the study.
In the first research it shows that for the better management of stress incontinence during pregnancy, adherence plays a crucial role. This research also shows that continuous daily engaging in pelvic floor muscle exercises help to reduce signs and symptoms of urinary stress incontinence even after giving birth. This research supports the idea that complete adherence and constant daily engagement in PFME can definitely help to improve stress incontinence during pregnancy. In the second research, the experimental group who had good understanding of stress urinary incontinence during pregnancy and who were able to perform correct PFEM daily for a period of 6 weeks had good strength of the pelvic floor muscles and improved stress urinary incontinence symptoms (Sangsawang and Serisathie ,2012, p.2004).This research demonstrates that the good knowledge of performing correct PFME will definitely help to prevent and treat the signs and symptoms of urinary stress incontinence. Sahakian and Woodward (2012) suggest that that factors that made the participants adhere to the PFME was because of the prior knowledge of the science behind the technique, the fun and encouraging environment led by motivational trainer. There were also factors that reduced their motivations to PFME mainly because of time, travel, negative interactions, lack of support, health beliefs and inconvenience (Sahakian and Woodward, 2012, p.S14). This research indicates that for the better performance and results of PFME on stress incontinence during pregnancy, different factors need to be taken into considerations. In that way, the emphasis can be given more on factors that motivate the participants. On the other hand, Sangsawang and
Serisatheien (2012) suggest that the factors that made the participants adhere to PFME was because of daily adherence of performing correct PFME daily for a period of six weeks. The control group lack the motivation because they didn’t get any stress urinary incontinence instruction during pregnancy and also there was no any proper training to support the performance of correct PFME (Sangsawang and Serisatheie, 2012, p.2004). This study neglected the control group. This research proves the notion that the ones who gets proper PFME training and adheres to it for a period of 6 weeks will have improvement of efficiency and strength in their pelvic muscles.
From both the studies it shows that effective pelvic floor muscle exercise can lead to improvement in the strength of the pelvic floor muscles in stress incontinence during pregnancy.
The assumption that pelvic floor exercises do help to reduce stress incontinence in pregnant women prove true. Some of the variables for developing urinary incontinence are- age groups, parity, previous urinary tract infection, constipation, UI in previous pregnancy, UI in previous postpartum period, UI in mother and UI insister (Kocaoz, Talas, Atabekoglu, 2010, p. 3320).It was found that there is a significant relationship between urinary incontinence during pregnancy and constipation. So, it is better to treat constipation and urinary incontinence during pregnancy and also during the postpartum period in order to prevent urinary stress incontinence developing later in life. The complications that results from the negligence of prevention and treatment of stress incontinence during pregnancy would be permanent urinary incontinence in later life.
Therefore, effective teaching should be done for the prevention and treatment of stress incontinence during pregnancy. Stress incontinence during pregnancy needs to be prevented and treated during the pregnancy otherwise it will lead to permanent urinary incontinence. It is always better to prevent and treat stress incontinence during pregnancy in its early stages before it gets worse. The best way to prevent stress incontinence in pregnant women would be pelvic floor muscle exercise
(PFME). This procedure is non-invasive and is the first line treatment and intervention to manage stress incontinence during pregnancy. Hence, it can be concluded that, stress incontinence during pregnancy can be treated, if it is prevented and treated as soon as signs and symptoms are visible and pelvic floor muscle exercise intervention should be used to actively manage stress incontinence during pregnancy.
References
Sangsawang, B., and Serisathien, Y. (2012). Effect of pelvic floor muscle exercise programme on stress urinary incontinence among pregnant women. Journal of Advanced Nursing, 68
(9), 1997-2007.
Sahakian, J., and Woodward, S. (2012). Stress incontinence and pelvic floor exercises in pregnancy. British Journal of Nursing, 21(18), S10-S15.
Kocaoz, S., Talas, M.S., and Atabekoglu, C.S. (2010). Urinary incontinence in pregnant women and their quality of life. Journal of Clinical Nursing, 19, 3314-3323
Rigzin Kundo
PBISN
Abstract
The aim of this paper is to is to find out whether pelvic floor muscle exercises (PFME) help to reduce stress incontinence during pregnancy or not. This paper also defines stress incontinence, and explains how it effects on the quality of life of pregnant women. Sangsawang and
Serisathien (2012) and Sahakian and Woodward (2012) focus on the pelvic floor muscle exercise (PFME) to decrease severity of stress incontinence during pregnancy. However,
Kocaoz, Talas, Atabekoglu (2010) focus on the prevalence of urinary incontinence during pregnancy and ways to assess its influence on the quality of life.
Stress Incontinence …show more content…
and Pelvic Floor Exercises During Pregnancy Stress incontinence is defined as the leakage of urine while sneezing or coughing or moving. Stress incontinence is one of the most common forms of urinary incontinence faced by pregnant women today. In pregnancy, stress incontinence is one of the major problems. Stress incontinence occurs in pregnant women because there is increase in intra-abdominal pressure from the growing uterus and fetal weight on pelvic floor muscles throughout pregnancy and also there is hormonal change in estrogen, progesterone and relaxin, and eventually lead to decrease in strength and function of urethral sphincter and detrusor muscles of pelvic floor muscles (Sangsawang and Serisathien, 2012, p.1998)
Stress incontinence is not life threatening but it can have negative impact on the quality of life of women. Most women are distressed from the constant feeling of dampness, malodor and discomfort r/t irritation from the urinary incontinence (Kocaoz, Talas, Atabekoglu, 2010,
p.3315). Sometimes, the level of distress from constant dampness gets so severe that these women choose themselves to isolate from society and live alone. Although stress incontinence is not a fatal disease but negligence on its prevention and treatment during pregnancy can lead to permanent urinary incontinence later in life and also may have adverse effects on quality of their life. The stress incontinence needs to be treated and prevented during pregnancy otherwise it may lead to permanent incontinence in postpartum (Sangsawang and Serisathien, 2012, p.1998).
Pelvic floor muscle exercises (PFME) is the only first line non-invasive treatment for stress incontinence. Studies have found that a 6 weeks pelvic floor muscle exercise programme is effective at relieving stress incontinence.
The purpose of this paper is to examine whether pelvic floors exercises help to reduce stress incontinence in pregnant women or not. Let us assume that pelvic floor exercises do help to reduce stress incontinence in pregnant women. The hypothesis can be tested using the following two studies of research. Let us assume Sahakian and Woodward (2012)- the first study research and Sangsawang and Serisathie (2012)- the second study research. Sahakian and Woodward (2012) demonstrate the literature critique of the impact of pelvic floor exercises on urinary stress incontinence in postnatal women The literature critiques were obtained by conducting research on 162 papers that were taken from four different databases.
Initially there were 162 papers that were analyzed, but out of them only 7 studies were
selected as those studies met all the criteria. Among them, six of the participants were placed either in pelvic floor muscle exercise intervention or a control group ( Sahakian, Woodward, 2012,
p.S12). On the other hand, Sangsawang and Serisathien (2012) examine the effects of pelvic floor muscle exercise (PFME) programme on stress urinary incontinence in pregnant women by conducting research on seventy pregnant women. In this research, the participants were pregnant women and they were selected if they met the following criteria- 18 years and above, gestational age of 20-30 weeks and expectation of single live fetus, atleast one involuntary loss of urine during pregnancy, moderate or severe stress urinary incontinence and pre-pregnancy BMI of <30 kg/m2. (Sangsawang and Serisathie ,2012, p.1999).
In the first research study, the participants were required to perform 8-12 contractions twice daily. The participants those who were active in their performance of pelvic floor muscle exercises, they had better improvement in their strength of pelvic floor muscles on stress incontinence. But those participants who had minimal input, the studies reported no any impact of pelvic floor muscle exercise on stress incontinence. This indicates that for the effectiveness of pelvic floor muscles on stress incontinence, there should be daily adequate input and correct
PFME, otherwise it will be waste of energy.
In this research, vaginal palpation and observation of perineum were analyzed (Sahakian,
Woodward, 2012, p.S12). This analysis was the indicator for the performance of the correct pelvic floor muscle exercises. Those participants who fail to perform the analysis of vaginal palpation and observation of perineum, they were always in doubt of whether their performance of PFME was correct or not. As a result, they always fail to have good performance of PFME and their performance of PFME couldn’t bring any significant change in the pelvic floor muscle on stress incontinence during pregnancy. In the second research, the participants were instructed to repeat total of 40 sets of PFME daily at least 5 days per week for a complete period of 6 weeks
(Sangsawang and Serisathie ,2012, p.2000). However, in this research vaginal palpation wasn’t performed but it encouraged participants to identify correct pelvic muscle to contract by stop- testing, which means to stop flow of urine for a second or two, relax and finish emptying without straining (Sangsawang and Serisathie ,2012, p.2000). This research proves the notion that correct pelvic muscle to contract will result in improving the efficiency and strength of pelvic floor muscles. In the first research, four out of seven studies displayed significant improvement in stress incontinence in postnatal women who were placed in pelvic floor muscle exercise during pregnancy (Sahakian, Woodward, 2012, p.S12). It is unclear from the study why only
4 studies have significant improvement in stress incontinence during pregnancy while the other
3 studies could not. On the other hand, the participants who followed the 6 week pelvic floor muscle exercise programme was effective in relieving stress urinary incontinence.
However, in the second research, those women who had already received treatment for stress urinary incontinence and didn’t have sufficient knowledge of Thai language were excluded from the study.
In the first research it shows that for the better management of stress incontinence during pregnancy, adherence plays a crucial role. This research also shows that continuous daily engaging in pelvic floor muscle exercises help to reduce signs and symptoms of urinary stress incontinence even after giving birth. This research supports the idea that complete adherence and constant daily engagement in PFME can definitely help to improve stress incontinence during pregnancy. In the second research, the experimental group who had good understanding of stress urinary incontinence during pregnancy and who were able to perform correct PFEM daily for a period of 6 weeks had good strength of the pelvic floor muscles and improved stress urinary incontinence symptoms (Sangsawang and Serisathie ,2012, p.2004).This research demonstrates that the good knowledge of performing correct PFME will definitely help to prevent and treat the signs and symptoms of urinary stress incontinence. Sahakian and Woodward (2012) suggest that that factors that made the participants adhere to the PFME was because of the prior knowledge of the science behind the technique, the fun and encouraging environment led by motivational trainer. There were also factors that reduced their motivations to PFME mainly because of time, travel, negative interactions, lack of support, health beliefs and inconvenience (Sahakian and Woodward, 2012, p.S14). This research indicates that for the better performance and results of PFME on stress incontinence during pregnancy, different factors need to be taken into considerations. In that way, the emphasis can be given more on factors that motivate the participants. On the other hand, Sangsawang and
Serisatheien (2012) suggest that the factors that made the participants adhere to PFME was because of daily adherence of performing correct PFME daily for a period of six weeks. The control group lack the motivation because they didn’t get any stress urinary incontinence instruction during pregnancy and also there was no any proper training to support the performance of correct PFME (Sangsawang and Serisatheie, 2012, p.2004). This study neglected the control group. This research proves the notion that the ones who gets proper PFME training and adheres to it for a period of 6 weeks will have improvement of efficiency and strength in their pelvic muscles.
From both the studies it shows that effective pelvic floor muscle exercise can lead to improvement in the strength of the pelvic floor muscles in stress incontinence during pregnancy.
The assumption that pelvic floor exercises do help to reduce stress incontinence in pregnant women prove true. Some of the variables for developing urinary incontinence are- age groups, parity, previous urinary tract infection, constipation, UI in previous pregnancy, UI in previous postpartum period, UI in mother and UI insister (Kocaoz, Talas, Atabekoglu, 2010, p. 3320).It was found that there is a significant relationship between urinary incontinence during pregnancy and constipation. So, it is better to treat constipation and urinary incontinence during pregnancy and also during the postpartum period in order to prevent urinary stress incontinence developing later in life. The complications that results from the negligence of prevention and treatment of stress incontinence during pregnancy would be permanent urinary incontinence in later life.
Therefore, effective teaching should be done for the prevention and treatment of stress incontinence during pregnancy. Stress incontinence during pregnancy needs to be prevented and treated during the pregnancy otherwise it will lead to permanent urinary incontinence. It is always better to prevent and treat stress incontinence during pregnancy in its early stages before it gets worse. The best way to prevent stress incontinence in pregnant women would be pelvic floor muscle exercise
(PFME). This procedure is non-invasive and is the first line treatment and intervention to manage stress incontinence during pregnancy. Hence, it can be concluded that, stress incontinence during pregnancy can be treated, if it is prevented and treated as soon as signs and symptoms are visible and pelvic floor muscle exercise intervention should be used to actively manage stress incontinence during pregnancy.
References
Sangsawang, B., and Serisathien, Y. (2012). Effect of pelvic floor muscle exercise programme on stress urinary incontinence among pregnant women. Journal of Advanced Nursing, 68
(9), 1997-2007.
Sahakian, J., and Woodward, S. (2012). Stress incontinence and pelvic floor exercises in pregnancy. British Journal of Nursing, 21(18), S10-S15.
Kocaoz, S., Talas, M.S., and Atabekoglu, C.S. (2010). Urinary incontinence in pregnant women and their quality of life. Journal of Clinical Nursing, 19, 3314-3323