Pelvic Floor Muscle Training for Incontinence

A systematic review, published in the International Journal of Environmental Research and Public Health, evaluated how effective pelvic floor muscle training (PFMT) is in treating urinary incontinence in non-pregnant women. It also compared PFMT alone to PFMT combined with tools like biofeedback, electrostimulation, and vaginal cones.

PFMT involves exercises to strengthen the pelvic floor muscles, which support the bladder and help control urination. Biofeedback is a technique that uses sensors to show women how well their pelvic muscles are working during exercises. Electrostimulation involves using mild electrical currents to help activate the pelvic muscles. Vaginal cones are small, weighted devices placed in the vagina that help women identify and strengthen pelvic floor muscles by trying to hold the cone in place; they are sometimes called kegal weights.

The review analyzed 15 randomized controlled trials (RCTs) from 2000 to 2021, that included more than 2,400 women with stress, urge, or mixed urinary incontinence. The review found that PFMT—on its own or combined with other methods—significantly reduced urinary leakage. Among those who did PFMT or PFMT with education, about 62% improved, and nearly 22% became continent (no leakage).

The review found that all these methods improved symptoms, with no major differences in how effective they were compared to PFMT alone. However, the active treatments worked better than no treatment.

PFMT, whether alone or with added tools like biofeedback, electrostimulation, or vaginal cones, is effective in reducing urinary incontinence and improving pelvic muscle strength in non-pregnant women.