Näytönastekatsaukset

Pelvic muscle training before giving birth for urinary incontinence symptoms

Näytönastekatsaukset

31.3.2026

Pauliina Aukee and Aleksi Raudasoja

Level of evidence: B

In a Cochrane review, pelvic muscle training program before giving birth reduced self-reported urinary incontinence in late pregnancy and in under 6 months follow-up after giving birth. For patients without incontinence when randomized, at 0-3 months (late pregnancy), 14% of participants in training programs vs 38% in control group experienced urinary incontinence (leakage) «Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1. At 3-6 months (mid postnatal period), respective numbers were 14% and 25%. Urinary incontinence prevalence decreases in longer follow-up, and the evidence for longer follow-ups is uncertain.

The level of evidence was downgraded due to high risk of bias.

Table 1. Description of the included studies.
Reference	Study type	Population	Intervention and comparison	Outcomes	Risk of bias
RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis; ICIQ‐SF=urinary incontinence specific quality of life
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1	SR/MA	Pregnant/postnatal women with or without urinary incontinence	Any pelvic muscle training program during pregnancy vs no intervention/usual care/placebo	Self-reported urinary incontinence, ICIQ-SF	High

Table 2. Table 2. Additional comments for included studies.
Reference	Comments
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1	Excluded trials with intervention combining training programs with drug treatment or with another stand-alone therapy. ICIQ-SF=urinary incontinence specific quality of life. Risk of bias was high in all trials due to no blinding and in some trials, also due to incomplete outcome data.

Results

Table 3. Outcome 1: Self-reported urinary incontinence (urine leakage) in late pregnancy.
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) C	Relative effect (95% CI)
Level of evidence: moderate The quality of evidence is downgraded due to study limitations. I=intervention; C=comparison; CI=confidence interval
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1	6 studies (296/328)	-	44 (15%)	138 (42%)	0.38 (0.20-0.72)

Table 4. Outcome 2: Self-reported urinary incontinence (urine leakage) in 0-3 months postpartum.
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) C	Relative effect (95% CI)
Level of evidence: moderate The quality of evidence is downgraded due to study limitations. I=intervention; C=comparison; CI=confidence interval
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1	5 studies (207/232)	0-3 months	29 (14%)	88 (38%)	0.38 (0.17-0.83)

Table 5. Outcome 3: Self-reported urinary incontinence (urine leakage) in 3-6 months postpartum.
Reference	Number of studies and number of patients (I/C)	Follow-up time	Absolute number of events (%) I	Absolute number of events (%) C	Relative effect (95% CI)
Level of evidence: moderate The quality of evidence is downgraded due to study limitations. There was also some imprecision (confidence interval could include clinically not meaningful benefit) but not warranting another downgrade in the evidence certainty. I=intervention; C=comparison; CI=confidence interval
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1	5 studies (335/338)	3-6 months	59 (14%)	85 (25%)	0.71 (0.54-0.95)

Table 6. Outcome 4: ICIQ‐SF 6-12 months postpartum.
Reference	Number of studies and number of patients (I/C)	Follow-up time	Mean (sd) I	Mean (sd) C	Mean difference (95% CI)
Level of evidence: low The quality of evidence is downgraded due to study limitations and imprecision. I=intervention; C=comparison; CI=confidence interval
«Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5)»1	1 study (20/21)	6-12 months	1.2 (2.5)	4.7 (5.6)	-3.50 (-6.13 to -0.87)

Woodley SJ, Lawrenson P, Boyle R, et al. Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev 2020;5(5):CD007471 «PMID: 32378735»PubMed