Wed 8, Jun 2016

What’s new in pelvic floor research

Pelvic floor exercises before prostate surgery speeds up recovery

Men who start doing pelvic floor exercises before prostate surgery regain their continence earlier than men who start them after surgery, according to Australian researchers.

Sydney University researchers analysed the findings of 11 independent studies, which involved a total of 739 prostate cancer patients of all ages. They concluded that men who did their pelvic floor muscle exercises before surgery had a 36 per cent lower chance of urinary incontinence at the three month point after surgery, compared with men who only did them after surgery. A similar improvement was found in their quality of life assessment at three months.

However, the researchers found there was no difference in the rates of urinary incontinence between the two groups one month post-surgery, and then at six months.

The findings, published European Urology, November 2015, led study author Dr Patel to conclude that “preoperative pelvic floor muscle exercises may help early continence recovery, but may not influence long-term incontinence rates beyond six months”.

Dr Patel said this finding supported current literature, which states that more than 90 per cent of patients recover urinary incontinence after prostate surgery in the longer term.

Sit-ups not good for the pelvic floor

A recent study has found that sit-ups could be bad for the pelvic floor.

The research, published last year in the International Urogynecology Journal, involved 90 women who were regular participants in group exercise, typically engaging in a variety of low and high-impact exercise classes such as Pilates, yoga, running, ball sports, aerobic classes and weight training.

Researchers at Curtin University’s School of Physiotherapy and Exercise Science used ultrasound to assess the impact sit-ups had on the women’s bladders and pelvic floors. The researchers also assessed their ability to effectively exercise their pelvic floor muscles.

They found that sit-ups increased the strain on each of the women’s pelvic floor, and that about one quarter of the women were doing their pelvic floor exercises incorrectly.

Researchers also found that pelvic floor strain was worse in women who had had children, with 76 per cent of this group reporting they regularly experienced stress urinary incontinence, most commonly triggered by exercise (compared to 60 per cent of all the women).

The study’s most significant finding was that sit-ups were potentially harmful to women who exercised, researchers said. “In symptomatic women or those at risk of pelvic floor dysfunction (women who had had a baby or gynaecological surgery), it would seem appropriate to recommend that they not participate in abdominal curl activities in order to minimise the risk of further pelvic floor muscle strain and incontinence,” researchers warned.

“The repeated pelvic floor muscle strain with abdominal curl exercises could potentially be putting asymptomatic women at risk of developing incontinence, prolapse or other pelvic floor muscle dysfunction.”

Pelvic floor exercises, not Pilates, for strengthening the pelvic floor

A new study highlights the need to regularly perform specific pelvic floor muscle exercises to ensure ongoing good pelvic floor function.

Researchers at Brazil’s Federal University of Rio Grande do Sul tested the theory that pelvic floor fitness could be improved through the practice of Pilates, a form of exercise that strengthens and improves the control of the core muscles, including the pelvic floor muscles.

Two groups of 30 women were tested, with one group doing Pilates at least twice a week and the other group not doing any exercise. The women were aged 20-40 years old, childless, in a healthy weight range and without any pelvic floor dysfunction.

Test results, published in January’s International Urogynecology Journal, found there was no significant difference in the functionality of the pelvic floor muscles in women who did the Pilates, and those who did not exercise.

The findings support the assertion by pelvic floor health specialists that regular performance of specific pelvic floor muscle exercises is the most effective way of improving pelvic floor function, which is vital for maintaining bladder and bowel control.

First appeared in Bridge Winter 2016 edition

References available on request.

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The Continence Foundation of Australia is the national peak body promoting bladder
and bowel health.

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