MANAGING FEMALE STRESS URINARY INCONTINENCE IN DEVELOPING WORLD – A RANDOMIZED CONTROL TRIAL ON EVALUATION OF SUPERVISED AND UNSUPERVISED PELVIC FLOOR MUSCLE TRAINING
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Abstract
Introduction: Stress urinary incontinence is a common condition affecting women, often underreported in developing countries. Pelvic Floor Muscle Training is the first-line treatment. Supervised PFMT showing better outcomes compared to unsupervised, home-based PFMT. Objective: This study compares the effectiveness of both approaches in improving SUI symptoms and pelvic floor muscle strength. Material & Methods: A randomized controlled trial was conducted at a Tertiary care center, from June 2023 to December 2024. Sixty women with confirmed SUI were randomly assigned to supervised PFMT (Group A) or unsupervised PFMT (Group B). The primary outcome was the reduction in urinary leakage, measured by the pad test. Secondary outcomes included pelvic floor muscle strength, urinary symptoms, and patient satisfaction. Results: Group A showed a significant reduction in leakage, with the pad test decreasing from 22.89 grams to 3.24 grams (p < 0.001), compared to Group B, which reduced from 25.71 grams to 17.82 grams (p = 0.07). Group A also demonstrated a greater improvement in pelvic floor strength, with 66.7% reaching Oxford grades 4-5 versus 13.3% in Group B (p = 0.023). A significant difference in daily leak episodes was observed, with Group A reducing from 7.63 to 1.69 compared to 8.88 to 7.75 in Group B (p < 0.001). Conclusion: Supervised PFMT is more effective than unsupervised PFMT in treating SUI. However, unsupervised PFMT remains a feasible alternative in resource-limited settings when patients adhere to the regimen. Keywords: Stress urinary incontinence, pelvic floor muscle training, urinary leakage.
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Stress urinary incontinence, pelvic floor muscle training, urinary leakage
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