Purpose: The purpose of this case study and evidence-based analysis is to determine if pelvic floor muscle exercise (PFME) with electrical stimulation (ES) is more effective than pelvic floor muscle exercise alone to improve urinary incontinence (UI) for women in their 60s with pelvic floor dysfunction. Background: Urinary incontinence is the involuntary loss of urine. It is a diagnosis and symptom that can prevent people from participating in social events due to the embarrassment, urine odors, and other personal reasons. In the physical therapy setting, there are several methods to treat UI such as diet and behavioral modifications, pelvic floor muscle exercises, biofeedback, vaginal cones, and electrical stimulation. The most efficacious physical therapy treatment for urinary incontinence is essential to find in order to treat patients, especially in clinics that have few physical therapists who specialize in gender health. Case Description: Patient is a 61-year-old gravida 2 para 2 Caucasian female 4 months status post a resection rectopexy, who was referred to outpatient physical therapy for incontinence with primary complaints of urgency and significant pelvic floor weakness. She presented with mixed urinary incontinence and no longer had complaints of fecal incontinence or constipation since resection rectopexy. Outcomes: The patient had some improvements by the fourth appointment with a decrease in urge and decrease in leaks, which may be attributed to patient education, reduction in diet coke intake, and pelvic floor muscle stretching. Stretching of the pelvic floor muscles was the initial treatment to improve the length of the muscles for an optimal muscle contraction. A formal pelvic floor muscle exercise program nor electrical stimulation was used as interventions because the patient did not return to physical therapy after the fourth appointment. Discussion: There is minimal research that compares or combines pelvic floor muscle exercise and intravaginal electrical stimulation as methods to treat women with urinary incontinence. Studies on electrical stimulation have mixed results, which may be due few high quality studies. There are copious studies and systematic reviews that indicate pelvic floor muscle training (PFMT) is an effective intervention for urinary incontinence of all types. Adding ES to PFME may have positive benefits to some patients, but should be considered on a case by case basis. At this point, there is lack of evidence to support that there is a difference between pelvic floor muscle exercise with or without electrical stimulation to improve urinary incontinence. More research needs to be done to assess whether adding electrical stimulation to pelvic floor muscle exercise is more efficient than pelvic floor muscle exercise alone for treating urinary incontinence, if it can be generalized to all types, or if it is limited to one form of urinary incontinence.
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Chaves, Felicia. "Pelvic Floor Dysfunction and Urinary Incontinence: A Comparison of Pelvic Floor Exercise with Electrical Stimulation to Pelvic Floor Exercise Alone." (2015). http://digitalrepository.unm.edu/dpt/115
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