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Pelvic floor therapy, such as kegel exercises, has been regarded as the first line of treatment for stress urinary incontinence (SUI). Surgery is often the last resort when all other treatment options have been explored. However, findings from a new Dutch study have shown that sling surgery offered better results for women with stress incontinence.
The study, led by Julien Labrie, MD, of University Medical Centre Utrecht in the Netherlands, was published in the New England Journal of Medicine.
Participants included 460 women with moderate-to-severe SUI. Half were randomly assigned to undergo midurethral-sling surgery, and the other half received physiotherapy. Some participants dropped out, and in the end, 174 women from the surgical group and 196 women from the physiotherapy group were available for a one-year follow up.
At around 32 weeks, nearly half of those in the initial physiotherapy crossed over to the alternative treatment (surgery), while only 11.2% of the surgery group started pelvic muscle training. After one year, 90.8% of women in the initial surgery group fared better results compared with 64.4% of those who received pelvic floor therapy first. An analysis showed that those who crossed over to the surgery group had similar outcomes to women who were initially assigned to the surgery group.
“Our findings suggest that women with this condition should be counseled regarding both pelvic-floor muscle training and midurethral-sling surgery as initial treatment options,” the researchers concluded.
Despite these findings, National Incontinence encourages women suffering from stress urinary incontinence to contact their doctor to discuss all possible treatment options, including biofeedback training and bladder retraining, before undergoing surgery. Results will vary from person to person – kegel exercises may work wonders for some, while others may find them ineffective.