Who will benefit from pelvic floor muscle training for stress urinary incontinence?

Objective: The purpose of this study was to determine which patient characteristics are predictive of outcome before pelvic floor muscle training for stress urinary incontinence.
Study design: This was an observational study at a single-center outdoor patient clinic in Brussels, Belgium, that comprised 447 women, aged 26 to 80 years (mean, 52.7 years), who had urinary stress incontinence. All the women received individual pelvic floor muscle training under the guidance of the same physiotherapist. Twenty-two patient characteristics were considered for outcome measurements.

Results: Forty-nine percent of the women considered their treatment to be successful; 51% of the women had experienced only some improvement, no change, or a worsening of their condition or had interrupted therapy. Three independent predictors of treatment failure were greater than or equal to2 leakages per day before treatment (P <.0001), the chronic use of psychotropic medication (P = .002), and a baseline positive stress test result at first cough (P = .042). The odds were only 15% for an individual patient to be treated successfully when these 3 predictors were present.

Conclusion: Pelvic floor muscle training is beneficial in one half of the patients who are treated in this manner. Two or more leakages per day at baseline and the chronic use of psychotropic medication significantly predicted therapy failure.