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Pelvic Floor Physical Therapy Technique Reduces Overactive Bladder Symptoms: Presented at AUGS

By Cheryl Lathrop

PROVIDENCE, RI -- September 19, 2011 -- Patients with overactive bladder who completed a short course of pelvic floor physical therapy (PFPT) with myofascial release techniques experienced a significant reduction in urinary urge and frequency symptoms, and avoided the use of medications and more invasive therapies.

Findings were presented here September 15 at the 32nd Annual Scientific Meeting of the American Urogynecologic Society (AUGS).

Sonia R. Adams, MD, Division of Urogynecology, Department of Obstetrics and Gynecology, Mount Auburn Hospital, Cambridge, Massachusetts, and colleagues analysed data from 29 women presenting with overactive bladder and painful bladder syndrome symptoms.

Symptom improvement was assessed by subjective measures of improvement as well as by using validated questionnaires, such as the Pelvic Floor Distress Inventory-Short Form 20 and the Patient Global Impression of Improvement (PGI-I).

After physician evaluation, participants underwent PFPT for 1 to 2 visits weekly for 10 weeks.

PFPT was performed using myofascial release techniques for >50% of the therapy. The therapist palpated the pelvic floor musculature looking for trigger points or other areas of tight/painful tissue. Trigger-point release was performed using manual techniques like direct pressure, strumming, and sustained stretch.

Patients were also educated about pelvic anatomy and function, dietary/fluid modifications, urge suppression techniques, and exercises/stretches to facilitate pelvic floor muscle release and coordination.

Women attended a median of 14.5 PT visits over a median of 11.9 weeks.

The number of voids per day was reduced from 11/day to 8/day post-PFPT. Women also experienced a significant reduction in urgency and frequency symptoms.

The PGI-I rating after PFPT was a little worse (4%), a little better (32%), much better (48%), and very much better (18%).

Participants’ primary diagnoses were painful bladder (34%), overactive bladder (31%), urge-dominant mixed incontinence (28%), and urge incontinence (7%). Eight (27.6%) patients had comorbid chronic pain diagnoses.

The researchers noted that patient motivation or logistic factors might play a role in the success of this treatment modality. They also say that additional research is needed to take into account patient compliance, optimum treatment length, and long-term efficacy.

[Presentation title: Pelvic Floor Physical Therapy as Primary Treatment of Overactive Bladder and Painful Bladder Syndromes. Abstract 98]

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