The Experience of People With Urinary Incontinence Using Invasive Devices in Pelvic Floor Muscle Training: A Qualitative Study

Abstract

Background and Purpose: Pelvic floor muscle training (PFMT) is a first-line conservative treatment for urinary incontinence (UI), often involving invasive devices such as vaginal or anal biofeedback. However, these devices can cause discomfort, negatively impacting PFMT engagement. We aimed to explore the experiences of individuals with UI regarding the use of invasive devices during PFMT. Methods: A qualitative study was conducted using semi-structured interviews. Participants were recruited through purposive sampling and interviews were conducted online. Data were analysed using Reflexive Thematic Analysis. Results: Fourteen participants (50% women; 50% men; age: 58 ± 17 years) who underwent PFMT involving invasive devices were interviewed. Four themes were generated: (1) ‘A Tool for Pelvic Floor Muscles: From Obligation to Acceptance’ as participants initially expressed discomfort and anxiety, which gradually evolved into acceptance. (2) ‘Building Trust Through Gradual Exposure and Tailored Guidance’ since supportive, patient-centred communication and gradual exposure were key elements to alleviating discomfort. (3) ‘A Compact Trainer for PFMT’ since devices enhanced pelvic floor muscle awareness and self-management through biofeedback, fostering independence and adherence. (4) ‘”Users” Needs: Privacy, Accessibility, Usability, and Autonomy’ emphasising barriers like lack of privacy, high costs, and need for user-friendly designs to enhance accessibility and integration into daily life. Discussion: The study highlights the journey of individuals using invasive devices during PFMT: from discomfort to acceptance. Gradual introduction, empathetic communication, and tailored rehabilitation approaches by physiotherapists seemed to improve user engagement and adherence with the devices. Participants emphasised the need for accessible, user-friendly devices to overcome logistical and psychological barriers.