Pelvic floor findings in urinary incontinence - Results of conditioning using vaginal cones

Abstract

Background. Conservative treatment of urinary incontinence (UI) may be more reliable if it is associated with improved testing of pelvic floor function. The results of cone training in patients and healthy controls are compared. Methods. Voluntary contractions of pelvic floor muscles in 16 women with genuine stress incontinence, 14 with mixed stress/urge incontinence, and eight healthy controls were assessed by digital transvaginal palpation, manometry, and inspection using the so-called speculum-lift test. In addition, the capability to hold vaginal cones was investigated. All examinations were done before and after four-week cone training (Femcon® 20-70 g). Results. Prior to cone training, no pelvic floor response was recordable from eight women (27%) by palpation and from seven women (23%) by inspection. After training, contractions were restored in all women. The best post-training results were obtained by palpation (27 positive responses), followed by manometry (25 women, 83%), and speculum-lift test (13 women, 43%). The capability to hold vaginal cones was also improved. Initial weights in 15 UI patients (50%) were lower (cone No. 1-2) than in eight healthy women (cone No. 5). Average contractility increased from 5 to 9.7 mmHg in patients and from 17.5 to 23.1 mmHg in healthy women. Twenty-four patients (80%) were cured (57%) or improved (23%). Twenty-six asked for continuation of cone training. Conclusions. Pelvic floor conditioning with vaginal cones is a good alternative to poor acceptance or insufficient availability of conventional exercises.