Effectiveness of Pelvic Floor Muscle Training in Preventing Urinary Incontinence After Vaginal Delivery: A Systematic Review

Abstract

Urinary incontinence (UI) is a common issue among women after vaginal delivery and can have various impacts on daily life. Pelvic floor muscle training (PFMT) is often used as a preventive intervention, although its effectiveness has shown mixed results in research. This systematic review evaluates the effectiveness of PFMT in preventing UI after vaginal delivery by synthesizing evidence from randomized controlled trials (RCTs). Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines, multiple databases were searched for relevant RCTs published before May 2025. Eight studies met the inclusion criteria and were assessed for risk of bias using the Cochrane risk of bias assessment tool 2 (RoB 2). Due to methodological differences, data were narratively synthesized. Overall, PFMT showed benefits in reducing UI and improving quality of life, particularly when delivered with structured support. However, some studies reported no significant effects. Adherence emerged as an important factor influencing outcomes. Most studies had a low risk of bias, though feasibility trials showed higher risks. PFMT appears to be a promising approach for preventing postpartum UI, especially with supervised or technology-assisted protocols. Further research is needed to standardize interventions, ensure long-term follow-up, and evaluate implementation across various healthcare settings.