DOI QR코드

DOI QR Code

Effect of Kegel Exercise to Prevent Urinary and Fecal Incontinence in Antenatal and Postnatal Women: Systematic Review

임신 및 출산 여성의 요실금 및 대변실금 예방을 위한 케겔운동의 효과: 체계적 문헌 고찰

  • Park, Seong-Hi (School of Nursing, Pai Chai University) ;
  • Kang, Chang-Bum (Research Development Team, Korea Health Promotion Foundation) ;
  • Jang, Seon Young (Office of Quality Improvement, Severance Hospital, Yonsei University Health System) ;
  • Kim, Bo Yeon (Health Insurance Review and Assessment Service)
  • 박성희 (배재대학교 간호학과) ;
  • 강창범 (한국건강증진재단 연구개발팀) ;
  • 장선영 (세브란스병원 적정진료관리실) ;
  • 김보연 (건강보험심사평가원)
  • Received : 2013.01.23
  • Accepted : 2013.05.17
  • Published : 2013.06.30

Abstract

Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

Keywords

References

  1. Bo, K., & Haakstad, L. A. (2011). Is pelvic floor muscle training effective when taught in a general fitness class in pregnancy? A randomised controlled trial. Physiotherapy, 97(3), 190-195. http://dx.doi.org/10.1016/j.physio.2010.08.014
  2. Boyle, R., Hay-Smith, E. J., Cody, J. D., & Mokved, S. (2012). Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, 10, CD007471. http://dx.doi.org/10.1002/14651858.CD007471.pub2
  3. Chiarelli, P., & Cockburn, J. (2002). Promoting urinary continence in women after delivery: Randomised controlled trial. BMJ: British Medical Journal, 324(7348), 1241. https://doi.org/10.1136/bmj.324.7348.1241
  4. Chiarelli, P., Murphy, B., & Cockburn, J. (2004). Promoting urinary continence in postpartum women: 12-month follow-up data from a randomised controlled trial. International Urogynecology Journal and Pelvic Floor Dysfunction, 15(2), 99-105; discussion 105. http://dx.doi.org/10.1007/s00192-004-1119-y
  5. Choi, J. B. (2010). Urinary incontinence in women. Korean Journal of Family Medicine, 31(9), 661-671. http://dx.doi.org/10.4082/kjfm.2010.31.9.661
  6. Choi, M. H., Kim, H. K., Kim, T. E., Lee, J. Y., Chung, D. Y., Shin, J. I., et al. (1995). The effects of pregnancy and delivery on stress urinary incontinence. Korean Journal of Obstetrics and Gynecology, 38(9), 1572-1576.
  7. Glazener, C. M., Herbison, G. P., MacArthur, C., Grant, A., & Wilson, P. D. (2005). Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: Six year follow up. BMJ: British Medical Journal, 330(7487), 337. http://dx.doi.org/10.1136/bmj.38320.613461.82
  8. Glazener, C. M., Herbison, G. P., Wilson, P. D., MacArthur, C., Lang, G. D., Gee, H., et al. (2001). Conservative management of persistent postnatal urinary and faecal incontinence: Randomised controlled trial. BMJ: British Medical Journal, 323(7313), 593-596. https://doi.org/10.1136/bmj.323.7313.593
  9. Hay-Smith, E. J., Bo Berghmans, L. C., Hendriks, H. J., de Bie, R. A., & van Waalwijk van Doorn, E. S. (2001). Pelvic floor muscle training for urinary incontinence in women. Cochrane Database of Systematic Reviews(1), CD001407. http://dx.doi.org/10.1002/14651858.cd001407
  10. Higgins, J. P. T., & Green, S. (2011). Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration. Retrieved March 30, 2011, from www.cochrane-handbook.org
  11. Hong, J. Y. (1997). The efficacy of pelvic floor muscle exercise in patients with genuine stress incontinence. Korean Journal of Urology, 38(6), 639-643.
  12. Hwang, J. S., Park, T. H., Kim, D. K., Kang, M. A., Kim, S. M., Bae, C. S., et al. (1998). The prevalence of female urinary and fecal incontinence. Korean Journal of Obstetrics and Gynecology, 41(6), 1552-1559.
  13. Jeong, N. O. (2009). Effects of an incontinence prevention program on postpartum women. Korean Journal of Women Health Nursing, 15(3), 177-185. http://dx.doi.org/10.4069/kjwhn.2009.15.3.177
  14. Kim, K. S., & Suh, M. J. (1997). A study on prevalence and its relating factors of urinary incontinence in women. Journal of Korean Academy of Fundamentals of Nursing, 4(1), 73-85.
  15. Kim, S. Y., & Park, J. S. (2000). The effect of pelvic muscle exercise program on women with stress urinary incontinence in the degree and amount of urinary incontinence and maximum vaginal contraction pressure. Journal of Korean Academy of Adult Nursing, 12(2), 267-277.
  16. Ko, P. C., Liang, C. C., Chang, S. D., Lee, J. T., Chao, A. S., & Cheng, P. J. (2011). A randomized controlled trial of antenatal pelvic floor exercises to prevent and treat urinary incontinence. International Urogynecology Journal, 22(1), 17-22. http://dx.doi.org/10.1007/s00192-010-1248-4
  17. Lee, K. S., & Lee, Y. S. (2007). Pharmacological therapy for urinary incontinence. Journal of the Korean Medical Association, 50(11), 1025-1036. http://dx.doi.org/10.5124/jkma.2007.50.11.1025
  18. Lemos, A., de Souza, A. I., Ferreira, A. L., Figueiroa, J. N., & Cabral-Filho, J. E. (2008). Do perineal exercises during pregnancy prevent the development of urinary incontinence? A systematic review. International Journal of Urology, 15(10), 875-880. http://dx.doi.org/10.1111/j.1442-2042.2008.02145.x
  19. Mokved, S., & Bo, K. (1997). The effect of postpartum pelvic floor muscle exercise in the prevention and treatment of urinary incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction, 8(4), 217-222.
  20. Mokved, S., & Bo, K. (2000). Effect of postpartum pelvic floor muscle training in prevention and treatment of urinary incontinence: A one-year follow up. BJOG: An International Journal of Obstetrics and Gynaecology, 107(8), 1022-1028. https://doi.org/10.1111/j.1471-0528.2000.tb10407.x
  21. Mokved, S., Bo, K., Schei, B., & Salvesen, K. A. (2003). Pelvic floor muscle training during pregnancy to prevent urinary incontinence: A singleblind randomized controlled trial. Obstetrics and Gynecology, 101(2), 313-319. https://doi.org/10.1016/S0029-7844(02)02711-4
  22. Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Annals of Internal Medicine, 151(4), 264-269, W264.
  23. Mon, Y. J., Lim, H. S., Jung, J. E., Cho, H. H., Kim, M. R., Lew, Y. O., et al. (2007). The effects of the number of normal vaginal deliveries to the function of low urogenital system. Korean Journal of Obstetrics and Gynecology, 50(4), 638-644.
  24. Reilly, E. T., Freeman, R. M., Waterfield, M. R., Waterfield, A. E., Steggles, P., & Pedlar, F. (2002). Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: A randomised controlled trial of antenatal pelvic floor exercises. BJOG: An International Journal of Obstetrics and Gynaecology, 109(1), 68-76. https://doi.org/10.1111/j.1471-0528.2002.t01-1-01116.x
  25. Sampselle, C. M. (2000). Behavioral intervention for urinary incontinence in women: Evidence for practice. Journal of Midwifery & Women's Health, 45(2), 94-103. https://doi.org/10.1016/S1526-9523(99)00016-1
  26. Sleep, J., & Grant, A. (1987). Pelvic floor exercises in postnatal care. Midwifery, 3(4), 158-164. https://doi.org/10.1016/S0266-6138(87)80035-9
  27. Taskin, O., Wheeler, J. M., Yalcinoglu, A. I., & Coksenim, S. (1996). The effects of episiotomy and kegel exercises on postpartum pelvic relaxation: A prospective controlled study. Journal of Gynecologic Surgery, 12(2), 123-127. https://doi.org/10.1089/gyn.1996.12.123
  28. Thomason, A. D., Miller, J. M., & Delancey, J. O. (2007). Urinary incontinence symptoms during and after pregnancy in continent and incontinent primiparas. International Urogynecology Journal and Pelvic Floor Dysfunction, 18(2), 147-151. http://dx.doi.org/10.1007/s00192-006-0124-8
  29. Wall, L. L., & Davidson, T. G. (1992). The role of muscular re-education by physical therapy in the treatment of genuine stress urinary incontinence. Obstetrical and Gynecological Survey, 47(5), 322-331. https://doi.org/10.1097/00006254-199205000-00015
  30. Wilson, P. D., & Herbison, G. P. (1998). A randomized controlled trial of aelvic floor muscle exercise sto treat, postnatal urinary incontinence. International Urogynecology Journal and Pelvic Floor Dysfunction, 9(5), 257-264. https://doi.org/10.1007/BF01901501
  31. Woldringh, C., van den Wijngaart, M., Albers-Heitner, P., Lycklama à Nijeholt, A. A., & Lagro-Janssen, T. (2007). Pelvic floor muscle training is not effective in women with UI in pregnancy: A randomised controlled trial. International Urogynecology Journal and Pelvic Floor Dysfunction, 18(4), 383-390. http://dx.doi.org/10.1007/s00192-006-0175-x
  32. Yoo, E. H. (2006). Pelvic floor muscle rehabilitation. Korean Journal of Obstetrics and Gynecology, 49(9), 1838-1843.
  33. Yoo, Y. J., & Lee, E. J. (1999). A study on the nursing needs and satosfactions of early postpartum women. Journal of Korean Academy of Women's Health Nursing, 5(3), 389-409.

Cited by

  1. 농촌거주 여성의 변실금과 우울 vol.25, pp.3, 2013, https://doi.org/10.12799/jkachn.2014.25.3.198
  2. Effects of Prenatal Perineal Massage and Kegel Exercises on the Integrity of Postnatal Perine vol.7, pp.4, 2013, https://doi.org/10.4236/health.2015.74059
  3. Faecal incontinence: Current knowledges and perspectives vol.7, pp.1, 2013, https://doi.org/10.4291/wjgp.v7.i1.59
  4. Vaginal hyperlaxity syndrome: a new concept and challenge vol.34, pp.5, 2018, https://doi.org/10.1080/09513590.2017.1418312
  5. Predictors of pelvic muscle exercise on the self‐efficacy of women giving birth vol.14, pp.2, 2013, https://doi.org/10.1111/ijun.12234
  6. Effects of yoga on the intervention of levator ani hiatus in postpartum women: a prospective study vol.33, pp.11, 2013, https://doi.org/10.1589/jpts.33.862
  7. What Is Fecal Incontinence That Urologist Need to Know? vol.25, pp.1, 2021, https://doi.org/10.5213/inj.2040240.120
  8. Development of an exercise attitude scale in Turkish for pregnant women: validity and reliability vol.61, pp.9, 2013, https://doi.org/10.1080/03630242.2021.1979166