for training the pelvic floor muscles to treat urinary stress incontinence in women.
Leaking urine when coughing, sneezing, or exercising (stress urinary incontinence) is a common problem for women. This is especially so after giving birth, when about one woman in three will leak urine. Training of the pelvic floor muscles is the most common form of treatment for this problem. One way that women can train these muscles is by inserting cone-shaped weights into the vagina, and then contracting the pelvic floor muscles to stop the weights from slipping out.
Seventeen small studies, involving 664 women were done. The results of these studies consistently showed that the use of vaginal weights is better than having no treatment. When vaginal weights were compared to other treatments, such as pelvic floor muscle training without the weights, and electrical stimulation of the pelvic floor, no clear differences between the treatments were evident. This may have been because the numbers of participants in the trials were small, and larger numbers may be required for any differences in the effectiveness of treatments to become clear.
Urinary continence is maintained when the urethral resistance (pressure) is greater than the intravesical pressure. Genuine stress incontinence occurs when pressure transmission to the urethra is compromised by poor anatomic support of the proximal urethra resulting from weakened pelvic floor musculature and/or defective endopelvic fascia. While the gold standard for treatment of genuine stress incontinence is still considered to be surgical, there is renewed interest among both patients and surgeons for non surgical (conservative) management. The goal of conservative therapy is to re strengthen and retrain the pelvic floor muscles to improve urethral pressure transmission and thus improve the continence mechanism.
With growing clinic and surgical waiting lists and rising hospital costs, weighted vaginal cones, is objectively proven to be a comparably effective alternative to physiotherapy, will offer an effective management option for stress incontinence, thus, perhaps avoiding referral to a tertiary hospital for physiotherapy, and surgery.
While women exercise with cones step by step, from lighter to heavier, the compliance and strength of muscles are increased. Incontinent women may avoid complaining of urine loss because of fear of surgery, therefore, providing non-surgical methods of treatment like pelvic floor exercise and aids to patients could help them, especially those with mild and moderate stress incontinence.
