Impact of kegel's exercise. elmagla.egy2010@yahoo.

com

Impact of kegel's exercise on reducing post group that realized exercises presented less
partum stress urinary incontinence. incontinence. The overall prevalence of SUI
1 1
Entisar M. Youness , Eman R. Ahmed , at the first week postpartum was 21% (42 of
1
Ghadah A. Mahmoud ,& Safwat Abdel- 200) and 19.5% (39 out of 200) of the
2
Rady Mohammad . intervention and control groups respectively
1
Department of Obstetrics and with no statistical significant difference
Gynecological Nursing, Faculty of Nursing, between groups. Stress urinary incontinence
2
Assuit University, Department of rate at 6-weeks postpartum was 8% and
Obstetrics and Gynecological Medicine, 12.5% of the intervention and control groups
Faculty of Medicin , Assuit University respectively with a highly statistical
,Egypt. significant difference P=0.002. At 12- weeks
postpartum the rate of SUI was (1%) and (9%)
ABSTRACT: of the intervention and control groups with a
Introduction: There is good evidence that highly statistical significant difference
vaginal delivery can be associated with P=0.0005.
damage to the innervations of the pelvic floor
as well as direct trauma to levator ani muscle Conclusion: Performance of Kegel's exercise
and endo-pelvic fascia. This may result in the seems to reduce the likelihood of stress
development of genuine stress incontinence. urinary incontinence.
Postpartum stress incontinence can occur in
up to 34% of women. Keywords: Pelvic floor exercises;
Postpartum; Stress urinary incontinence
Aim of the study was to assess the effect of
postpartum women's training with Introduction:
reinforcement of pelvic floor muscles exercise Urinary incontinence in women is one of the
on reduction and improvement of postpartum most common pelvic floor disorders
stress urinary incontinence. associated with giving birth. It is defined by
the International Continence Society as the
Research design: Quasi-experimental design complaint of any involuntary leakage of urine.
was utilized in this study. It can result from a variety of different
conditions and it is useful to classify them
Subjects and methods: A total of 440 accordingly. The most common type of
postpartum women were recruited for this urinary incontinence in women is stress
study according to power analysis, they were [1]
incontinence .
divided into two groups. 220 women were Childbearing is an established risk
allocated for the intervention group and given factor for urinary incontinence among young
an instructional schedule for performing and middle-aged women. It has been
kegel's exercise from the first day postpartum suggested that vaginal delivery is the main
up to 3 months , about 10% of participants contributing factor, possibly because of
were lost to follow-up. The control group damage to important muscle tissue or nerves.
didn't have any information about kegel's However, pregnancy itself may cause
exercise( had the ordinary postpartum mechanical changes, hormonal changes, or
instructions). Both groups were followed-up [1]
both that can lead to urinary incontinence .
to assess the presence of stress urinary Stress urinary incontinence is a
incontinence at the first week, 6-week and 12- problem that affects many women after
week postpartum. childbirth. In the immediate postnatal period
(less than 14 days after delivery) about 22.7%
Results: Findings of this study presented that, of all women complain of some degree of
there were statistically significant differences stress incontinence. Having any kind of
between both groups regarding the presence vaginal delivery carries a higher risk of
of stress urinary incontinence, that is, the
42
Jan. 2012
Impact of kegel's exercise. postnatal incontinence compared with having
[2]
caesarean section .
 [email protected]
Surveys of women more than 3months after
delivery have shown that about one in five squeeze of the pelvic floor. The number of
women report experiencing stress contractions recommended across studies
[3]
incontinence during the first postnatal year . ranges from 8-12 contractions three times a
day, to 20 contractions four times a day, to
Pregnancy and vaginal delivery are many as 200 contractions per day. The
known to be associated with damage to the duration of 'squeeze and hold' , or contraction,
pelvic floor innervations, direct trauma to the varies in published studies from 4s to 30-40s.
levator ani muscles and endopelvic fascia by Author Kegel is the founder of contemporary
way of stretching or tearing. It has been pelvic floor exercises[7]. In addition to the
observed that bladder neck mobility is
treatment of incontinence, pelvic floor
worsened following vaginal births and this is
exercises may be suggested during the
postulated to be the cause of urinary stress
incontinence secondary to parturition. A study postnatal period as a preventative measure [8].
[4]
by Van Brummen et al . showed that the The recommended posture of kegel's
antenatal development of stress incontinence exercise to be adopted during the prescribed
lead to an 18-times higher risk of developing exercise regimen also varies and includes
stress incontinence during the year following
sitting, kneeling, standing, lying down and
child birth, and that this was most prevalent in
[4] standing with legs astride. The recommended
the group that delivered vaginally . duration of the prescribed regimen varies
The pelvic floor consists of group of widely, from one week to six months, with
12 striated muscles arranged in 3 layers. This three months being most frequently
muscular plate expands from pubic symphysis recommended [9].
to the side walls of the ileum towards the Kegel's exercises have many
coccyx. The striated muscle fibers of each advantages as no side effects, non-invasive ,
muscle run in the same direction in each patient participation and motivation. Pelvic
muscle but in different direction of the other floor exercises are most effective with persons
muscles of the pelvic floor group. However,
who have SUI but can also be effective in
when the pelvic floor contracts it is always en
persons with urge incontinence. Researchers
masse, moving the pelvic girdle in one
[5] working with varied populations have
direction . The only known voluntary reported an average of 70% improvement in
function of the pelvic floor muscle group is a SUI after 4 to 6 weeks of intensive, daily
mass contraction, best described as an inward pelvic floor muscle exercises[10].
lift and squeeze around the urethera, vagina
and rectum. The function of pelvic floor Aim of the study is:
muscles is to lend structural support to the To assess the effect of postpartum
pelvic structures, the urethera, vagina and women's training with reinforcement of pelvic
[6]
rectum . floor muscles exercise on reduction and
The pelvic floor muscle training improvement of postpartum stress urinary
involves the repetitive contraction of the incontinence.
pelvic floor muscle, which builds strength and
perineal support, and improves muscle tone. Subjects and Methods:
As the pelvic floor is entirely composed of Research Design: Quasi-experimental
striated muscle, the principles of strength design was utilized in this study.
training for striated muscle should be
followed when attempting to tone and Setting:
strengthen the pelvic floor. The movement is The study was conducted at
a voluntary inward and upward contraction or postpartum ward, Obstetrics Department,
Woman's Health Center, Assuit University
Jan. 2012 Hospital, Egypt.
This study was conducted in a tertiary
care obstetrical hospital with approximately
43
Impact of kegel's exercise. 8500 vaginal deliveries each year. Between
January 2010 and September 2010; parturient
women were invited to enrolled in this study.
These women were recruited during labor . [email protected]
Inclusion criteria were any parity, no history
of urinary tract abnormalities or pelvic Questionnaire:
surgery, no significant medical illness, and no Data were collected using an
medication that would alter urinary tract interview questionnaire that was designed by
function. The power analysis, based on a the researchers to collect the necessary data. It
predicted stress urinary incontinence rate of based on review of related literature and
10% for postpartum incontinence indicated reviewed by experts from Obstetrics and
that 440 women must completed the study. Gynecological nursing and medical related
Considering the mobility patterns of today's specialists. The questionnaire was
population, we anticipated that about 10% of compromised of three parts. The first part was
participants would be lost to follow-up. designed to investigate women's of both
Twenty –three women were lost to follow – groups regarding demographic characteristics,
up. Thus ,417 women completed the 6-week obstetric history: age, education status,
follow-up. Between completion of the 6-week occupation and parity status. The second part
follow-up and 12-week follow-up, 17 women was planned to determine the presence of SUI
were lost to follow-up , resulting in a study using the question '' Do you have any urinary
sample of 400 women in the two groups. leakage during your daily activities, cough or
Subjects: sneezing etc., symptoms, episodes and grades
Participants were 440 women, aged 18-42 of SUI. The third part is the part of follow-up
years, who had immediate vaginal deliveries. which included reminding the women at least
Subjects of this study will be divided into two once a week by telephone to practice the
main groups. pelvic floor exercise and the data about the
Group (A): presence of SUI at the first week, 6-week and
The intervention group : It is consisted of after 12- weeks postpartum, its symptoms if
220 post-partum women who learned to present, episodes and severity. Data collection
perform Kegel's exercise during post partum took place within 6 months from 1/1/2010 to
period from the first day post partum up to the 30/6/2010. Follow up of the cases end in
third month post partum. The women were 30/9/2010.
interviewed in their rooms on postpartum
ward and followed up by telephone at the end Content Validity:
of first week, 6 weeks, and 12 weeks It was established by panel of 5 experts from
postpartum . These women also given an Obstetrics and Gynecological nursing and
educational pamphlet and written instructions medical related specialists and review of
about how to do kegel's exercise. related literature for clarity, relevance,
comprehensiveness, understanding,
Group (B) : applicability and easiness.
The control group: It is consisted of 220
post-partum women. Women of this group Pilot Study: A pilot study was conducted on
followed the ordinary written postpartum 10% of the studied women(44 postpartum
instructions from the Woman's Health Center women) to test feasibility of tools and time
and not receive any information about Kegel's required to be applied. Simple modification
exercise and checked for stress urinary was done of some items of the interview
incontinence by the end of first week, 6 weeks questionnaire and the assessment sheet that
and 12 weeks postpartum by telephone. they were not consistent with this study.

Administrative design:
Official letters clarifying the purpose and
setting of the study were obtained from the
Jan. 2012 Dean of Faculty of Nursing at Assuit
University and the director of Woman's Health
Center, Assiut University Hospitals,
requesting their approval for data collection.
44
Impact of kegel's exercise. The study was conducted through the
following phases:
1-Interviewing phase:
The investigator interviewed the women, an [email protected]
explanation of the nature and the purpose of
the study was done, then a verbal consent and afternoon and at night. The woman will be
a complete personal and obstetrical history informed that performing Kegel's exercises
were taken. Personal data included socio- should take as long as three months (12
demographic characteristics such as age, weeks). Each woman in the intervention
residence, occupation, educational level and group was given a household card including
telephone number. Obstetrical history such as the benefits of practicing Kegel's exercises,
parity and gravidity status, mode of last time of doing it, the duration and frequency of
delivery , place of last delivery and Current the exercise, and a structured schedule of the
obstetrical history . The investigators filled total period (12 weeks)to be checked in it
the interviewing questionnaire form while performing the exercise( for women
individually and assured that confidentiality who are illiterate, we instructed them to make
was maintained. someone read and check on it for them).

2-Assessment phase: There are general guidelines to ensure

The investigator asked the women about the women practicing Kegel's exercises:-
presence of postpartum stress urinary (1) Avoid exercising while urination, or
incontinence, and its symptoms and stopping to prevent voiding difficulties.
accordingly classifying the SUI into grades. (2) Emptying the bladder before beginning
exercises.
3-Intervention phase: (3) Keeping abdominal and thigh muscles
Every women in the intervention relaxed.
group was informed that Kegel's exercise is (4) Drawing muscles up and in not straining
very simple ,risk-free and painless. It involves down with the abdomen.
squeezing the pelvic floor muscles. It can be (5) Breath while holding muscles
done anytime and anywhere. The women contracted.
were be taught that the muscles she tightens (6) Trying to get the maximum tightening
are the muscles should contract during with each muscle contractions.
Kegel's exercise. The researchers did the (7) Trying contracting muscles in different
palpation test to teach the woman which positions e.g., while standing, sitting, lying
muscles to contract. Teaching was done with and with the feet together and
[11]
gloved fingers inserted into the vagina while apart(Caldecott,2006) .
asking the woman to contract the appropriate
muscles. The investigator was identify the 4-Follow up Phase:
correct muscle accurately to the women The researchers followed- up these women of
because some women initially have difficulty the intervention group and motivated them to
to identify them. They mistaken contract their perform the exercises through telephone calls
abdominal or thigh muscles instead of their by reminding the women with the benefits of
pelvic floor muscles. Kegel's exercises and motivating them to
perform exercises every day at regular times
The woman is instructed to tighten the to avoid forgetting it and make Kegel's
pelvic muscles for 3 seconds and then relaxes exercise a habit.
them for 3 seconds, repeating the Kegel's For both groups ,evaluating the presence of
exercises 10 to 15 times per session and doing stress urinary incontinence symptoms and
at least 3 sessions per day. To enhance the making the grades of it at the end of first
effect of these exercises, a typical regimen week, after 6 weeks and at the end of the 12-
starts with 15 contractions in the morning and week postpartum.

Jan. 2012 Definitions:

Stress Urinary Incontinence: Unintentional
loss of urine prompted by a physical
movement or activity such as coughing,

45
Impact of kegel's exercise. sneezing, or heavy lifting that puts pressure
[12]
(stress) on the bladder .
Stress Urinary Incontinence Grades [email protected]
[13]
according to (Sandvik,2000) .
Grade 0: Continent. women among the intervention and control
Grade 1: Loss of urine with sudden increase groups were multipara( 66% vs 64.5%)
in abdominal pressure, not in bed at night. respectively with no statistical significant
Grade 2: Incontinence worsens with lesser difference among both groups, P= 0.752.
degree of physical stress. About one –third of the studied women
Grade 3: Incontinence with walking, standing (28.5% vs 29%) of the intervention and
erect from sitting position or sitting up in bed. control groups respectively had vaginal
Grade 4:Total incontinence occurs and is lost delivery with episiotomy ,and minority of
without relation to physical activity or them had instrumental delivery(2.5% vs 2% )
position. of the intervention and control groups
respectively. Majority of the studied women
had previous hospital delivery of both groups.
Ethical consideration: As regards the data related to the incidence of
Confidentiality was obtained, data is only postpartum SUI, table (3) shows that, the
available to the researchers and the overall prevalence of immediate postpartum
participants. SUI in the intervention group was(21%) 42
out of 200,and (19.5%) in the control group
Statistical Analysis: 39 out of 200 with no statistical significant
Collected data were coded and analyzed. difference between both groups, P=0.803.
Descriptive statistics for the variables were Fortunately SUI rate at 6- weeks postpartum
calculated. Variables were compared using was 8% and 12.5% of the intervention and
chi-square test. The variables were significant control groups respectively with a statistical
at P value < 0.05. All the statistical analysis significant difference, P=0.002. After12-
was performed using SPSS package version 17. weeks postpartum the rate of SUI was 1% and
9% of the intervention and control groups
Results: with a highly statistical significant differences
Socio-demographic characteristics of the between them, P=0.0005.
studied women are summarized in table (1).
The mean age of the women were Table (4) shows the frequency of practicing
(25.50±5.042 and 24.93±4.034) years among Kegel's exercises among the intervention
the intervention and control groups group. It illustrates that 37% of the women
respectively with no statistical significant practiced the exercise more than 75% of the
difference between both groups. Regarding given schedule, 18% of the women practiced
the level of education, more than one quarter the exercise from 50% to less than 75%, 29%
of the sample were illiterate (29%vs 27%) of of the women practiced the exercise from
the intervention and control groups 25% to less than 50% and 16% of the women
respectively, on the other hand, secondary practiced the exercise less than 25% of the
education represented (36% vs 40% ) of the given schedule.
intervention and control groups respectively.
Majority of the studied women were Table (5) It points to the subjective
housewives (83% vs 84% ) and came from assessment of SUI after the intervention of
rural areas(74%vs 76%) of the intervention Kegel's exercises are displayed. It evident that
and control groups respectively with no there is an improvement of SUI after
significant difference. exercising and those who perform Kegel's
exercises sufficiently reported a great
Table (2): shows the obstetrical history of the improvement of SUI. It shows a statistically
studied women . It illustrates that most of the significant improvements in the rate of SUI
after the intervention. As regards the
Jan. 2012 prevalence of SUI after 12 weeks of
performing the exercise, this table noticed that
2 women only had persistent postpartum
46
Impact of kegel's exercise. SUI among the group who practiced the
exercise less than 25% of the given schedule.
This table proved the association between the
improvement of SUI with practicing Kegel's [email protected]
exercise.
women who had postpartum SUI had one
Classification of SUI into grades after episode per day , 5 out of 18(27.8%)had few
performing Kegel's exercises are summarized episodes per day and 9out of 18 (50%) had
in table (6). Stress urinary incontinence once a week episode of urinary leakage with a
Grade 1 incidence at the first week highly statistical significant difference
postpartum among intervention and control between groups, P= 0.0004.
group were (61.9% vs 41%) 26 out of 42 and
16 out of 39 respectively with no statistical
significant difference between groups. After
th
6 week, Grade 1 represents 11 of 16 (68.9%)
of the intervention group versus 15 out of 25
(60%) of the control group. Among women
complaining of SUI after 12 weeks
postpartum, 2 cases reported to have SUI
Grade 1 of the intervention group which may
be affected by performance of Kegel's
exercises for 3 months compared to 9 of 18
women Grade 1 of the control group , 6 of 18
Grade 2 also 2 of 18 Grade 3 and 1 of 18
Grade 4 with a highly statistical significant
differences between the two groups, P=0.03.

Table (7) shows the symptoms of postpartum

SUI. It illustrates that during the first week
postpartum, there is no significant difference
between the intervention and control groups
regarding postpartum SUI symptoms. At the
th
6 week postpartum there is no significant
difference among groups regarding the SUI
symptoms. Fortunately after 12-weeks
postpartum, it is obvious from this table that
the intervention group who received the
intervention as allocated showed reduction in
the symptoms of SUI with a highly statistical
significant difference, P=0.04.
Data pertaining to episodes of urinary leakage
among the studied women are presented in
table (8). It is obvious from this table that
episodes of urinary leakage shows no
significant differences among the intervention
and the control group at the first week
postpartum, P=0.806. After 12 weeks
postpartum the intervention group shows that
the 2 women who had SUI had once a week
episode of urinary leakage ,while the control
group shows that ; 4 out of 18(22.2%) of

Jan. 2012

47
Impact of kegel's exercise. [email protected]

Results:
Table(1): Socio-demographic characteristics of the studied women.

Intervention Control P-value

Group(200). Group(200).
Age (yr):
Mean ± SD 25.50± 5.042 24.93± 4.034 0.212

Education: 0.738
.Illiterate. 58(29%) 54(27%)
.Read & write. 4(2%) 8(4%)
.Basic education. 24(12%) 22(11%)
.Secondary education. 72(36%) 80(40%)
.University. 42(21%) 36(18%)
-Occupation: 0.787
.House wife. 166(83%) 168(84%)
.Occupied. 34(17%) 32(16%)
Residence:- 0.644
.Rural. 148(74%) 152(76%)
.Urban. 52(26%) 48(24%)
Table (2):Obstetrical history of the studied women.

Intervention Control P-value

Group(200). Group(200).
Parity: 0.752
Primipara . 68(34%) 71(35.5%)
.Multi-para 132(66%) 129(64.5%)
Mode of last delivery: 0.969
.No deliveries. 68(34%) 71(35.5%)
. NVD. 70(35%) 67(33.5%)
.NVD é episiotomy. 57(28.5%) 58(29%)
.Instrumental delivery. 5 (2.5%) 4(2%)
Place of last delivery: 0.549
.Hospital delivery. 114(57%) 108(54%)
.Home delivery. 18 (9%) 21(10.5%)

Table (3): Incidence of post partum SUI among groups.

Intervention Control Group P-value

Group(perform (not perform
kegel's exercise) kegel's exercise)
(200)
(200)
st
1 week 42 ( 21%) 39 ( 19.5%) 0.803
postpartum
6th week 16 ( 8%) 25 (12.5 %) 0.002
postpartum
nd
12 week 2 (1 %) 18 ( 9 %) 0.0005
postpartum
48
Jan. 2012
Impact of kegel's exercise. [email protected]

Table (4):Frequency of reported post partum practices of pelvic floor muscles exercises.

Intervention
Performance Group(200).
-Less than 25% 32(16%)
- >25% to 50% 58(29%)
- > 50% to 75% 36(18%)
- >75% to 100% 74(37%)

Table (5): Relation between performing kegel's exercise and the prevalence of SUI among
the intervention group.

st nd
1 week 12 week P-value
6th week

-Less than 25% 22 ( 52.4%) 8 (50%) 2(100%)

- >25% to 50% 10 ( 23.8%) 8(50 %) 0( 0.0%)

- > 50% to 75% 6 (14.3 %) 0( 0.0%) 0( 0.0%) 0.0001

- >75% to 100% 4 (9.5%) 0( 0.0%) 0( 0.0%)

49
Jan. 2012
Impact of kegel's exercise. [email protected]

Table(6):Grade classification of post partum women with SUI after intervention group performance of kegel's exercise.

Intervention Control Interventio Control Intervention Control

Group(200). Group(200). p- n Group(200) p- Group(200). Group(200). p-
value value
value Group(200)
First week postpartum After 6- weeks
After 12- weeks
postpartum postpartum
Grade 1 26(61.9%) 16(41.0%) 11(68.9%) 15(52.6%) 2(100%) 9 (50%)
Grade 2 10(23.8%) 14 (35.9%) 3(18.6%) 7(26.3%) 0(1%) 6(33.3%)
Grade 3 6(14.3%) 9(23.1%) 0.170 2(12.5%) 2(15.8%) 0.728 0(0%) 2 (11.1%) 0.03
Grade 4 0(0.0%) 0 (0.0%) 0 (0.0%) 1 (5.3%) 0(%) 1(5.6%)
Total 42(100%) 39(100%) 16(100%) 25(100%) 2(100%) 18(100%)

50
Jan. 2012
Impact of kegel's exercise. [email protected]

Table(7):Symptoms of post partum women with SUI after intervention group performance of kegel's exercise.

Intervention Control Intervention Control Intervention Control

Group(200). Group(200) p- Group(200). Group(200). p- Group(200). Group(200) p-
value value . value
ST th th
1 week postpartum 6 week postpartum 12 week postpartum
Dribbling of 26(61.9%) 25(64.1%) 10(62.5%) 17 (68%) 0 (0.0%) 11(61.1%)
urine
Involuntary 2(4.8%) 3 (7.7%) 1(6.2%) 3 (12%) 2 (100.0%) 4(22.2%)
urination 0.924 0.728 0.04
Dysuria 10 (23.8%) 8(20.5%) 2(12.5%) 3 (2%) 0 (0.0%) 1 (5.6%)
More than one 4(9.5%) 3(7.7%) 3 (18.8%) 2 (8%) 0 (0.0%) 2(11.1%)
symptom
Total 42(100%) 39(100%) 16(100%) 25(100%) 2(100%) 18(100%)

51
Jan. 2012
 Impact of kegel's exercise. [email protected]

Table (8):Episodes of urinary leakage of post partum women with SUI after intervention group performance of kegel's exercise .

Intervention Control Intervention Control Interventio Control

Group(200). Group(200) p- Group(200). Group(200). p- n Group(200). p-
value
value Group(200 value
).
ST th th
1 week postpartum 6 week postpartum 12 week postpartum
-Once a day. 11( 26.2%) 12(30.8%) 2 (12.5%) 6 (24%) 0 (0.0%) 4 (22.2%)
-Few times a day 2(4.8%) 1 (2.6%) 0 (0.0%) 3(12%) 0 (0.0%) 5(27.8%)
- Once a week 29 (69%) 26(66.6%) 0.806 14(87.5%) 16(64%) 0.18 2(100%) 9 (50%) 0.0004
Total 42(100%) 39(100%) 16(100%) 25(100%) 2(100%) 18(100%)

52
Jan. 2012
Impact of kegel's exercise.
 [email protected]
Discussion:
Incontinence is a common and distressing problem after childbirth. [18]
Three months after delivery,20-30% of women have urinary which was done by Eftekhar et al., (2006) who assess the
incontinence .The most common type of urinary prevalence of postpartum SUI in Tahran, Iran.
[1] As regards SUI rate at 6- weeks postpartum it was 8% and 12.5% of
incontinence is the stress incontinence . Despite the extent of the
the intervention and control groups respectively. At 12- weeks
problem, There is good evidence that postnatal pelvic floor
exercises are effective in the treatment of postpartum stress postpartum the rate of SUI was 1% and 9% of the intervention and
[14] control group respectively with a highly statistical significant
incontinence . A well recognized treatment for stress differences between groups. There are two possible explanations for
incontinence is the practice of pelvic floor exercises. Pelvic floor
the differences between the rate of SUI reported by those groups ,
exercises involve repeated contractions of the muscles of the pelvic
floor in order to build up strength of the muscles and improve first ; the reduction of the rate of SUI at 12-
[15] weeks postpartum among the intervention group may be due to the
control of micturation . '
This study compromised 440 postpartum women who delivered effect of practicing kegel s exercises despite the frequency of
vaginally and divided into two main groups ,the intervention and performance, second ; the considerable reduction of the SUI rate
control groups. It was conducted at the Women's Health Center, among the control group may be due to the three months duration
Assuit University Hospital, Egypt. Personal, labor and delivery following childbirth which may allow pelvic floor muscles function
to return to normal and
characteristics of women who were recruited in this
consequently relieve the SUI symptoms. These findings are similar
study were compared and no significant differences was found. [3]
Concerning the prevalence of postpartum SUI of the present study, to the study by Farrel et al., 2001 who study the incidence and
it was estimated that at the first week post partum the prevalence of relative
SUI is 21% of the intervention group and 19.5% of the control risks of postpartum urinary incontinence .After a follow-up of 3-
[16]
group with no statistical significant differences P =(0.708). These months , Viktrup and Lose, (1993) found that, symptoms had
[3]
findings are similar to the study of Farrell,(2001) who estimated resolved in most of their patient, reporting a 7% prevalence rate of
the incidence of postpartum SUI to be 22% after vaginal delivery . postpartum incontinence and 4% persistent incontinence rate . In a
[19]
As stated earlier by other authors, the prevalence rate of postpartum similar study by Chaliha and Stanton(2002) they found that 3
stands within the range of values found in the months postpartum the incontinence rate was 14.6%. These findings
literature, which extends from 4% in a study by Viktrup and Lose shows that a longer follow-up allows more time for pelvic function
(1993)
[16] to return to normal.
[17]
to 34.3% in another study by Abrams et al,2003) while later on ,
the prevalence of SUI was 14.1% following vaginal delivery at the After implementation of the present study exercise,
study statistically significant improvement were revealed among most
women in the intervention group. This was evident in the grades of
SUI, subjective assessment of the
Jan. 2012
53
Impact of kegel's exercise. SUI symptoms and episodes of SUI. This successful outcome of the
intervention group is in congruence
 [16] [email protected]
with the findings of Viktrup and Lose (1993) who found that
women who
followed up after delivery for 3 months, most of them their
symptoms had resolved. Moreover, Mohamed , (1996)
[20]
who the control group after 3 months of follow up. Pelvic floor exercises
study the efficacy of late pregnancy kegel's exercises on control are beneficial and have no significant adverse effects. Substantial
postpartum stress urinary and durable improvements in continence can be achieved, when the
incontinence reported that the subjective evaluation of SUI after post-partum women are appropriately selected and the exercises are
practicing Kegel's exercises had 80% complete relief of women's adequately done.
symptoms. As regard Kegel's exercises frequency of performance,
the current study found that, more than one third (37%) of the Recommendation:
intervention group would be more likely to do the exercises Further trials for post partum urinary
adequately(> 75% to 100 % ).Just (18%)of women in the incontinence types and fecal incontinence are needed.
intervention group reported that they had practiced pelvic floor
exercises from (> 50% to75%) . The women who reported doing Acknowledgement: We would like to acknowledge the help of all
Kegel's exercises sufficiently were more advantaged and were women who participating in this study for their valuable
significantly better than who perform the Kegel's exercises less participation.
than (25%) of the given schedule, P= 0.0001.
These findings are similar with the study which was done by References:
[2] 1-Haylen(2010):An International Urogynecological Association
Whitford et al , (2007) , who studied the practices of pelvic floor
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