Introduction
Urinary incontinence is a common symptom during pregnancy.
The most common type of urinary incontinence in
pregnant women is stress urinary incontinence (SUI) which
is defined by the International Continence Society as ‘the
complaint of any involuntary leakage of urine on effort or
exertion, or on sneezing or coughing’ (Abrams et al. 2002).
The prevalence of SUI varies from 12% to 49% (King &
Freeman 1998, Pregazzi et al. 2002, Goldberg et al. 2003,
Dolan et al. 2004). Both prevalence and severity SUI increase
throughout pregnancy (Thorp et al. 1999, Sun et al. 2005).
Pregnancy is one of the main risk factors in the development
of SUI in young women (Peyrat et al. 2002). Prenatal
physiological changes such as increases in intra-abdominal
pressure of the growing uterus and foetal weight on the pelvic
floor muscles throughout pregnancy together with pregnancy-
related hormonal changes in progesterone, oestrogen
and relaxin may lead to reduced strength and the supportive
and sphincteric functions of the pelvic floor muscle (Hilton &
Dolan 2004).
Stress urinary incontinence affects the quality of life of
approximately 54ฦ3% of all pregnant women (Dolan et al.
2004) and it has been found that pregnant women with
urinary incontinence have poor quality of life during pregnancy
as compared to continent pregnant women (Mascarenhas
et al. 2003). Moreover, pregnant women with SUI are
especially at increased risk of permanent incontinence in the
postpartum period or later in life (Schytt et al. 2004).
Pelvic floor muscle exercise (PFME) remains the preferred
first-line method of treatment before consideration of other
treatments (Neumann et al. 2005) because PFME helps
strengthen the pelvic floor muscles and improves the efficiency
of the sphincter function of the periurethral muscle (Berghmans
et al. 1998). As shown in several previous studies, PFME is an
effective prevention for SUI during pregnancy (Sampselle et al.
1998, Morkved et al. 2003) and following delivery (Morkved
&Bo 1997, Chiarelli &Cockburn 2002). However, there is a
gap in knowledge concerning the effect of PFME on the
treatment of SUI in pregnant women