Treatment for postnatal incontinence may work if patients comply

While nurse-led conservative treatment of postnatal urinary and fecal incontinence may help in the short-term, the benefits do not persist in about 75% of women when followed for 6 years. This may, however, have more to do with a fall-off in patient compliance than with the efficacy of the intervention.

Researchers from the United Kingdom and New Zealand studied 747 women with fecal or urinary incontinence 3 months after childbirth, of whom 524 were revisited at 1 year and 516 were revisited at 6 years. The women were provided pelvic floor muscle and bladder training at 5, 7, and 9 months after delivery or standard care.

At 1 year, fewer women who received the nurse training had urinary (60% vs. 69%, P=0.037) and fecal (4% vs. 11%, P=0.012) incontinence when compared with controls. But at 6 years, the differences narrowed; 76% of the treatment group suffered urinary incontinence versus 79% of controls, and 12% of the intervention group versus 13% of controls experienced fecal incontinence-regardless of whether the women had subsequent deliveries.

Glazener CM, Herbison GP, MacArthur C, et al. Randomised controlled trial of conservative management of postnatal urinary and faecal incontinence: six year follow up. BMJ. 2005;330:337.