A 10-year follow-up after Kegel pelvic floor muscle exercises for genuine stress incontinence.

Objective: To determine the outcome 10 years after an individual course of pelvic floor muscle (PFM) exercises for genuine stress incontinence.

Patients And Methods: Postal questionnaires were sent to 52 women who had undergone PFM training 10 years earlier, and their medical files were reviewed. The main outcome measures were the patients' self-assessment of therapy outcome, the frequency of PFM exercises at home, and the demand for surgery after physiotherapy.

Results: Forty-five women (87%; mean age 61 years) were suitable for analysis. On completing the course of PFM exercises, physiotherapy had been apparently successful in 24 (53%), and considered to have failed in 21 women (47%). Sixteen of the 24 successful patients remained satisfied with their urinary continence when reassessed 10 years later; two women had undergone surgery (8%). In the group where physiotherapy initially failed, five women (24%) who had not had surgery claimed to be much improved; 13 women (62%) had undergone surgery. Overall, women in whom the conservative treatment of stress incontinence had produced an improvement over the 10 years had practised PFM exercises more regularly (76%) than the others (55%; not significant). However, an active voluntary PFM contraction before a sudden intra-abdominal pressure rise ('perineal lock') appeared to be responsible for most of the success.

Conclusions: When PFM training is initially successful, there is a 66% chance that the favourable results will persist for at least 10 years.