Rectal Balloon Training as an Adjunctive Method for Pelvic
Floor Muscle Training in Conservative Management of
Stress Urinary Incontinence: A Pilot Study
Sujira Roongsirisangrat MD*, Sarissa Rangkla MD*,
Tarinee Manchana MD**, Natthiya Tantisiriwat MD*,***
Affiliation :
* Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
** Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
*** Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
Background : Pelvic floor muscle training (PFMT) is currently considered as the first line conservative management for
women with stress urinary incontinence (SUI). However, it is difficult for some women to self-identify the contraction of the
pelvic floor muscle after they were trained by verbal instruction. Various techniques including rectal balloon probe have
been developed to improve PFMT.
Objective : To compare vaginal squeezing pressure, one-hour pad test, leakage episodes, rating scores about severity of
SUI, and patient satisfaction between traditional PFMT and rectal balloon training (RBT).
Material and Method: Twenty-eight patients with SUI were randomized into two groups, PFMT, and RBT groups. The
PFMT group was verbally instructed to perform exercise as the traditional technique. In the RBT group, a Foley catheter
filled with tap water to create balloon was inserted into the rectum in combination with the same exercise as in the PFMT
group. The vaginal squeezing pressure before and after 6-week exercise program was measured by biofeedback machine
model MYO420.
Results : One patient in each group was lost to follow-up . This left 13 patients in each group. Both groups had statistically
significant gained in vaginal squeezing pressure after exercise. The different pressure between pre and post exercise were
9.9 mmHg and 9.2 mmHg in PFMT and RBT group respectively (p = 0.84). Significant improvement of leakage episodes
and self-rating scores assessed the severity of SUI after exercise was reported in both groups, although there was no
significant difference between both groups. The number of patients wearing protection after exercise was lowered in both
groups, which were 75% in PFMT group and 80% in RBT group. However, satisfaction was greater after completing exercise
in both groups.
Conclusion : PFMT is an effective conservative treatment of SUI. PFMT combined with rectal balloon training did not
provide greater strength of the pelvic floor muscle than isometric contraction.
Keywords : Pelvic floor muscle training, Rectal balloon, Stress urinary incontinence
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