Treatment of urinary incontinence in cystic fibrosis

J Cyst Fibros. 2003 Dec;2(4):171-6. doi: 10.1016/S1569-1993(03)00088-2.

Abstract

Background: Urinary incontinence (UI) is a newly recognised problem in cystic fibrosis. Whilst prevalence is well documented, there are no reports of assessment and treatment of the problem.

Methods: A previous study reports the prevalence of UI in women with CF to be 51/75 (68%). Nineteen women subsequently requested help for the problem and were referred to a physiotherapist specialising in women's health. A digital assessment was performed to measure pelvic floor muscle strength and endurance. An individualised programme of pelvic floor muscle exercises (PFME) was taught based on the assessment. A questionnaire addressed issues of assessment and treatment.

Results: 12 women were assessed. The median (range) age, FEV1% predicted and BMI were 20.9 (19.3-46.1) years, 45.9 (14.8-82.7) and 20.5 (16.1-26.0), respectively. The median strength of the pelvic floor muscle was moderate (Oxford Scale grade 3) with a hold time (endurance) of 5 s. At reassessment (median time 13.1 weeks), there was an improvement in endurance (P = 0.04), with no change in strength. This was supported by a subjective improvement in symptoms. Patients found the exercises were difficult to perform, difficult to fit into their treatment programme and adherence was poor.

Conclusions: PFME are effective at improving endurance and reducing leakage over the short-term. Women are reluctant to be assessed and the CF team should provide support and encouragement with treatment. Long-term outcome and the mechanisms of UI in this group of patients need further evaluation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / diagnosis
  • Exercise Therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Pelvic Floor
  • Prevalence
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urinary Incontinence / epidemiology
  • Urinary Incontinence / etiology*
  • Urinary Incontinence / therapy*
  • Urinary Incontinence, Stress / etiology
  • Urinary Incontinence, Stress / therapy