To evaluate the effects of a pelvic floor muscles training program on urinary symptoms, sexuality and body awareness in groups of elderly women of different socioeconomic levels.

This is a time series study.  57 elderly women were evaluated and divided into two groups: high (A) and low (B) socioeconomic level, according to the human development index of the region where they lived. They participated in a five weekly pelvic floor muscles training group program and answered structured questionnaires before and after each meetings. Participants conversation in each meeting were recorded and transcribed in order to carry out  a qualitative evaluation, through discursive analysis. All meetings had specific pelvic floor exercises and each week difficulties were added, including breathing, postural and stability exercises. For statistical evaluation, a descriptive analysis of data was performed with a significance level of 5% (p<0.05). Variables were compared between the two groups (A and B).

The average age of the women was 65.25 years old. 50.87% of them referred urinary incontinence (UI) and 33.33% intestinal constipation. Regarding body mass index, obese women are more likely to have UI when compared to eutrophic women, respectively p=0.045 and p=0.041. Group B had a higher percentage of non-white women (30.4% versus 5.9%; p = 0.023), with more pain (82.6%; versus 52.9%; p = 0.021), urinary incontinence (30.4%; versus 2.9%; p = 0.005), and lack of libido than those in group A (75% versus 46.9%; p = 0.046). In relation of the pelvic floor (PF) knowledge before intervention, 70,6% of group B and 32.4% of group A (p=0.012), reported no knowledge about what PF meant and its localization in their bodies. Some evaluated variables showed positive results for both groups after intervention: 61.8% of group A and 81.5% of group B were able to better perceive and control their breathing; 94.1% of the women in group A and 100% in group B reported improved posture; 100% of both groups reported that they learned the correct localization and function of PF in the body and in incontinent women, 32.4% of group A and 64.7% of group B believed that their symptoms improved. The discursive analysis showed that pelvic floor and sexuality were the themes more often discussed in the group meetings.

Both groups, regardless of socioeconomic level, reported improvement in urinary leakage and body awareness. Discursive analysis of conversations held during the meetings also showed improvement in their knowledge about pelvic floor and an awakening of sexuality.

Group meetings with pelvic floor muscles training and body education, constitute an efficient strategy for health promotion for women in process of aging, encouraging them to think about their sexuality, prevent and even treat urinary incontinence. This can also be considered as a practice that promotes positive aging. The group promotes socialization, exchange of experiences and increases the knowledge of those who participate, important factors for improving self-esteem and search for new life purposes.

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Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005654. doi: 10.1002/14651858.CD005654.pub4. PMID: 30288727; PMCID: PMC6516955.

Continence 2S2 (2022) 100479
DOI: 10.1016/j.cont.2022.100479