Pelvic floor muscle training (PFMT) has been recommended as the first-line treatment for women with stress urinary incontinence. Traditionally, PFMT should be guided by a physiotherapist. A recent online article in International Urogynecology Journal introduces a mobile app developed by Dr. Asklund and colleagues. This app provides instruction and reminders for women to perform PFMT. The article, Treatment of stress urinary incontinence with a mobile app, examines factors associated with success. It reports the effect of a 3-month app-based treatment for stress urinary incontinence symptoms and patients’ quality of life in a randomised controlled trial (RCT).
The study further explores target patients who can get substantial benefit from this non-face-to-face treatment, which is based on a secondary analysis of the RCT. Treatment success was defined as patients’ self-rated improvement of urinary incontinence. Participants’ baseline and follow-up ratings were investigated. Finally, the study shows that patients with higher expectations for treatment, and self-assessed enhancement of pelvic floor muscle strength, are more likely to obtain successful outcomes. Conversely, those with weight gain during treatment have a lower likelihood of success.
Generally, expectations for treatment indicate patients’ positive attitude and good adherence towards the mobile app-based intervention. This might be the prerequisite of successful treatment. For those who fail to identify an improvement in pelvic floor muscle strength, lack of effectiveness could be attributed to incorrect practice in PFMT and personalized face-to-face instruction might be helpful. In addition, it is also important for women performing PFMT to control their weight.
Mobile app-based treatment is a novel therapeutic approach which maximizes patient privacy and limits transportation constraints. However, only a certain group of women are suitable for this non-face-to-face treatment. Other patients may need to seek additional help from the specialty physiotherapist.
Nyström E, Asklund I, Sjöström M, et al. Treatment of stress urinary incontinence with a mobile app: factors associated with success. Int Urogynecol J. 2017 Dec 8. Epub ahead of print
Article by Ran Pang on behalf of the Publications and Communications Committee