Comparison of pelvic floor muscle training plus connective tissue massage and pelvic floor muscle training alone in women with overactive bladder

The aim of this study was to compare the effects of pelvic floor muscle training (PFMT) plus connective tissue massage (CTM) and PFMT alone on overactive bladder (OAB) symptoms, pelvic floor muscle functions and quality of life in women with OAB. The study included 34 women with OAB. The patients were randomly divided into groups of PFMT+CTM (n:17) and PFMT (n:17). The PFMT was applied every day of the week, and CTM was applied 3 days a week for 6 weeks. The pelvic floor muscle strength (PFMS) with Modified Oxford Scale and perineometer (Cardio Design Pty Ltd, Australia), bladder symptoms with urine diary, the severity of the bladder symptoms with Overactive Bladder-Version 8 (OAB-V8), urgency with Patient Perception of Intensity of Urgency Score (PPIUS), quality of life with King's Health Questionnaire (KHQ) were assessed. All assessments were performed before the treatment (BT), intermediate period (IP, 3rd week) and after the treatment (AT, 6th week). After the treatment, in both groups, PFMS increased, while OAB symptoms, OAB-V8, PPIUS and KHQ scores decreased (p<0.05). In IP, in both groups, there was an increase in PFMS, and there were decreases in the mean daytime urination frequency and numbers of incontinence, OAB-V8 and the symptom severity measurements and complaint severity scale sub-dimension scores of KHQ (p<0.05). Moreover, in IP, while there were decreases in the mean nighttime urination frequency and daily urine volume per void, PPIUS scores and the general health perception, incontinence impact, social limitations and emotional problems sub-dimensions of the KHQ in the PFMT+CTM group, there was a decrease only in the sleep/energy disturbances scores as the sub-dimensions of KHQ in the PFMT group (p<0.05). The intergroup comparisons revealed a further decrease in the OAB-V8, PPIUS and incontinence impact scores in the PFMT+CTM group in comparison to the PFMT group in IP (p<0.05). In AT, there was a further decrease in the mean daytime urination frequency, the OAB-V8 and the PPIUS scores and the incontinence impact and complaint severity scale sub-dimensions of the KHQ in the PFMT+CTM group compared to the PFMT group (p<0.05). According to these results, the PFMT in addition to CTM was found to be more effective in reducing the OAB symptoms in the early (3rd week) and late (6th week) periods than PFMT alone. Keywords: Overactive bladder, urgency, pelvic floor muscle training, connective tissue massage