Comparison of the effectiveness of stress urinary incontinence with knack maneuver applied with the education program according to different teaching techniques

The aim of this study was to compare the effectiveness of knack maneuver training applied to women with stress urinary incontinence together with education programme according to different teaching techniques. Forty-six women with mild to moderate stress and stress-dominant mixed urinary incontinence, aged 30-75, were included in the study. Incontinence severity by Incontinence Severity Index (ISI), symptoms by Urogenital Distress Inventory-6 (UDI-6) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), pelvic floor muscle (PFM) functions by vaginal palpation and electromyography, pelvic floor health and incontinence knowledge levels were evaluated with Pelvic Floor Health Knowledge Test (PFHKT) and Prolapse and Incontinence Knowledge Questionnaire (PIKQ). The women were divided into 3 groups as electromyography-biofeedback and knack maneuver training, verbal expression and knack maneuver training, and vaginal palpation and knack maneuver training. Individual women were given information about pelvic floor health and stress urinary incontinence, and knack maneuver training according to the teaching method of the group they belonged to, once a week for 4 weeks. At the end of the study, it was determined that there was improvement in UDI-6, ISI, ICIQ-SF, PFHKT, PIKQ scores of all groups (p<0.05). It was observed that the maximum voluntary contraction of the women in the knack maneuver training group with verbal expression (p=0.002), both the PFM maximum voluntary contraction (p=0.011) and the PFM contraction during valsalva in the women in the knack maneuver training group with vaginal palpation (p=0.042) increased. In this study, it was determined that the knack maneuver and information training in women with mild and moderate stress urinary incontinence were effective on urinary symptoms and related quality of life, increased the knowledge level of women, and vaginal palpation and verbal expression and knack maneuver training improved PFM maximum voluntary contraction. We think that all three different teaching methods can be used in the treatment programs of women with stress urinary incontinence.