Virtual yoga-Pilates program improves stress urinary incontinence symptoms

An 8-week web-based yoga-Pilates program improved symptoms of stress urinary incontinence and reduced the number of incontinence episodes, according to findings of a prospective cohort study.

However, the data — which were presented at the American Urogynecologic Society and International Urogynecological Association Scientific Meeting — showed no changes in the urethral rhabdosphincter during the intervention period.

“Many women with stress urinary incontinence would like nonsurgical treatments,” Meagan Cramer, MD, a urogynecology fellow at Oregon Health & Science University, told Healio. “Currently, pelvic floor physical therapy is the first-line nonsurgical treatment, but it can be costly, time-consuming and works best when supervised by a pelvic floor physical therapist. There is some literature that shows that yoga and Pilates can be helpful for urinary incontinence, but more robust studies are needed.”

Cramer and colleagues enrolled 78 women (67% premenopausal; 65% vaginally parous) with stress urinary incontinence (SUI) between November 2020 and September 2021 who followed the 8-week web-based video yoga-Pilates program and attended in-person visits before and after the program. Also, 76% of the women had done yoga in the past, and 44% had done Pilates. At visits, they completed surveys on their quality of life and symptom severity. They also underwent a pelvic exam including Pelvic Organ Prolapse Quantification (POP-Q), cough stress test, Brink pelvic floor strength score and resting three-dimensional transperineal ultrasound.

In total, 60 women completed the study, 73% of whom performed exercises at least three times per week. Scores on the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form improved from 9.5 (95% CI, 8.7-10.4) to 7.1 (95% CI, 6.3-7.9) between the pre- and post-intervention visits, indicating “an improvement in symptoms and bother of stress urinary incontinence,” Cramer said.

The number of incontinence episodes significantly decreased following the intervention (P < .001). The Brink scores also improved, increasing from 7.1 (95% CI, 6.6-7.7) pre-intervention to 7.7 (95% CI, 7.2-8.2) after the intervention (P = .013).

Meagan Cramer

Although “most women were very satisfied with the intervention and enjoyed the online format,” Cramer said, there were no significant changes in urethral measurements.

“Currently, there is not enough evidence to recommend yoga-Pilates as a therapy for stress incontinence, but our study adds to the growing body of evidence supporting its efficacy,” Cramer told Healio. “The next step would be to conduct a larger randomized study comparing this yoga-Pilates intervention to the current nonsurgical standard-of-care treatment, pelvic floor physical therapy.”