Post partum anal and urinary incontinence are potentially debilitating conditions, the incidence of which has been
grossly under appreciated mainly due to the reluctance of women to seek medical attention for this sensitive problem.
Recent epidemiologic studies have highlighted the fact that anal and urinary incontinence after childbirth is not as rare
as has been assumed.
Objective: To assess the effect of pelvic floor exercises after vaginal delivery on pelvic floor characteristics using
clinical assessment and perineal and endoanal ultrasonography in nulliparous women.
Design : Prospective cohort study.
Methods: 355 primigravid women were enrolled in the study between January 2004 to December 2007 who were
attending antenatal care of obstetrics & gynecologic department, Mansoura University from whom 205 women who
delivered vaginally at the emergency unit of the same department completed the study. Those nulliparous women were
examined during pregnancy, 6 weeks and 12 months after vaginal delivery; the method used included questionnaire,
clinical examination, perineal sonography and endoanal ultrasonography for assessment of the integrity of pelvic floor
muscles. After Ihe 2nd examination the women were assigned in alternating manner to either 12 seessions of pelvic
floor exercise (n = 102) or no training (2 = 103) and the two groups were compared in the 3rd examimation.
Results: There was a significant decrease in the incidence of urinary and anal incontinence in the group who underwent
pelvic floor exercise 62% vs 6% in UI & 70% vs 0% in anal incontinence respectively (p = 0.002).
Conclusion: Pelvic floor exercises starting 6 weeks postpartum significantly reduced the incidence of stress urinary
incontinence and anal incontinence.