New Research: Pelvic Floor Muscle Training and Nocturia
Electrical stimulation (E-stim) of pelvic floor muscles is widely used to treat both urge and stress incontinence. However, the direct impact of E-stim treatment on nocturia has not been widely studied. Recently, a team of experienced incontinence researchers published a study in which they evaluated two non-drug nocturia treatments. The first technique, called tibial nerve stimulation, electrically stimulates a nerve near the ankle to remotely calm bladder muscles. Patients achieved a significant improvement in sleep quality. The second treatment was pelvic floor muscle training (PFMT). The subject performed weekly in-clinic Kegel exercises under the supervision of a physical therapist and daily Kegel exercises at home. Patients receiving PFMT achieved an even greater improvement in sleep quality.
In another report, PFMT was used with biofeedback to help women suffering from stress and urge incontinence, and who were bothered primarily by nocturia. Treatment reduced their nighttime bathroom visits to 1–2 per week, which tremendously improved their quality of sleep.
Although neither report investigated exactly how the therapies acted to treat the nocturia, the favorable clinical outcomes support the need for further investigation. Most medications seek to reduce urine production or calm the bladder muscles, however, PFMT could improve the function of the muscles that control bladder leakage. Given the common occurrence of nocturia during and after pregnancy, this outcome is intuitive. By improving pelvic floor muscle function, the bladder accommodates greater urine volume resulting in less frequent nighttime voiding.