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Can Women Correctly Contract Their Pelvic Floor Muscles Without Formal Instruction?

Henderson, Joseph Welles MD*; Wang, Siqing MD, MS, MStat; Egger, Marlene J. PhD; Masters, Maria RN*; Nygaard, Ingrid MD, MS*

Female Pelvic Medicine & Reconstructive Surgery: January/February 2013 - Volume 19 - Issue 1 - p 8–12
doi: 10.1097/SPV.0b013e31827ab9d0
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Objectives It is unknown how many women presenting for primary care can appropriately contract their pelvic floor muscle (PFM) or whether this ability differs between women with or without pelvic floor disorders. We sought to describe the proportion of women who initially incorrectly contract the PFM and how many can learn after basic instruction.

Methods This cross-sectional study enrolled 779 women presenting to community-based primary care practices. During PFM assessment, research nurses recorded whether women could correctly contract their PFM after a brief verbal cue. We defined pelvic organ prolapse (POP) as prolapse to or beyond the hymen and stress urinary incontinence (SUI) as a score of greater than equal 3 on the Incontinence Severity Index.

Results Pelvic floor muscle contraction was done correctly on first attempt in 85.5%, 83.4%, 68.6%, and 85.8% of women with POP, SUI, both POP and SUI, and neither POP nor SUI, respectively (P=0.01 for difference between POP and SUI versus neither POP nor SUI). Of 120 women who initially incorrectly contracted the PFM, 94 women (78%) learned after brief instruction. Women with POP were less likely to learn than women with neither POP nor SUI (54.3% vs 85.7%, P=0.001). Increasing vaginal delivery and decreasing caffeine intake (but not age or other demographic factors) were associated with incorrect PFM contraction; only decreased caffeine intake remained significant on multivariable analysis.

Conclusions Most women with no or mild pelvic floor disorders can correctly contract their PFM after a simple verbal cue, suggesting that population-based prevention interventions can be initiated without clinical confirmation of correct PFM technique.

Most women with no or mild pelvic floor disorders can correctly contract their pelvic floor muscles after a simple verbal cue.

From the *Departments of Obstetrics and Gynecology, and †Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT.

Reprints: Ingrid Nygaard, MD, MS, Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT. E-mail:

The authors have declared they have no conflicts of interest.

This work was supported by Grant Number R01HD057895-01 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins