Pelvic Floor Muscle Exercises for the Management of Urinary Incontinence Historical Review

Document Type : Short Communication

Authors

1 Physiotherapist, Post-graduate student of Medical School, National and Kapodistrian University of Athens, Greece

2 Urologist, Head of Private Urodynamic and Neuro-urology practice, Athens, Greece

10.30476/rhm.2024.103578.1234

Abstract

Urinary incontinence is a significant health issue, and various international organizations (ICS, IUGA, AUA, EAU) have concentrated on managing this condition. Conservative management, especially programs for Pelvic Floor Muscle Exercises (PFME), is of particular interest.
The earliest known texts date back to antiquity, but after a long period of inactivity during the Middle Ages, individual cases began to be reported from the 16th to 18th centuries. Scientific interest in the topic resumed in the mid-1800s in Sweden, followed by the UK. Physiotherapy developed into an independent profession at the end of the 19th century, and in 1921, Mary McMillan (USA) founded the American Physical Therapy Association (APTA). Miss Minnie Randel introduced pelvic floor exercises for women in the maternity ward in 1936. Margaret Morris, a student of M. Randel, created an exercise system emphasizing conscious contraction and relaxation of the pelvic floor muscles. Prof Arnold Kegel, known as the “father” of PFME, established Kegel’s exercises as a regular practice in 1948. In the 1970s, Dorothy Mandelstam developed a new physiotherapy internship, and Dr. Jo Laycock became the first physiotherapist to join the ICS Board. Over the past 20 years, the importance of PFME for managing post-prostatectomy incontinence has been documented.
In conclusion, physiotherapists specializing in the pelvic floor, as part of a multidisciplinary team with urologists and urogynecologists, play an active role in managing patients with urinary incontinence.

Highlights

Leonidas Floratos (Google Scholar)

Diamantis Floratos (Google Scholar)

Keywords

References

  1. Abrams, P., et al., 2018. 6th International Consultation on Incontinence. Recommendations of the International Scientific Committee: Evaluation and treatment of urinary incontinence, pelvic organ prolapse and faecal incontiennce. Neurourol Urodyn, 37(7), pp. 2271–2272. doi:10.1002/nau.23551.
  2. Bø, K., and Stien, R., 1994. Needle EMG registration of striated urethral wall and pelvic floor muscle activity patterns during cough, Valsalva, abdominal, hip adductor, and gluteal muscle contractions in nulliparous healthy females. Neurourol Urodyn, 13(1), pp. 35–41. doi: 10.1002/nau.1930130106.
  3. Chapman, M.M., 1997. Pelvic muscle exercise/biofeedback for urinary incontinence after prostatectomy: an education program. J Cancer Educ, 12(4), pp. 218–23. doi: 10.1080/08858199709528492.
  4. Cooke, R., 1803. A Case of Incontinence of Urine. Med Phys J, 10(57), p. 423. PMID: 30491305
  5. Floratos, D.L., Sonke, G.S., Rapidou C.A., et al., 2002. Biofeedback vs verbal feedback as learning tools for pelvic muscle exercises in the early management of urinary incontinence after radical prostatectomy. BJU International, 89(7), pp. 714–719. doi:10.1046/j.1464-410X.2002.02721.x.
  6. Haslam, J., 2008. Historical Perspective of Pelvic Floor Muscle Training. In: J. Haslam and J. Laycock (ed.) Therapeutic Management of Incontinence and Pelvic Pain. 2nd London: Springer. doi: 10.1179/106698107790819873.
  7. Haylen, Β.Τ., et al., 2010. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J, 21(1), pp. 5-26. doi:10.1007/s00192-009-0976-9.
  8. https:/ /www.ncbi.nlm. nih.gov/pmc/ articles/PMC5545337/.
  9. ICS Member Profession, 2021. Available at: https://www.ics.org/members/statistics. [Accessed December 2021]
  10. Kegel, A.H., 1948. Progressive resistance exercise in the functional restoration of the perineal muscles. AJOG, 56(2), pp. 238–248. doi:10.1016/0002-9378(48)90266-X.
  11. Laycock, J., 1988. Interferential therapy in the treatment of genuine stress incontinence. Neurourol Urodyn, 7(3), pp. 268–269. doi: 10.1002/nau.1930070301 11.
  12. Laycock, J., and Jerwood, D., 2001. Pelvic Floor Muscle Assessment: The PERFECT Scheme. Physiotherapy, 87(12), pp. 631–642. doi:10.1016/S0031-9406(05)61108-X.
  13. Millin, Τ., 1939. Some Observations on the Surgical Treatment of Urinary Incontinence: (Section of Urology). Proc R Soc Med, 32(7), pp. 777–90. PMID: 19991939;
  14. Morris, M., and Randell, M., 1936. Maternity and post-operative exercises. Oxford: Oxford University Press. doi:10.1001/jama.1937.02780250075028
  15. Oliphant, I., 1786. Two Instances of the Good Effects of Blisters in Incontinence of Urine. Lond Med J, 7(4), pp. 416-418.
  16. Pettman, E., 2007. A history of manipulative therapy. J Manual and Manipulative Therapy, 15(3), pp. 165–174. doi:10.1179/106698107790819873.
  17. Randell, M., 1948. Fearless Childbirth. What every mother-to-be Should know. 1st ed. London, UK: Churchill Livingstone Publications.
  18. Van Kampen, M., et al., 2000. Effect of pelvic-floor re-education on duration and degree of incontinence after radical prostatectomy: A randomised controlled trial. Lancet, 355(9198), pp. 98–102. doi:10.1016/S0140-6736(99)03473-X.
  19. Wells, T.J., 1990. Pelvic (Floor) Muscle Exercise. J American Geriatrics Society, 38, pp. 333-337. doi.org/10.1111/j.1532-5415.1990.tb03515.x
Journal of Research on History of Medicine
Volume 14, Issue 3
August 2025
Pages 263-268

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