Written by Peter Liu
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Therapeutic pelvic yoga improved urinary incontinence and is an option for women for whom it is available.
Synopsis
This randomized trial, conducted across three sites in California, evaluated a 12-week therapeutic pelvic yoga program versus a physical conditioning program for urinary incontinence (UI) in women aged 45 and older. Reductions were observed in total UI frequency, with decreases of 2.3 episodes per day in the pelvic yoga group compared to 1.9 in the physical conditioning group (difference = 0.3 episodes per day, 95%CI 0.7 to 0.0, P = 0.054). Urgency-type UI was also reduced more with yoga, but this difference was not statistically significant (p-values near 0.05). There was a modest benefit for pelvic yoga in reducing urinary symptom distress scores, but overall, the yoga intervention did not significantly outperform physical conditioning. [AI-generated, human edited]
Nama-stay with Kegels
Urinary incontinence is a common issue that significantly impacts women’s quality of life, with pelvic floor exercises (Kegels) being the first-line treatment for stress, urge, and mixed urinary incontinence. Initial management also involves assessing red flag symptoms (e.g., sudden onset, abdominal pain, hematuria) and encouraging lifestyle changes like weight loss, dietary adjustments, and smoking cessation. This study highlights pelvic yoga as a potential option for patients inclined toward yoga, but it falls short of comparing yoga directly to pelvic floor exercises, which remain the standard of care. Instead, yoga was compared to general physical conditioning, which likely underperforms compared to pelvic floor therapy. The study also faced adherence issues, with under 70% of participants practicing yoga at 36 weeks, compared to 85% adherence for pelvic exercises in another trial. I would reserve pelvic yoga only for patients resistant to pelvic floor exercises but open to yoga. Accessibility may also be challenging, as pelvic-focused yoga centers are uncommon outside regions like California.
Source
Efficacy of a Therapeutic Pelvic Yoga Program Versus a Physical Conditioning Program on Urinary Incontinence in Women : A Randomized Trial. Ann Intern Med. 2024 Oct;177(10):1339-1349. doi: 10.7326/M23-3051. Epub 2024 Aug 27. PMID: 39186785
