Effect of perineal and abdominal exercises in the vesical displacement in postpartum women

Resumo

Objective. To investigate the immediate effect of six different perineal and abdominal exercises on the displacement of the bladder neck and bladder base in parous versus nulliparous women. Methods. Vertical and horizontal displacements of the bladder neck and bladder base were measured by transabdominal and transperineal ultrasound imaging. A repeated-measures multi-factor ANOVA with Bonferroni correction was employed to compare differences in the bladder neck and base displacements among exercises and between groups. Besides, validity and reliability of a custom MATLAB code to measure offline the bladder displacement were analyzed. Results. Recruiting submaximal perineal and deep abdominal muscles produced an elevation of the bladder neck and bladder base in postpartum and nulliparous women. However, perineal and superficial abdominal muscle exercises caused the bladder neck and bladder base to descend in postpartum women. Bladder neck moved significantly forwards during submaximal perineal contraction in nulliparous vs postpartum women. The MATLAB code showed to be valid and reliable. Conclusions. Perineal and abdominal exercises provoked a disparate immediate effect on the displacement of the bladder depending on the exercise, group (parous vs. nulliparous), and measurement location (base or neck). Future randomized clinical trials are warranted to assess their long-term effect on parous women.