P A Norton1, J E Baker. 1. Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City.
Abstract
OBJECTIVE: To assess the efficacy of postural changes, such as crossing the legs, in reducing urine leakage in women with stress urinary incontinence. METHODS: Sixty-five women with urodynamically proven stress incontinence underwent a series of standing cough stress tests in each of four postures: standing, crossing the legs, bending forward from the hips, and a combination of crossing the legs and bending forward. The bladder volume and strength of coughing were standardized, and the volume of leakage in each test was measured as the change in pad weight. RESULTS: The mean loss was 12.3 g (95% confidence interval [CI] 8.5-16.1) in the standing position; this was significantly reduced to 1.3 g (95% CI 0.5-2.1, P < .001) with crossed legs and to 4.7 g (95% CI 1.4-7.7, P < .01) by the combination of crossing the legs and bending forward. Bending forward alone did not reduce fluid loss (mean loss 10.2 g, 95% CI 6.5-13.9). The mean reduction in fluid loss was -14.7 g (95% CI -21.2 to -8.2) using the best posture compared to the standing position. Seventy-three percent of the subjects became continent using one or more postural changes. CONCLUSION: Postural changes are an effective means of reducing urine leakage in women with stress urinary incontinence and should be an integral part of the management of this condition.
OBJECTIVE: To assess the efficacy of postural changes, such as crossing the legs, in reducing urine leakage in women with stress urinary incontinence. METHODS: Sixty-five women with urodynamically proven stress incontinence underwent a series of standing cough stress tests in each of four postures: standing, crossing the legs, bending forward from the hips, and a combination of crossing the legs and bending forward. The bladder volume and strength of coughing were standardized, and the volume of leakage in each test was measured as the change in pad weight. RESULTS: The mean loss was 12.3 g (95% confidence interval [CI] 8.5-16.1) in the standing position; this was significantly reduced to 1.3 g (95% CI 0.5-2.1, P < .001) with crossed legs and to 4.7 g (95% CI 1.4-7.7, P < .01) by the combination of crossing the legs and bending forward. Bending forward alone did not reduce fluid loss (mean loss 10.2 g, 95% CI 6.5-13.9). The mean reduction in fluid loss was -14.7 g (95% CI -21.2 to -8.2) using the best posture compared to the standing position. Seventy-three percent of the subjects became continent using one or more postural changes. CONCLUSION: Postural changes are an effective means of reducing urine leakage in women with stress urinary incontinence and should be an integral part of the management of this condition.