Considering the different results in previous studies and because the Quality of Life is increasingly being used as a primary outcome measure in studies to evaluate the effectiveness of treatment, (14) the present study was done to compare the effectiveness of behavioral intervention program and vaginal cones on SUI and its related quality of life.
Vaginal cones are stainless steel devices with a plastic coating and a nylon thread at their apex to facilitate their removal.
The two most frequently described or systematically investigated treatment options were chosen as a focus for this article and include 1) strengthening pelvic floor muscles with pelvic floor muscle training, including biofeedback and weighted vaginal cones; and 2) the use of intravaginal support devices such as incontinence pessaries and bladder neck support prostheses.
Weighted vaginal cones. Weighted vaginal cones are used to retrain the pelvic floor as opposed to acting as a support to pelvic organs (Haddad, Ribeiro, Bernardo, Abrao, & Baracat, 2011; Karon, 2009; Pereira, de Melo, Correia, & Driusso, 2012), and they are commonly used for pelvic floor retraining (Bettez et al., 2012; Bo, 2012; Castro et al., 2008).
Vaginal cones are ineffective and not well-tolerated
Two RCTs found that vaginal cones didn't improve continence or QOL compared with no treatment.
Despite the changes that occurred when combining biofeedback with PFMT, few studies have demonstrated differences between the various training methods of PFMT, ES, and vaginal cones. Castro et al (19) conducted a study in which 118 subjects with SUI were randomized into PFMT, ES, vaginal cones, and no treatment groups and assessed after treatment 3 times per week for 6 months.
Although the majority of studies showed no difference between treatment methods, B0 et al16 assessed 107 females with SUI over 6 months and reported greater improvements with PFMT when compared to ES and vaginal cones and stated that PFMT exercises are effective and safe and should be offered as the first choice of treatment for SUI.
: You insert a specially-made cone (available from chemists) and hold it by contracting your pelvic muscles.
Special vaginal cones
, electrical stimulation and/or biofeedback can be used.
are less successful, a bit more fiddly, but still worth a try.