Effect of Knack Pelvic Floor Contraction on Sexual Dysfunction

Effect of Knack Pelvic Floor Contraction on Sexual Dysfunction in Females With Stress Urinary Incontinence

This study aims to investigate the effect of knack pelvic floor contraction on sexual dysfunction in females with stress urinary incontinence.

Stress urinary incontinence may have a tremendous effect on psychological and social well-being. Women with SUI report an inferior health-related quality of life (HRQOL) compared to continent women. Sexual well-being is an important aspect of women's health, and dysfunction can lead to a decrease in HRQOL and affect the marital relationship. It has been reported that women with UI also have problems with sexual activity. The presence of urinary leakage during intercourse can adversely affect sexual function.

Physiotherapy treatments for female SUI include PFMT such as knack maneuver, biofeedback, electrical stimulation, core stabilization, diet modifications, and behavioral therapy.

The knack is a simple, quick exercise technique that improves bladder control and increases PFM strength; it increases the urethral closure pressure, improves bladder stabilization and increases the structural support during PFM contraction. A previous study compared the knack effect on SUI using different methods like EMG biofeedback, verbal instructions, and vaginal palpation. It was found to have a positive impact on urinary symptoms, regardless of the teaching methods. Another previous study investigated the knack effect on vaginal laxity and found that it improved PFM contraction and sexual function and reduced vaginal laxity.

Up to now, no study has investigated the effect of the knack maneuver on female SUI associated with sexual problems, so this study will be the first one on this issue; therefore this study will be of valuable benefits and increase the knowledge of the physical therapist and health care provider in the women's health field.

Inclusion Criteria:

1. Females with mild and moderate degrees of SUI according to Incontinence Severity Index score (mild: 1-2; and moderate: 3-4 scoring).
2. Their ages will range from 25 to 45 years old.
3. Their body mass index (BMI) will be less than 30 kg/m2.
4. They are multiparous women.
5. Females complain of sexual disorders related to SUI, identified by an FSFI score of less than 28.1
6. They have a sedentary lifestyle.

Exclusion Criteria:

1. Severe degree of SUI.
2. Other types of urinary incontinence, such as urge urinary incontinence and mixed urinary incontinence.
3. Other neurological diseases such as myasthenia gravis and Parkinsonism.
4. History of pelvic fractures.
5. Menopausal women.
6. Females with pelvic organ prolapse (POP).