OBJECTIVES: The aim of this article is to report evidence-based knowledge on short- and long-term effects, adverse effects, adherence, dropout and motivational problems of pelvic floor muscle (PFM) training for stress urinary incontinence (SUI). METHODS: Randomised controlled trials (RCTs) retrieved from computerized search, Clinical Practice Guidelines (AHCPR, US), the Cochrane Library, and International Consultation on Incontinence (ICI) consensus statements were used as sources of evidence. RESULTS: Several RCTs have demonstrated that PFM training is more effective than no treatment for SUI. Subjective cure/improvement rates of PFM training reported in RCTs vary between 56 and 70%. Cure rates defined as < 2 grams of leakage on different pad tests vary between 44 and 69%. Only one study has analysed data of long-term follow-up for as long as 10 years. Successful results were maintained in two thirds of the patients originally classified as successful. CONCLUSIONS: Pelvic floor muscle training has proved to be an effective treatment for female SUI in RCTs. It has no side effects, and is cost effective compared to surgery. There is a need for more physiotherapists specializing in this area, and better collaboration between urologists and physiotherapists to organize better health services for SUI patients and for planning of future high quality clinical trials.

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