The purposes of this study were to examine the effectiveness of a behavioral intervention program combining pelvic floor muscle exercise with bladder training for urinary incontinence and also to conduct follow-up assessment after self-training.

This study was conducted using a non-equivalent control group, pretest-posttest design. The subjects were 60 middle-aged women (control group, n=30; intervention group, n=30) who experienced an episode of urinary incontinence at least once a week. The program was run over a 4 week period (once a week) and composed of urinary incontinence education, pelvic floor muscle exercise, and bladder training.

Overall, there was a significant difference in urinary incontinence symptoms and psycho-social well-being related to urinary incontinence between the treatment and control group. Of the variables, weekly leakage frequencies, leakage amounts on each occasion, leakage index, frequencies of nocturia, and quality of life were significantly different between the groups. Follow-up assessment (9th week) indicated that overall incontinence symptoms and psycho-social well-being were significantly different between the posttest and follow-up assessments. Most variables of incontinence symptoms and psycho-social well-being were significantly improved at follow-up assessment versus posttest.

The program was overall effective in terms of relieving symptoms and improving psycho-social well-being related to urinary incontinence, and this effect continued after a 4-weeks self-training period. In the respect that this is a community-based application study, the results can be meaningful and applicable.

The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence.

Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1.

Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity.

There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.