Özgür ASLAN, Tuğba DEMİRTAŞ, Mülayim TETİK, Özlem Yüksel AYBEK, Hakan GÜRASLAN
Anatolian Journal of Obstetrics and Gynecology Research - 2026;3(2):105-111
Purpose: Pelvic floor muscle training is the first-line conservative therapy for stress urinary incontinence, but its value as a preoperative adjunct to mid-urethral sling surgery remains uncertain. Our purpose was to determine whether structured six-week preoperative pelvic floor muscle training (PFMT) improved objective and subjective cure rates in women undergoing transobturator tape (TOT) surgery for stress-predominant mixed urinary incontinence (MUI). Methods: In this single-center retrospective cohort study, we reviewed the records of women who underwent TOT for stress-predominant MUI between January 2020 and December 2024 and who attended an in-person follow-up with a cough stress test at 12 months or later. Patients were stratified by completion of a structured preoperative PFMT program of at least six weeks (PFMT group) versus proceeding directly to surgery (non-PFMT group). The primary outcome was objective cure, defined as the absence of leakage on a standardized cough stress test; the secondary outcome was subjective cure, defined as an improvement of at least 4 points on the international consultation on incontinence questionnaire-urinary incontinence short form (ICIQ-UI SF). Between-group and within-group comparisons were performed using non-parametric tests. Results: Of 137 women, 82 completed preoperative PFMT and 55 proceeded directly to surgery; baseline characteristics were comparable. Objective cure occurred in 87.8% of the PFMT group versus 81.8% of the non-PFMT group (p=0.468), and subjective cure in 92.7% versus 85.5% (p=0.280); no between-group differences were significant. ICIQ-UI SF scores improved markedly in both groups, confirming effective surgery regardless of PFMT. Conclusion: In this retrospective cohort, a six-week preoperative PFMT program was not associated with significantly higher objective or subjective cure rates after TOT in women with stress-predominant MUI. Given the high cure rate of surgery alone, this does not preclude a true benefit of PFMT. Whether such a benefit exists, particularly in women with greater baseline urgency, warrants confirmation in adequately powered prospective studies.
