Comparing Use of a Digital Health System of Pelvic Floor Exercise Program to Kegel Exercises in Stress Urinary Incontinence
Stress Urinary Incontinence, Mixed Urinary Incontinence
About this trial
This is an interventional treatment trial for Stress Urinary Incontinence focused on measuring Digital Health, Female
Eligibility Criteria
Inclusion Criteria:
- Capable of giving informed consent.
- Self-reported stress-type UI symptoms of >= three months duration
- Diagnosis of stress predominant urinary incontinence based on MESA stress symptom score greater than MESA urge symptom score (percent of total possible urge score).
- UDI-6 score >/= 25
- Willing to participate in the 8-week study with follow up at 6-and 12-months, refraining from the pursuit of treatment for Stress Urinary Incontinence using other modalities (i.e. will not wear a pessary, participate in pelvic floor PT or surgery) during the first 8- weeks.
Exclusion Criteria:
- Absence of a vagina.
- Age <18 years.
- Stage 3-4 pelvic organ prolapse (as determined by POP-Q).
- Diagnosis of any neuromuscular disease.
- Non-ambulatory.
- Currently pregnant or <12 months post-partum.
- </= 3 months after failed surgery for stress urinary incontinence.
- Previous pelvic floor muscle training (PFMT) within the last 12 months under a supervised therapeutic plan of care.
- Currently taking, or has taken within the last 2 months, medication to treat urinary incontinence.
- Prior augmentation cystoplasty or artificial sphincter.
- Implanted nerve stimulator for urinary symptoms.
- Participation in another clinical study within 30 days of screening.
- Impaired cognitive function.
- Contraindication to the use of a vaginal probe.
- Unable to understand instructions on the use of the leva® Plus Pelvic Digital Health System.
- Unable to actively recruit the pelvic floor muscles to any degree for attempted volitional contraction.
Sites / Locations
- University of Alabama
- Cedars-Sinai Medical Group
- Northwestern University
- Massachusetts General Hospital
- Cleveland Clinic
- Univeristy of Oklahoma
- Urology San Antonio
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Leva Arm
Kegel Arm
Subjects will undergo pelvic floor muscle training using the leva device (a vaginal probe) which provides immediate visual feedback via smartphone regarding the motion of pelvic floor muscles. Subjects will perform exercises 2 1/2 minutes twice daily for 8 weeks. At the beginning of the study, four weeks later, and eight weeks later subjects will undergo pelvic floor muscle testing using the PFDx device and surveys to document response to training. After eight weeks, subjects may pursue any additional treatments they wish, but may continue to use the device. They will be further randomized to receive reminder text messages or no messages over 10 months. Subjects will be asked to complete follow up surveys at 6- and 12-months.
Subjects in this arm will perform pelvic floor muscle exercises (Kegels) for the treatment of stress or mixed urinary incontinence. Subjects will be asked to perform exercises three times daily for 8 weeks. At the beginning of the study, four weeks later, and eight weeks later, subjects will undergo pelvic floor muscle testing (using the PFDx device) and surveys to document response to training. After eight weeks, subjects may pursue any additional treatments they wish, but may continue to use the device.