Rehabilitación de piso pélvico: mensajes para médicos generales, especialistas y fisioterapeutas


  • Jorge Alejandro Pinzón Durán Universidad del Valle, Escuela de Medicina, Grupo de Investigación UROGIV, Cali, Colombia.
  • Ángela Inés Ocampo Trujillo Universidad del Valle, Escuela de Medicina, Grupo de Investigación UROGIV, Cali, Colombia.
  • Herney Andrés García-Perdomo Universidad del Valle, Unidad de Urología/Urooncología. Departamento de Cirugía. Escuela de Medicina. Cali, Colombia.



Description: Pelvic floor therapy is a fundamental part of the rehabilitation process for patients. According to the American College of Physicians, techniques such as Kegel exercises are part of the rehabilitation of the pelvic floor, these are used in the non-pharmacological management of female urinary incontinence. in patients with multiple clinical conditions that affect the quality of life of patients. In this article, it is intended to review the importance of pelvic floor muscle therapy in urinary incontinence, pregnancy, and chronic pelvic pain, as well as to focus on the concept of therapy itself.

Relevance: Pelvic floor muscle therapy is a low-cost tool, indicated in international guidelines and which, to date, has not reported large deleterious effects for people who practice it as a treatment for urinary incontinence. It is vitally important not only to emphasize the pelvic muscles, as stated in the text, since working the muscles in the center of the body, which includes the abdominal and lower back muscles, provide better results for people in this type of exercise. treatment.

Conclusions: This review allows providing clear concepts and perspectives within the reach of medical personnel and physiotherapists in general.



Culbertson S, Davis AM. Nonsurgical Management of Urinary Incontinence in Women. JAMA. 2017 Jan 3;317(1):79–80. doi:

Irwin GM. Urinary Incontinence. Prim Care. 2019 Jun;46(2):233–42. doi:

Bardsley A. An overview of urinary incontinence. Br J Nurs. 2016 Oct 13;25(18):S14–21. doi:

Buckley BS, Lapitan MCM, Epidemiology Committee of the Fourth International Consultation on Incontinence, Paris, 2008. Prevalence of urinary incontinence in men, women, and children--current evidence: findings of the Fourth International Consultation on Incontinence. Urology. 2010 Aug;76(2):265–70. doi:

García-Perdomo HA, López-Ramos H, Carbonell-Gonzalez J, Castillo D. Impacto de la incontinencia urinaria sobre la salud sexual femenina. Revista Urología Colombiana. 2010;XIX(3):59–67.

Lukacz ES, Santiago-Lastra Y, Albo ME, Brubaker L. Urinary Incontinence in Women: A Review. JAMA. 2017 Oct 24;318(16):1592–604. doi:

Gómez Londoño M, Castaño Botero JC, Saldarriaga Hernández EC. Trastornos de la contracción de los músculos del piso pélvico femenino. Urología Colombiana. 2015 Apr 1;24(1):35–43. [accessed 16 Nov 2022] Available from:

García-Perdomo HA, Rodes MC. From Kegel exercises to pelvic floor rehabilitation: A physiotherapeutic perspective. Revista Mexicana de Urología. 2018 Oct 19;78(5). [accessed 16 Nov 2022] Available from:

Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct. 2004 Apr;15(2):76–84. doi:

Sapsford R. The Pelvic Floor: A clinical model for function and rehabilitation. Physiotherapy. 2001 Dec 1;87(12):620–30. [accessed 16 Nov 2022] Available from:

Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther. 2004 Feb;9(1):3–12. doi:

Talasz H, Kremser C, Kofler M, Kalchschmid E, Lechleitner M, Rudisch A. Proof of concept: differential effects of Valsalva and straining maneuvers on the pelvic floor. Eur J Obstet Gynecol Reprod Biol. 2012 Oct;164(2):227–33. doi:

Kamel DM, Thabet AA, Tantawy SA, Radwan MM. Effect of abdominal versus pelvic floor muscle exercises in obese Egyptian women with mild stress urinary incontinence: A randomised controlled trial. Hong Kong Physiotherapy Journal. 2013 Jun 1;31(1):12–8. [accessed 16 Nov 2022] Available from:

Ferla L, Darski C, Paiva LL, Sbruzzi G, Vieira A. Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies. Fisioter mov. 2016 Jun;29:399–410. [accessed 16 Nov 2022] Available from:

Vesentini G, El Dib R, Righesso LAR, Piculo F, Marini G, Ferraz GAR, et al. Pelvic floor and abdominal muscle cocontraction in women with and without pelvic floor dysfunction: a systematic review and meta-analysis. Clinics (Sao Paulo). 2019;74:e1319. doi:

Radzimińska A, Strączyńska A, Weber-Rajek M, Styczyńska H, Strojek K, Piekorz Z. The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review. Clin Interv Aging. 2018;13:957–65. doi:

Dumoulin C, Morin M, Danieli C, Cacciari L, Mayrand M-H, Tousignant M, et al. Group-Based vs Individual Pelvic Floor Muscle Training to Treat Urinary Incontinence in Older Women: A Randomized Clinical Trial. JAMA Intern Med. 2020 Oct 1;180(10):1284–93. doi:

Hodges PW, Sapsford R, Pengel LHM. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007;26(3):362–71. doi:

Neumann P, Gill V. Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct. 2002;13(2):125–32. doi:

Zivkovic V, Lazovic M, Vlajkovic M, Slavkovic A, Dimitrijevic L, Stankovic I, et al. Diaphragmatic breathing exercises and pelvic floor retraining in children with dysfunctional voiding. Eur J Phys Rehabil Med. 2012 Sep;48(3):413–21.

Hung H-C, Hsiao S-M, Chih S-Y, Lin H-H, Tsauo J-Y. An alternative intervention for urinary incontinence: retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function. Man Ther. 2010 Jun;15(3):273–9. doi:

Dumoulin C, Lemieux M-C, Bourbonnais D, Gravel D, Bravo G, Morin M. Physiotherapy for persistent postnatal stress urinary incontinence: a randomized controlled trial. Obstet Gynecol. 2004 Sep;104(3):504–10. doi:

Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10:CD005654. doi:

Zachovajeviene B, Siupsinskas L, Zachovajevas P, Venclovas Z, Milonas D. Effect of diaphragm and abdominal muscle training on pelvic floor strength and endurance: results of a prospective randomized trial. Sci Rep. 2019 Dec 16;9(1):19192. doi:

Patel MI, Yao J, Hirschhorn AD, Mungovan SF. Preoperative pelvic floor physiotherapy improves continence after radical retropubic prostatectomy. Int J Urol. 2013 Oct;20(10):986–92. doi:

Centemero A, Rigatti L, Giraudo D, Lazzeri M, Lughezzani G, Zugna D, et al. Preoperative pelvic floor muscle exercise for early continence after radical prostatectomy: a randomised controlled study. Eur Urol. 2010 Jun;57(6):1039–43. doi:

Bales GT, Gerber GS, Minor TX, Mhoon DA, McFarland JM, Kim HL, et al. Effect of preoperative biofeedback/pelvic floor training on continence in men undergoing radical prostatectomy. Urology. 2000 Oct 1;56(4):627–30. doi:

Burgio KL, Goode PS, Urban DA, Umlauf MG, Locher JL, Bueschen A, et al. Preoperative biofeedback assisted behavioral training to decrease post-prostatectomy incontinence: a randomized, controlled trial. J Urol. 2006 Jan;175(1):196–201; discussion 201. doi:

Manassero F, Traversi C, Ales V, Pistolesi D, Panicucci E, Valent F, et al. Contribution of early intensive prolonged pelvic floor exercises on urinary continence recovery after bladder neck-sparing radical prostatectomy: results of a prospective controlled randomized trial. Neurourol Urodyn. 2007;26(7):985–9. doi:

Artal R. Exercise during pregnancy and the postpartum period. UpToDate. 2022. [accessed 16 Nov 2022] Available from:

Friedman S, Blomquist JL, Nugent JM, McDermott KC, Muñoz A, Handa VL. Pelvic muscle strength after childbirth. Obstet Gynecol. 2012 Nov;120(5):1021–8. doi:

Mottola MF, Davenport MH, Ruchat S-M, Davies GA, Poitras VJ, Gray CE, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018 Nov;52(21):1339–46. doi: 10.1136/bjsports-2018-100056

Boyle R, Hay-Smith EJC, Cody JD, Mørkved S. Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database Syst Rev. 2012 Oct 17;10:CD007471. doi:

Bonder JH, Chi M, Rispoli L. Myofascial Pelvic Pain and Related Disorders. Phys Med Rehabil Clin N Am. 2017 Aug;28(3):501–15. doi:

Kotarinos RK. Myofascial pelvic pain syndrome in females: Pelvic floor physical therapy for management - UpToDate. UpToDate. 2022. [accessed 16 Nov 2022] Available from:

Starr JA, Drobnis EZ, Lenger S, Parrot J, Barrier B, Foster R. Outcomes of a comprehensive nonsurgical approach to pelvic floor rehabilitation for urinary symptoms, defecatory dysfunction, and pelvic pain. Female Pelvic Med Reconstr Surg. 2013 Oct;19(5):260–5. doi:






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