***TASK*** the task is to summarize an input biomedical literature in six sentences 
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    Input: Objective To assess the effect of pelvic floor education after vaginal delivery on pelvic floor characteristics in nulliparous women . Methods We examined 107 nulliparas during pregnancy and at 9 weeks and 10 months after vaginal delivery . Methods used included a question naire , clinical examination , perineosonography , urethral pressure profiles , and intravaginal and intra-anal pressure recordings during pelvic floor contraction . After the second examination , the women were assigned in alternating manner to either 12 sessions of pelvic floor exercises with biofeedback and electrostimulation ( n = 51 ) or no training ( n = 56 ) . The two groups were compared at the third examination . Results Stress urinary incontinence incidence decreased in 2 % of control subjects compared with 19 % of women who underwent pelvic floor education ( P = .002 ) , whereas the incidence of fecal incontinence ( 5 % versus 4 % , P = 1 ) and the percentage of women who recovered predelivery pelvic floor contraction strength ( 33 % versus 41 % , P = .4 ) were no different . We observed no significant differences in bladder neck position and mobility , urethral functional length , maximal urethral closure pressure , pressure transmission ratio , residual area of continence at stress st and ing , or intravaginal or intra-anal pressures during pelvic floor contraction between groups at the third examination . Conclusion Pelvic floor education , begun 2 months postpartum , significantly reduced the incidence of stress urinary incontinence , but not fecal incontinence or weak pelvic floor . Similarly , bladder neck behavior , urodynamic characteristics , intravaginal or intra-anal pressures during pelvic floor squeezing also were not modified OBJECTIVE The aim of this study was to evaluate the effect of perineal massage performed during pregnancy on perineal symptoms 3 months after delivery . STUDY DESIGN Pregnant women from 5 hospitals in the province of Quebec , Canada , participated in this single-blind , r and omized , controlled trial . All participants received oral and written information on the prevention of perineal trauma . Women in the experimental group were taught the perineal massage technique and were asked to perform a 10-minute perineal massage daily from the 34th through 35th weeks of pregnancy until delivery . Participants completed a self-administered question naire on perineal pain , dyspareunia , sexual satisfaction , and incontinence of urine , flatus , and stool at the time of enrollment and 3 months after delivery . RESULTS Among participants without a previous vaginal birth there were no differences between the  massage ( n = 283 ) and the  control ( n = 289 ) groups with respect to perineal pain , dyspareunia , sexual satisfaction , and incontinence of urine , gas , or stool 3 months post partum . Among women with a previous vaginal birth more women in the massage group ( n = 187 ) than in the control group ( n = 190 ) were free of perineal pain ( 93.6 % vs 85.8 % ; P = .01 ) but the frequencies of dyspareunia and incontinence of urine , gas , or stool were similar in the 2 groups . CONCLUSIONS Perineal massage during pregnancy neither impairs nor substantially protects perineal function at 3 months post partum The effect of exercise on pressure developed by the circumvaginal muscles ( CVM ) in postpartum women was studied . The CVM assessment system described earlier by Dougherty , Abrams , and McKey used an intravaginal balloon device ( IVBD ) developed from an impression and model of the vagina . The system ( IVBD , pressure transducer and strip chart recorder ) provided permanent CVM pressure tracings with high test-re-test reliability ( n = 16 ; r = .85 ) for maximum pressure ( MP ) . The hypothesis in the research reported here was that exercise with and without an IVBD , when compared to no exercise , would result in significantly higher MP and pressure over time ( POT ) . Forty-five healthy PP volunteers were r and omly assigned to a 10-minute per day home training program , for six weeks . The baseline and six-week assessment s consisted of CVM pressure tracings during contraction . Dependent variables were MP ( highest pressure attained ) and POT ( area under the pressure curve ) . Although no significant differences were found between the home training groups , greater improvement was found in the exercise groups . Variability within subjects partly accounts for the results . Pressure changes before and after pregnancy and before and after CVM exercise are demonstrated in a case study . The findings support the use of CVM exercise in the postpartum We examined the results of teaching pelvic floor muscle exercises ( PME ) on micturition parameters , urinary incontinence , post-micturition dribbling , and quality of life in patients after transurethral prostatectomy ( TURP ) . Fifty-eight consecutive patients who were selected to undergo TURP for benign prostatic hyperplasia ( BPH ) were admitted into the study : 28 were r and omly assigned to a control group  ( A ) , 30 formed the investigational group ( B ) during an initial visit conducted before surgery . In group B patients , perineal exercises were demonstrated in detail , and tested for their correct use via simultaneous rectal and abdominal examination . After the removal of the urethral catheter , these patients were instructed to perform pelvic floor muscle exercises at home and were evaluated before the exercises and at weekly intervals postoperatively . The American Urological Association Symptom Score improved significantly after TURP in both groups . The average quality of life score improved more significantly in group B after TURP , from 5.5 to 1.5 ( P < 0.001 ) . The grade of muscle contraction strength after 4 weeks of PME increased from 2.8 to 3.8 in group B ( P < 0.01 ) ; it was unchanged in the group A. The number of patients with incontinence episodes and post-micturition dribbling was significantly lower in the group B at weeks 1 , 2 , and 3 ( P < 0.01 ) . Our results show that pelvic floor muscle re-education produces a quicker improvement of urinary symptoms and of quality of life in patients after TURP . Its early practice reduces urinary incontinence and post-micturition dribbling in the first postoperative weeks . The exercises are simple and easy to perform in the clinical setting and at home , and therefore should be recommended to all cooperative patients after TURP OBJECTIVE To determine the prevalence of and characteristics associated with anal incontinence in the general community . SETTING Community survey . PARTICIPANTS The population of the state of Wisconsin sample d in the Wisconsin Family Health Survey . Subjects were identified by r and om digit dialing with telephone interview . The individual within each household identified as most knowledgeable about the health status of all other members of the household was asked about the health status of each member of the household . Approximately 200 households were surveyed each month . MAIN OUTCOME MEASURES The presence of anal incontinence to solid or liquid feces or gas , who suffered from it , the frequency of anal incontinence , and how the incontinent person coped with it . RESULTS A total of 2570 households comprising 6959 individuals were surveyed , and 153 individuals were reported to have anal incontinence  , representing 2.2 % of the population ( 95 % confidence interval [ Cl ] , + /- 0.3 % ) . Thirty percent of the incontinent subjects were older than 65 years , and 63 % were women . Of those with anal incontinence , 36 % were incontinent to solid feces , 54 % to liquid feces , and 60 % to gas . In a multivariate analysis , independent associations of the following risk factors with anal incontinence were found : female sex ( odds ratio [ OR ] , 1.5 ; Cl , 1.1 to 2.1 ) , age ( continuously adjusted ) ( OR , 1.01 ; Cl , 1.01 to 1.02 ) , physical limitations ( OR , 1.8 ; Cl , 1.2 to 2.7 ) , and poor general health ( OR , 1.6 ; Cl , 1.4 to 1.9 ) . CONCLUSIONS Anal incontinence was reported in 2.2 % of the general population . Independent risk factors for incontinence include female sex , advancing age , poor general health , and physical limitations Objective To evaluate the long term effect of a postpartum pelvic floor muscle training course in prevention and treatment of urinary incontinence OBJECTIVE Fecal incontinence represents an embarrassing social problem , the magnitude of which remains largely unknown . The present study prospect ively examined the prevalence and demographic distributions of fecal incontinence . METHODS demographic data , in addition to information regarding the reason for visit , bowel habits , and the frequency , type , and severity of fecal incontinence , were collected from individuals at the time of visits to their primary care physician or gastroenterologist .  RESULTS Eight hundred and eighty-one individuals 18 yr or older were included in the analysis . The overall prevalence of fecal incontinence was 18.4 % . When stratified by frequency , 2.7 , 4.5 , and 7.1 % of participants admitted to incontinence daily , weekly , or once per month or less , respectively . Incontinence increased progressively with age and was 1.3 times more common in males than females . Only one-third of individuals with fecal incontinence had ever discussed the problem with a physician . CONCLUSIONS The prevalence of fecal incontinence appears to be more common than previously appreciated . Moreover , only a minority with a physician . It would seem important to more actively pursue this " silent affliction " particularly in patients who do not readily volunteer this information Objective To test the effect of pelvic muscle exercise on  postpartum symptoms of stress urinary incontinence  and  pelvic muscle strength in primigravidas during pregnancy and postpartum . Methods A prospect i ve trial r and omized women into treatment ( st and ardized instruction in pelvic muscle exercise ) or control ( routine care with no systematic pelvic muscle exercise instruction ) . Urinary incontinence symptoms were measured by question naire . Pelvic muscle strength was quantified by an instrumented gynecologic speculum . Time points were 20 and 35 weeks ' gestation and 6 weeks , 6 months , and 12 months postpartum . Results Outcomes are reported for 46 women with vaginal or cesarean birth and for a sub sample of 37 women with vaginal birth . Longitudinal analyses are reported for cases with complete data across time points . Diminished urinary incontinence symptoms were seen in the treatment group , with significant treatment effects demonstrated at 35 weeks ' gestation ( F [ 1,43 ] = 4.36 , P = .043 ) , 6 weeks postpartum ( F [ 1,43 ] = 4.94 , P = .032 ) , and 6 months postpartum ( F [ 1,43 ] = 4.29 , P = .044 ) . A repeated measures analysis of variance showed a significant interaction between time and treatment for urinary incontinence ( F [ 4 , 41 ] = 2.83 , P = .037 ) . A significant effect of initial pelvic muscle strength was demonstrated ; ie , pelvic muscle strength at 20 weeks ' gestation predicted significantly 12-months postpartum strength ( F [ 1 , 13 ] = 8.12 , P = .014 ) . Group differences in pelvic muscle strength were observed ( the treatment group had greater strength at 6 weeks and at 6 months postpartum than did controls ) , but these differences were not statistically significant . Conclusion Practice of pelvic muscle exercise by primiparas results in fewer urinary incontinence symptoms during late pregnancy and postpartum AIMS To determine the prevalence of  constipation and faecal incontinence in the community . METHODS A 20- question multi-field postal question naire was sent to 1500 adults ( over 18 years ) r and omly selected from the electoral roll in the Canterbury region . Questions detailed frequency of bowel function , time spent at the toilet , incidence and severity of faecal incontinence , constipation , and the effect of disordered bowel function . RESULTS Of 1500 question naires , 717 ( 48 % ) were returned ( male : female 388:329 ) . The median age was 46 years ( range 18 - 70 ) . 24 ( 4 % ) had self-reported gastrointestinal disease . There was a median frequency of seven bowel motions per week ( BM/wk ) ( range 1 to 70 ) with 89 % having between two motions a day and one every two days . Faecal incontinence affected lifestyle in 58 ( 8.1 % ) . Incontinence of solid stool at least once a month occurred in 70 ( 9.8 % ) , of liquid stool in 91 ( 12.7 % ) , of gas in 459 ( 64 % ) , while 12 ( 2 % ) regularly wore a pad . Those with self-reported gastrointestinal disease had a significantly higher ( p<0.05 ) bowel motion frequency ( 17 vs 7 BM/wk ) and median faecal incontinence score ( 2.5 vs 0 ) . Laxatives were used by 4.9 % of the population , while 26.2 % increased fibre to avoid constipation . CONCLUSIONS The normal frequency of bowel motions ( + /- 2SD ) was 2 - 17 per week . Faecal incontinence affecting life style affected 8.1 % , while constipation requiring regular laxative use affected 4.9 % of people . There is acceptance in the community that a moderate degree of bowel dys 
    Output:
    
REVIEW ER 'S CONCLUSIONS There is insufficient evidence to determine whether physical therapies can prevent incontinence in childbearing women , or men following prostate surgery .