Measurement of vaginal pressure profile during horseback riding and its effect on pelvic floor function in a woman with stress urinary incontinence: a case report

Stress urinary incontinence (SUI), the complaint of involuntary leakage during effort or exertion, occurs at least weekly in one third of adult women. Additional studies have demonstrated that horseback riding promotes pelvic floor training in women with stress incontinence, leading to increased resting pelvic floor tension and stronger tension during active pelvic floor muscle contraction. No study to date has measured the vaginal pressure profile using FemFit® during different types of horseback riding or assessed its effects on pelvic floor function in a woman with mild symptoms of SUI. This case report describes a 46-year-old woman with SUI who practiced recreational horseback riding over a period of 12 weeks. Significant differences were observed between the gallop and all other types of riding, with the highest values recorded during the gallop. Examination of pelvic floor muscle function (via manometer, 2D/3D ultrasound using volume contrast imaging software) revealed an increase in maximal voluntary contraction from 27.5 (1.4) to 45.7 (2.2) cm H2O and its duration from 5 (0.2) to 8 (0.4) s. A decrease in the hiatal area was noted during contraction (from 16.5 (0.8) to 15.0 (0.7) cm2) and during the Valsalva maneuver from 19.6 (0.9) to 18.8 (0.9) cm2. Horseback riding with pelvic floor muscle activation positively improved pelvic floor muscle function and reduced urinary leakage symptoms. It would be beneficial to perform similar measurements on larger groups of female horse riders.