Effect of Pelvic Floor Down-Training on Women with Idiopathic Overactive Bladder: Literature Review

Background: Overactive Bladder (OAB) syndrome, a com-mon and debilitating condition, significantly impacts women’s quality of life. It is characterized by urinary urgency, frequency, nocturia, with or without urgency urinary incontinence (UUI) in the absence of other identifiable pathologies. Conventional treatments include behavioral interventions, pharmacotherapy, neuromodulation, and pelvic floor muscle training (PFMT), but each has limitations, particularly regarding adherence and long-term effectiveness. Aim of Study: This literature review aims to evaluate the ef-fectiveness of pelvic floor down-training, a conservative man-agement strategy for women with idiopathic OAB. Material and Methods: A comprehensive literature search was conducted of studies published up to 2024. The search-es were conducted across PubMed, Scopus, Web of Science, Cochrane Library, Clinical Trials, Science Direct, Pedro, and Google Scholar databases. The reviewed literature was ana-lyzed descriptively and summarized. Results: The analysis of existing studies suggests that pelvic floor down-training can effectively reduce urgency epi-sodes, frequency of urination, and UUI by retraining the pelvic floor muscles and inhibiting detrusor overactivity. Some studies also report improvements in bladder compliance and reduced sensory signaling contributing to urgency perception. Addition-ally, biofeedback-guided down-training interventions appear to enhance patient adherence and symptom relief compared to un-supervised exercises. However, variations in training protocols and follow-up durations pose challenges in establishing stand-ardized clinical guidelines. Conclusion: Pelvic floor down-training offers a promising non-pharmacological and cost-effective approach to managing idiopathic OAB in women. Although preliminary evidence sup-ports its efficacy, further high-quality RCTs with standardized methodologies and long-term follow-up are essential to confirm its clinical applicability.