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Stress Urinary Incontinence (SUI) shows difficulties, not only for the correct diagnosis, but also with the type of therapeutics. In fact, with the news modalities of the treatment and different techniques for surgical approach, the unsuccessful indexes are around 15 to 20% in the following 5 years of surgery, independent of the type of procedure and the ability of the surgeon 1.
The striated musculature of the pelvic floor has a relevant part in the mechanism of urinary incontinence, because it is fundamental for the maintenance of anatomical support and intra-urethral pressure. The fibers of this musculature are of type I and II. Type I are characterized because they contract slowly and for long periods, without feeling fatigue, they are responsible for the maintenance of the muscular tonus 2. Type II fibers are more tiring; they present a large quantity of glycolytic enzymes, a small concentration of mitochondria which gives them a low aerobic potential. They are fibers that contract quickly in response to the sudden raise of the intra-abdominal pressure 2. The type I fibers are predominant over the type II 2,3.
The traumatic effect of a transpelvic birth or tissue atrophy which occurs during menopause result in a musculature pelvic floor dysfunction, that normally is not valued in a gynecological exam, even though it is one the main ethiopathogenic factors of SUI and/or genital prolapse and responsible for the high rate of recidivous post-surgical.
That is the reason that many techniques that aim to strengthen the pelvic floor musculature have been developed. This therapeutic modality has been reserved for light and moderate forms of SUI, besides being able to be used as a preventive method or help in surgery 4.
The first technique was described by Kegel 4, which extolled quick voluntary contractions of the muscles of the pelvic floor. Meanwhile, even though oriented about the anatomy and function of these muscles, 30% of the patients cannot correctly distinguish the muscles of the pelvic floor from the contractions of other muscles, like the abdominal rectum, gluteus maximum and thigh adductors 5.
The use of vaginal cones for the strengthening of the musculature of the pelvic floor was first proposed by PLEVNIK 6. The author observed that the patients adequately contract this muscular group so they can retain the cone, making this therapeutic more objective and efficient.
So the high rate of recidivous post-surgery and the relation of SUI with the musculature disjunction of the pelvic floor, motivated us to do this study.