A 2016 randomized clinical trial published in the European Journal of Obstetrics & Gynecology and Reproductive Biology explored the effectiveness of pelvic floor muscle training (PFMT) using vaginal weights versus Tolterodine, a commonly prescribed anticholinergic, for treating overactive bladder (OAB) in women.
Study Design
The study assessed changes in:
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Lower urinary tract symptoms (LUTS)
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Sexual function
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Quality of life (QOL)
Validated tools included:
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UDI-6
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IIQ-7
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OAB-V8
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Wagoner’s Questionnaire for QOL
Urodynamic testing and 24-hour pad tests were performed before and after the intervention.
Treatment Groups
✔️ Vaginal Weight Group:
Participants used one of four progressively heavier cones for 10 minutes, twice daily, while standing or doing light activity. Once they could maintain a weight beyond 10 minutes, they advanced to the next level.
✔️ Tolterodine Group:
Participants took 4 mg of Tolterodine daily. Both groups had check-ins at 4 and 8 weeks to monitor adherence and side effects.
Outcomes
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Both groups showed a ~68% reduction in pad weight at 8 weeks.
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The vaginal weight group had a significant increase in pelvic floor strength and improvements across all outcome measures—including QOL.
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The medication group improved in all areas except the Wagoner QOL score.
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Detrusor overactivity resolved in 8 patients using vaginal weights vs. just 2 in the medication group.
No adverse effects were reported in either group.
Clinical Implication
This study supports vaginal weights as a safe, effective, and conservative treatment for OAB—particularly for symptoms like urgency and frequency. The 10-minute, twice-daily protocol, though more intensive than typical recommendations, was well tolerated and highly effective.
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