Lifestyle Medicine and Female Urinary Incontinence in Viet Nam: Pelvic Floor Muscle Training, Bladder Training, and Appropriate Referral

Lifestyle Medicine and Female Urinary Incontinence in Viet Nam: Pelvic Floor Muscle Training, Bladder Training, and Appropriate Referral

Primary category: Evidence & Clinical Practice

Secondary category: Lifestyle Medicine in Viet Nam

Article type: VLMA Perspective

Last reviewed: October 30, 2026

For some women, urinary leakage begins with a small amount of urine escaping when they cough, laugh, or exercise. Others experience a sudden need to urinate and occasionally cannot reach the toilet in time. What begins as an occasional inconvenience may gradually affect work, physical activity, sleep, relationships, and confidence in everyday life.

Many women hesitate to discuss these symptoms. Some feel embarrassed, while others assume urinary leakage is an unavoidable consequence of childbirth, menopause, or aging. They may use protective pads, avoid exercise, or plan their activities around the availability of toilets, sometimes for years before seeking professional advice.

Urinary incontinence is common, but it should not simply be accepted as an inevitable part of life. Effective treatments are available, and many women can benefit from appropriately selected conservative interventions.

Evidence-based Lifestyle Medicine can contribute through health behavior support, weight management when indicated, and attention to factors that influence bladder symptoms. Targeted pelvic floor muscle training and bladder training also have important roles, although these are clinical interventions with different objectives and requirements.

For healthcare professionals in Viet Nam, the challenge is to recognize the different patterns of urinary incontinence, identify women who need additional assessment, and support access to appropriate treatment without unnecessary investigation, embarrassment, or delay.

Urinary Incontinence Is Not One Clinical Condition

Urinary incontinence refers to involuntary leakage of urine. Although the symptom may appear straightforward, understanding when and how leakage occurs is essential to selecting appropriate care.

Stress urinary incontinence occurs when urine leaks during activities that increase pressure within the abdomen, such as coughing, sneezing, laughing, running, or lifting. The word stress refers to physical pressure rather than psychological stress. This form of incontinence is commonly associated with impaired urethral support or reduced effectiveness of the mechanisms that maintain continence when abdominal pressure increases.

Urgency urinary incontinence has a different presentation. Leakage occurs in association with a sudden, difficult-to-defer need to urinate. It may be accompanied by increased urinary frequency or waking at night to pass urine.

Urgency is the defining symptom of overactive bladder, which may occur with or without urinary leakage. Overactive bladder is a symptom syndrome that should be considered after urinary infection and other relevant causes have been appropriately evaluated.

Mixed urinary incontinence involves both stress-related and urgency-related leakage. Some women are primarily troubled by leakage during exercise or coughing, while others find urgency and unpredictable episodes more disruptive. Identifying the most bothersome symptoms can help guide treatment priorities.

Other presentations also require consideration. Continuous urinary leakage may suggest an abnormal connection between the urinary tract and another structure, such as a urogenital fistula. Difficulty emptying the bladder or leakage associated with substantial residual urine may indicate impaired bladder emptying or urinary retention.

In some older women, reduced mobility, cognitive impairment, or difficulty reaching the toilet may contribute to urinary leakage even when impaired urethral control is not the primary problem.

These distinctions matter because treatment approaches differ. A woman with stress urinary incontinence may benefit from targeted pelvic floor muscle training, while someone with urgency-predominant symptoms may require bladder training and assessment of contributing factors. Patients with suspected retention, neurological disease, or structural abnormalities may need a different clinical pathway.

The first step is therefore to understand the symptoms and their possible causes rather than automatically recommending the same exercises to every woman.

Clinical Assessment Should Guide Treatment Selection

International guidelines emphasize that a careful history and focused examination are central to the initial assessment of female urinary incontinence.

The European Association of Urology's 2026 Guidelines on Non-neurogenic Female Lower Urinary Tract Symptoms provide a comprehensive framework for evaluating urinary symptoms and selecting appropriate management. The 2026 edition is a reprint of the 2025 guideline with minor formatting changes, rather than a full revision of its clinical recommendations. [1]

Assessment should establish when leakage occurs, how frequently it happens, whether urgency is present, and how symptoms affect daily life.

Relevant information may include pregnancy and childbirth history, menopause-related symptoms, previous pelvic or continence surgery, neurological conditions, medications, constipation, recurrent urinary infections, and associated pelvic symptoms.

A focused examination may help identify pelvic organ prolapse, abnormalities of pelvic floor function, or findings suggesting another condition. A cough stress test may be useful when stress urinary incontinence is suspected.

Pelvic examinations and internal pelvic floor assessments require appropriate professional competence, informed consent, respect for privacy, and sensitivity to the patient's comfort and preferences. Their purpose and available alternatives should be explained clearly before proceeding.

Urine testing is another important part of initial assessment.

The United Kingdom's National Institute for Health and Care Excellence recommends urine dipstick testing in women presenting with urinary incontinence to identify findings such as blood, glucose, protein, leukocytes, or nitrites that may require further consideration. [2]

A bladder diary can provide useful information that may not emerge during a brief consultation. Recording fluid intake, voiding times, urgency, leakage episodes, and nighttime urination helps identify patterns and establish a baseline for evaluating treatment.

NICE recommends a bladder diary covering at least three days, including variations in normal activities where possible. The European Association of Urology similarly recommends using bladder diaries during assessment and follow-up. [1,2]

These records should support clinical judgment rather than replace it.

Routine cystoscopy, urinary tract imaging, or invasive urodynamic testing is generally unnecessary in uncomplicated presentations when initial conservative treatment is appropriate. These investigations become more relevant when the diagnosis is uncertain, additional pathology is suspected, or the findings are likely to change treatment decisions.

The objective is to avoid both inadequate assessment and unnecessary testing.

Pelvic Floor Muscle Training Requires More Than Repeated Contractions

Pelvic floor muscle training is among the best-supported conservative treatments for women with stress urinary incontinence.

The pelvic floor muscles contribute to pelvic organ support and urinary continence. Appropriate training aims to improve muscle strength, endurance, coordination, and the ability to contract and relax the muscles when needed.

The European Association of Urology recommends supervised intensive pelvic floor muscle training lasting at least three months as first-line treatment for women with stress or mixed urinary incontinence. [1]

NICE similarly recommends a supervised program lasting a minimum of three months. [2]

These recommendations are supported by clinical trials and systematic reviews demonstrating improvements in urinary leakage, symptoms, and quality of life.

However, pelvic floor muscle training involves more than telling someone to perform repeated Kegel exercises.

Some women have difficulty identifying the correct muscles. Others may contract abdominal, gluteal, or thigh muscles without generating an effective pelvic floor contraction. Incorrect technique, excessive straining, or an unsuitable training program may reduce the benefits of treatment.

A structured approach should therefore begin with assessment of the woman's ability to contract and relax the pelvic floor muscles appropriately. Training can then be adapted to her symptoms, muscle function, physical capacity, and response to treatment.

Pelvic floor function involves relaxation as well as contraction. Women experiencing pelvic pain, excessive muscle tension, or difficulty relaxing the pelvic floor may require a different therapeutic approach. Repeated strengthening exercises alone may be inappropriate or may aggravate symptoms in selected patients.

Women should also not routinely practice pelvic floor contractions by repeatedly interrupting urine flow during urination. Using this as a regular training method is not recommended because it may interfere with normal voiding.

For some women with stress urinary incontinence, treatment may eventually include learning to coordinate a pelvic floor contraction with activities that commonly trigger leakage, such as coughing or lifting.

The objective is not simply to demonstrate stronger muscles during examination, but to improve urinary control during everyday activities.

Supervision does not necessarily require prolonged individual sessions for everyone. Following appropriate assessment and instruction, selected women may benefit from supported home programs or group-based training.

The most suitable approach depends on clinical needs, the availability of qualified professionals, and whether correct technique can be established and maintained.

What the Evidence Says About Different Training Approaches

Pelvic floor muscle training can be delivered through individual sessions, group programs, supported home exercises, and selected technology-assisted approaches.

An important question is whether more complex or intensive delivery methods necessarily produce better outcomes.

A Cochrane systematic review published in December 2024 examined different approaches to pelvic floor muscle training for women with urinary incontinence. The review included 63 trials involving 4,920 women. [3]

The investigators compared exercise types, training doses, and approaches to supervision or delivery.

The findings support the importance of direct pelvic floor muscle training involving repeated voluntary contractions of the targeted muscles. Indirect exercises that do not specifically involve pelvic floor contractions should not automatically be assumed to produce equivalent continence benefits.

However, the evidence concerning differences between training methods remains variable. Some approaches may offer advantages, while others appear to produce similar results. Many comparisons were based on small studies or evidence of low or very low certainty.

The review found that individual and group supervision probably produce little or no difference in urinary incontinence-related quality of life under the conditions examined.

This does not mean professional assessment is unnecessary. Many programs involved individual instruction or confirmation of correct pelvic floor contraction before participants continued training.

The findings also do not establish that every patient requires an expensive or highly individualized program.

For healthcare organizations, a practical lesson is that treatment quality depends on selecting an appropriate approach, ensuring correct instruction, and evaluating outcomes rather than simply providing more sessions or equipment.

What the October 2026 Trial Adds

A randomized controlled trial published online in the International Urogynecology Journal on October 15, 2026, provides new evidence concerning exercise specificity. [4]

The study compared Pilates training, Pilates combined with voluntary pelvic floor muscle contractions, and specific pelvic floor muscle training in women with stress urinary incontinence.

A total of 105 women were randomly assigned to three groups. Participants were offered 12 supervised sessions over six weeks, and 88 completed the intervention.

The researchers evaluated urinary incontinence impact using the International Consultation on Incontinence Questionnaire–Short Form. They also measured pelvic floor muscle strength and vaginal squeeze pressure.

The group receiving specific pelvic floor muscle training experienced greater improvements across the assessed outcomes than either Pilates group.

The mean reduction in questionnaire score was 4.4 points in the targeted training group, compared with 0.7 points in each Pilates group. Pelvic floor muscle strength and vaginal squeeze pressure also improved more in the targeted training group.

The findings suggest that specific pelvic floor muscle training may provide greater short-term benefits for women with stress urinary incontinence than the particular Pilates programs evaluated in the trial.

However, the study was relatively small, the intervention lasted only six weeks, and it did not establish whether the differences would persist over longer periods.

The findings also cannot be generalized automatically to women with urgency urinary incontinence, significant pelvic organ prolapse, neurological conditions, or other complex presentations.

Nor do the results establish that Pilates is ineffective for general physical fitness or that women with urinary incontinence should avoid it.

The study addresses a narrower clinical question: whether the particular Pilates programs tested produced benefits comparable to targeted pelvic floor muscle training for stress urinary incontinence.

Its findings reinforce the importance of selecting exercises that address the intended clinical function.

For Lifestyle Medicine, the broader lesson is that general physical activity and condition-specific rehabilitation may complement one another, but they are not necessarily interchangeable treatments.

Bladder Training Addresses a Different Problem

Pelvic floor muscle training and bladder training are related but distinct interventions.

Bladder training is particularly relevant to overactive bladder and urgency urinary incontinence. It aims to help patients manage urinary urgency, reduce troublesome frequency, and establish more manageable voiding patterns.

The American Urological Association and Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction's 2024 guideline recommends offering bladder training to patients with idiopathic overactive bladder. This is a strong recommendation supported by high-quality evidence. [5]

NICE recommends bladder training lasting at least six weeks as first-line treatment for women with urgency or mixed urinary incontinence. [2]

A structured program typically involves education, review of voiding patterns, planned intervals between urination, and strategies for responding to urgency. These intervals may be increased gradually according to symptoms, tolerance, and clinical suitability.

The purpose is not to force patients to retain urine for excessively long periods or ignore pain, urinary retention, infection, or new neurological symptoms.

For example, someone who frequently urinates as a precaution may benefit from understanding how these habits relate to urgency and how they can be modified safely. Another woman may need attention to excessive fluid intake, troublesome nighttime urination, or medical conditions contributing to urinary frequency.

Bladder training should be individualized, particularly when mobility limitations, cognitive impairment, recurrent urinary infections, or possible incomplete bladder emptying are present.

For mixed urinary incontinence, management may involve both bladder training and pelvic floor muscle training, with treatment priorities guided by the symptoms causing the greatest difficulty.

The 2024 American Urological Association guideline also emphasizes shared decision-making rather than requiring every patient with overactive bladder to follow a rigid sequence of treatment stages. Behavioral approaches, medications, and other treatment options may be considered according to the patient's needs, preferences, risks, and expected benefits. [5]

Conservative care should therefore be offered appropriately without creating unnecessary delays in accessing medication or specialist treatment when these are clinically indicated.

Lifestyle Adjustments Should Be Targeted, Not Restrictive

Several everyday behaviors can influence urinary symptoms, but their relevance varies between individuals.

Fluid intake is one example. Some women substantially reduce drinking because they fear leakage. Others consume large quantities of fluid within a short period, potentially worsening urgency or frequency. Neither extreme is necessarily appropriate.

NICE recommends considering fluid intake adjustments for women with urinary incontinence or overactive bladder who consume unusually high or low amounts. [2]

The objective is to establish an appropriate drinking pattern rather than impose a universal fluid restriction.

Patients with heart failure, kidney disease, or other conditions requiring individualized fluid management need particular consideration. Advice intended to reduce urinary leakage should not conflict with medically necessary hydration or fluid restrictions.

Caffeine reduction may help some women with overactive bladder symptoms. However, the evidence does not justify telling every woman with urinary leakage to eliminate all caffeinated beverages.

Weight management may also be relevant. Excess body weight can contribute to stress urinary incontinence, and appropriate weight reduction may improve symptoms in selected women with overweight or obesity.

NICE advises weight reduction for women with urinary incontinence or overactive bladder when body mass index exceeds 30. [2]

This is a recommendation within a United Kingdom guideline, not a universal treatment target or a Vietnamese regulatory requirement.

Weight reduction should not automatically be recommended to women with normal weight, those experiencing unintended weight loss, or people at risk of malnutrition.

Constipation also deserves attention because repeated straining and bowel dysfunction may aggravate pelvic floor symptoms. Reviewing bowel habits and providing appropriate management can therefore contribute to comprehensive care.

Persistent coughing, smoking, medications, diabetes, and other medical conditions may influence urinary symptoms or overall pelvic health.

These factors should be considered according to clinical relevance rather than assuming that urinary leakage is always caused by lifestyle behavior.

Lifestyle Medicine can support beneficial changes, but it should not place responsibility on women for symptoms that may involve anatomical, neurological, hormonal, functional, or other medical causes.

What Clinical Experience From Viet Nam Adds

Evidence from Vietnamese healthcare settings is important because delivering pelvic floor rehabilitation depends on professional expertise, service availability, patient understanding, and the ability to maintain treatment over time.

A narrative review by Huỳnh Thúy Lan from Hung Vuong Hospital in Ho Chi Minh City was published in the Pham Ngoc Thach Journal of Medicine and Pharmacy in January 2026. [6]

The article reviewed international evidence for pelvic floor muscle training and presented clinical experience from the hospital's pelvic floor service. It described a rehabilitation approach involving assessment, individualized exercises, selected supportive techniques, and follow-up.

The publication also reported observations from 86 women with stress urinary incontinence.

According to the review, urinary incontinence symptom scores improved during treatment, and more than 70% of the women were reported to have experienced symptom improvement and satisfaction following 12 weeks of guided pelvic floor muscle training.

These observations are encouraging but require careful interpretation.

The publication is a narrative review incorporating local clinical experience, not a randomized trial comparing pelvic floor muscle training with another intervention or no treatment.

Without an appropriate comparison group, improvements cannot be attributed exclusively to the training program. Patient selection, natural symptom variation, other interventions, and additional factors may have influenced the findings.

The reported percentage should therefore not be presented as a general treatment success rate for Vietnamese women.

Nevertheless, the experience offers useful insight into rehabilitation delivery, particularly the importance of correct technique, professional guidance, treatment adherence, and continued assessment.

A further development occurred on March 26, 2026, when Hung Vuong Hospital formally inaugurated its specialized Pelvic Floor Center. [7]

The center represents growing clinical attention to pelvic floor disorders and women's pelvic health in Viet Nam.

However, the development of specialized services at one hospital does not establish that similar expertise or treatment capacity is available throughout the country.

Further Vietnamese research would be valuable, particularly studies with appropriate comparison groups, longer follow-up, standardized outcomes, and participation from different healthcare settings.

Viet Nam's 2026 National Guidance Recognizes Pelvic Floor Rehabilitation

On January 29, 2026, the Ministry of Health issued Decision No. 298/QĐ-BYT, introducing national professional guidance for reproductive healthcare services concerning sexual health. [8]

The guidance includes content relating to pelvic floor physiotherapy and its place within appropriate reproductive and sexual healthcare services.

This is relevant to professional education because it provides a Vietnamese reference for pelvic floor rehabilitation within a broader clinical framework.

However, the scope of the document must be understood accurately.

Decision No. 298/QĐ-BYT addresses sexual health as part of reproductive healthcare services. It is not a dedicated national guideline covering the complete diagnosis and treatment of all forms of female urinary incontinence.

Nor does recognition of pelvic floor physiotherapy establish that every associated technology, device, or intervention has sufficient evidence for routine urinary incontinence treatment.

Appropriate clinical assessment, professional competence, informed consent, and applicable facility requirements remain important.

International condition-specific guidance can provide additional scientific context, but its recommendations should be interpreted in relation to the Vietnamese healthcare setting.

The practical priority is to combine current evidence, individual needs, suitable professional expertise, and applicable Vietnamese requirements.

Technology Should Support Care, Not Replace Clinical Assessment

Technology is increasingly discussed in pelvic floor rehabilitation.

Mobile applications, reminder systems, biofeedback devices, and other tools may help patients understand exercises, record symptoms, or maintain participation.

However, technology does not automatically improve treatment quality.

An application may remind someone to exercise, but it cannot necessarily determine whether the correct pelvic floor muscles are contracting or whether the program is appropriate for the person's condition.

Similarly, a device measuring muscle activity may provide useful feedback without establishing that its routine use produces better outcomes than appropriately supervised training.

NICE does not recommend routine use of perineometry or pelvic floor electromyography as biofeedback during pelvic floor muscle training. It recommends considering electrical stimulation or biofeedback in selected women who cannot actively contract the pelvic floor muscles, where these approaches may help with technique, motivation, or adherence. [2]

The 2024 Cochrane review also found some evidence that technology-supported approaches may improve selected outcomes compared with written instructions alone. However, the certainty of evidence varied, and it remains uncertain whether remote technology can reliably replace appropriate assessment and supervision. [3]

These findings support selective rather than indiscriminate use of technology.

Commercially promoted procedures deserve similar scrutiny.

The European Association of Urology's guidance does not recommend vaginal laser therapy for stress urinary incontinence or overactive bladder outside appropriately regulated and closely monitored clinical research because uncertainties remain concerning effectiveness and long-term safety. [1]

The availability of a procedure should therefore not be confused with evidence that it is appropriate for routine treatment.

This matters when healthcare organizations evaluate new technologies or develop pelvic floor services. A newer or more expensive intervention is not automatically more effective than established conservative care.

For VLMA, the educational contribution is to encourage critical appraisal of evidence without endorsing commercial devices, digital applications, or procedures whose benefits remain uncertain.

When Conservative Treatment Is Not Enough

Conservative treatment can be effective for many women with stress, urgency, or mixed urinary incontinence, but it is not sufficient for every patient.

Visible blood in the urine, persistent bladder or urethral pain, recurrent or unexplained urinary infections, difficulty emptying the bladder, suspected urinary retention, or continuous urinary leakage suggesting a fistula deserve particular attention.

Previous pelvic cancer treatment, pelvic radiation, continence surgery, significant pelvic organ prolapse, or suspected neurological disease may also change the appropriate evaluation and treatment pathway.

The urgency of assessment depends on the clinical presentation.

New urinary dysfunction accompanied by acute neurological symptoms, including progressive leg weakness or altered sensation around the perineum, may require emergency evaluation.

Urinary symptoms associated with fever, flank pain, or systemic illness may indicate an infection requiring prompt medical assessment.

These situations should not be managed solely through pelvic floor exercises or bladder training.

For women whose symptoms remain troublesome despite appropriate conservative care, additional treatment options may be considered.

Medications can have a role in managing overactive bladder and urgency urinary incontinence, including antimuscarinic medicines and beta-3 adrenergic agonists in selected patients.

Treatment decisions require consideration of contraindications, adverse effects, interactions, other medical conditions, and patient preferences.

Antimuscarinic medicines may cause dry mouth, constipation, and other adverse effects, with cognitive concerns particularly relevant in some older patients. Beta-3 adrenergic agonists also require attention to cardiovascular precautions and other medication-specific considerations.

For selected women with stress urinary incontinence, mechanical support devices or surgical treatment may be appropriate after specialist assessment and shared decision-making.

Women with associated genitourinary symptoms related to menopause may also benefit from specifically indicated treatment, but such interventions should not be assumed necessary for everyone with urinary incontinence.

The availability of conservative treatment should not delay appropriate specialist care. Conversely, invasive treatment should not proceed without adequate assessment and discussion of expected benefits, limitations, possible complications, and alternatives.

Pelvic floor muscle training is valuable because it offers an effective treatment option for many women, not because it eliminates the need for other forms of medical or surgical care.

Measuring Outcomes Beyond Muscle Strength

Improved pelvic floor muscle strength can be a useful physiological finding, but it does not fully describe whether treatment has improved a woman's life.

A patient may demonstrate stronger contractions during examination while continuing to experience frequent leakage. Another may show modest changes in measured muscle strength but report fewer episodes, greater confidence, and improved participation in everyday activities.

Treatment evaluation should therefore consider outcomes that matter to patients.

The frequency of urinary leakage, urgency episodes, pad use, nighttime urination, and interference with daily life can provide useful information.

A bladder diary completed before treatment and during follow-up may help identify changes in symptoms.

Validated patient-reported instruments, such as the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, can also support consistent assessment of symptom severity and quality-of-life impact.

Whenever possible, these instruments should be appropriate for the language and population in which they are used. An internationally developed questionnaire should not automatically be assumed to have a validated Vietnamese version.

The woman's own goals are equally important.

For one person, improvement may mean returning to exercise without leakage. For another, it may mean sleeping with fewer interruptions, participating in social activities without anxiety, or reducing reliance on protective pads.

Follow-up should consider these goals alongside clinical findings. It should also assess whether the patient can perform exercises correctly, whether treatment causes discomfort, and whether the program remains feasible.

When improvement is inadequate, healthcare professionals should reconsider the initial assessment, treatment technique, adherence, possible contributing conditions, and need for additional investigation or referral.

Simply prescribing more repetitions or continuing an ineffective program indefinitely may not address the problem.

The objective is to determine whether treatment improves urinary control and quality of life rather than focusing exclusively on a measure of muscle strength.

Improving Access to Appropriate Care in Viet Nam

Female urinary incontinence provides an opportunity to connect evidence-based Lifestyle Medicine with gynecology, urology, rehabilitation medicine, and primary healthcare.

Effective care depends not only on treatment availability, but also on helping women recognize symptoms and feel comfortable discussing them.

Embarrassment, limited awareness of treatment options, financial constraints, and difficulty attending repeated appointments may contribute to delayed care.

Healthcare professionals can help by asking about urinary symptoms respectfully when clinically appropriate and explaining that effective treatments are available.

Communication should avoid suggesting that urinary leakage is inevitable with aging or that women should simply tolerate symptoms following childbirth.

Pelvic examinations and internal assessments require particular attention to informed consent, privacy, professional competence, and patient preferences. Women should receive clear explanations of the purpose of an examination, available alternatives, and the implications of declining it.

Service development also depends on appropriately trained healthcare professionals.

Pelvic floor muscle training should be assessed and supervised by physiotherapists or other practitioners with relevant expertise, working within their authorized professional responsibilities.

Where specialized services are limited, referral arrangements and accessible educational resources may help patients receive more consistent care.

For healthcare organizations, practical improvements may begin with reliable initial assessment, timely recognition of symptoms requiring referral, access to qualified rehabilitation professionals, and simple methods for evaluating treatment outcomes.

Digital tools may assist communication and follow-up but should not replace professional assessment or create unnecessary privacy risks.

The presence of more devices, educational sessions, or rehabilitation services should not automatically be interpreted as evidence of better care.

The relevant question is whether women receive appropriate treatment and experience improvements that matter to them.

Professional and Legal Considerations in Viet Nam

Lifestyle Medicine can contribute to female urinary incontinence care through evidence-based professional education, health behavior support, and an understanding of how conservative interventions relate to overall health and quality of life.

However, diagnosing urinary disorders, performing pelvic examinations, assessing pelvic floor function, prescribing clinical rehabilitation, selecting medication, and determining the need for surgery are regulated healthcare activities.

In Viet Nam, the Law on Medical Examination and Treatment No. 15/2023/QH15, as amended, provides the principal legal framework for medical examination and treatment. [9]

Healthcare professionals and facilities must act within their qualifications, professional responsibilities, and legally authorized scopes of practice.

Completion of a Lifestyle Medicine course, health coaching program, or general exercise training program does not independently authorize someone to conduct internal pelvic assessments, diagnose urinary incontinence, prescribe clinical rehabilitation, or provide regulated healthcare services.

International recommendations from the European Association of Urology, NICE, and the American Urological Association may inform education and professional understanding, but they do not automatically become binding Vietnamese requirements or establish local regulatory approval of particular medicines, devices, or procedures.

Privacy and informed consent are particularly important in women's pelvic health.

Information concerning urinary symptoms, sexual health, reproductive history, pelvic examinations, and related treatment may involve sensitive personal data.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/NĐ-CP, both effective January 1, 2026, establish relevant requirements for processing and protecting personal data. [10,11]

Healthcare organizations should ensure that patient information is accessed, used, shared, and protected in accordance with applicable legal and professional requirements.

For the Vietnam Lifestyle Medicine Alliance (VLMA), the appropriate contribution is professional education, scientific knowledge exchange, and responsible collaboration.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. Its role is to support evidence-based Lifestyle Medicine through education, professional capability development, critical interpretation of scientific evidence, and appropriate collaboration.

Female urinary incontinence is a relevant subject for professional learning because it demonstrates how health behaviors, condition-specific rehabilitation, accurate assessment, and specialist care can complement one another.

Potential educational topics may include the evidence for pelvic floor muscle training, distinctions between stress and urgency urinary incontinence, the role of bladder training, limitations of commercial technologies, and recognition of symptoms requiring timely referral.

Such activities would benefit from collaboration with appropriately qualified urogynecologists, urologists, gynecologists, rehabilitation professionals, and other relevant healthcare practitioners.

These are potential directions for professional education rather than claims that VLMA currently operates a pelvic floor rehabilitation program or provides urinary incontinence treatment services.

The objective is to strengthen professional understanding while respecting the expertise and legal responsibilities required for safe clinical care.

Toward More Personalized and Meaningful Continence Care

Female urinary incontinence illustrates why lifestyle-related care needs to begin with accurate clinical understanding rather than a standard set of recommendations.

Pelvic floor muscle training is an evidence-supported treatment for women with stress or mixed urinary incontinence. Bladder training has a different but important role, particularly for urgency-related symptoms.

Other measures, including appropriate fluid intake, caffeine reduction, weight management when indicated, and management of constipation, may provide additional benefits for selected patients.

These interventions should be chosen according to the type of urinary incontinence, clinical findings, and individual circumstances.

The October 2026 randomized trial reinforces the importance of targeted pelvic floor muscle training, while published clinical experience from Hung Vuong Hospital and the Ministry of Health's 2026 professional guidance provide relevant context for developing pelvic floor rehabilitation in Viet Nam.

At the same time, these developments demonstrate why clinical programs and new technologies should be evaluated carefully rather than promoted through broad claims of effectiveness.

For healthcare professionals in Viet Nam, the opportunity is to connect appropriate assessment, individualized conservative treatment, timely specialist referral, and meaningful follow-up.

Lifestyle Medicine can contribute by supporting beneficial health behaviors and helping women understand the place of conservative treatment within comprehensive care.

However, pelvic floor rehabilitation remains a clinical intervention requiring suitable professional expertise, and lifestyle support should not delay assessment or treatment of conditions requiring medical or surgical attention.

The ultimate goal is not simply stronger pelvic floor muscles or fewer visits to the toilet. It is better urinary control, improved quality of life, and care that allows women to participate in everyday activities with greater confidence.

That is where evidence-based Lifestyle Medicine can make a practical and responsible contribution to female urinary incontinence care in Viet Nam.

Selected References

1. European Association of Urology. EAU Guidelines on Non-neurogenic Female Lower Urinary Tract Symptoms. 2026 edition. Reprint of the 2025 guideline with minor formatting updates.

2. National Institute for Health and Care Excellence. Urinary Incontinence and Pelvic Organ Prolapse in Women: Management. NICE Guideline NG123. Published April 2, 2019.

3. Hay-Smith EJC, Starzec-Proserpio M, Moller B, et al. Comparisons of Approaches to Pelvic Floor Muscle Training for Urinary Incontinence in Women. Cochrane Database of Systematic Reviews. 2024;12. Published December 20, 2024. DOI: 10.1002/14651858.CD009508.pub2.

4. Borges FA, Rodrigues EP, Oliveira WS, José-Vaz LA, Bernardes BT, Resende APM. Pelvic Floor Muscle Training Outperforms Pilates in Women With Stress Urinary Incontinence: A Randomized Controlled Trial. International Urogynecology Journal. Published online October 15, 2026. DOI: 10.1007/s00192-026-06900-4.

5. Cameron AP, Chung DE, Dielubanza EJ, et al. The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder. The Journal of Urology. 2024. DOI: 10.1097/JU.0000000000003985.

6. Huỳnh Thúy Lan. Vai trò của tập cơ sàn chậu trong phục hồi chức năng sàn chậu – Bằng chứng và kinh nghiệm lâm sàng. Tạp chí Y Dược học Phạm Ngọc Thạch. 2026;5(1):21–26. DOI: 10.59715/pntjmp.5.1.3.

7. Hung Vuong Hospital. Khánh thành Khoa Điều trị trong ngày và Trung tâm Sàn chậu – Dấu mốc mới nâng tầm chăm sóc sức khỏe phụ nữ tại Bệnh viện Hùng Vương. March 26, 2026.

8. Ministry of Health of Viet Nam. Decision No. 298/QĐ-BYT Issuing the National Guidelines for Reproductive Healthcare Services: Sexual Health. January 29, 2026.

9. National Assembly of Viet Nam. Law on Medical Examination and Treatment No. 15/2023/QH15. January 9, 2023, as amended.

10. National Assembly of Viet Nam. Law on Personal Data Protection No. 91/2025/QH15. June 26, 2025. Effective January 1, 2026.

11. Government of Viet Nam. Decree No. 356/2025/NĐ-CP Detailing Certain Articles and Measures for Implementing the Law on Personal Data Protection. December 31, 2025. Effective January 1, 2026.

12. National Institute for Health and Care Excellence. Pelvic Floor Dysfunction: Prevention and Non-Surgical Management. NICE Guideline NG210. Published December 9, 2021.

Editorial and Professional Scope Note

This article presents the professional perspective of the Vietnam Lifestyle Medicine Alliance on the contribution and limitations of evidence-based Lifestyle Medicine in female urinary incontinence care, including pelvic floor muscle training, bladder training, health behavior support, and appropriate referral. It reflects scientific and regulatory information reviewed as of October 30, 2026.

The article is intended for professional information, education, and scientific knowledge exchange. It does not constitute an official clinical practice guideline, individualized medical advice, a diagnostic assessment, a pelvic floor rehabilitation prescription, a bladder training protocol, a medication recommendation, or an authoritative interpretation of Vietnamese law. The introductory scenarios are illustrative and do not describe actual VLMA clinical activities.

Urinary incontinence has several potential causes, and not all women require the same treatment. Conservative interventions must not delay appropriate assessment of suspected urinary retention, urogenital fistula, neurological disease, infection, malignancy, or other clinically significant conditions.

Pelvic floor muscle assessment, internal examination, supervised rehabilitation, medication prescribing, diagnostic investigations, and specialist treatment must be undertaken by appropriately qualified and authorized healthcare professionals and facilities acting within their lawful scopes of practice.

International guidelines and scientific publications are referenced for educational purposes. Their inclusion does not imply automatic adoption as Vietnamese clinical requirements or establish the local approval, availability, reimbursement, or suitability of particular medicines, devices, technologies, or procedures.

VLMA is a physician-led professional platform operated by Vietnam Lifestyle Medicine Alliance Company Limited. It is not a licensed medical examination or treatment facility, urogynecology clinic, pelvic floor rehabilitation service provider, medical licensing authority, or healthcare accreditation organization. VLMA does not independently diagnose urinary incontinence, conduct pelvic examinations, prescribe clinical rehabilitation, or provide individualized patient follow-up.

Patient information, particularly intimate health and reproductive information, must be managed in accordance with applicable confidentiality, informed consent, and personal data protection requirements.

This article does not endorse any specific commercial pelvic floor training device, digital application, laser procedure, medication brand, or healthcare provider. References to clinical studies, hospitals, and international guidelines do not imply that VLMA has formally adopted, clinically implemented, evaluated, validated, or certified any urinary incontinence treatment or Lifestyle Medicine program discussed in this article.