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The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis

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Abstract

Introduction and hypothesis

Our objective was to assess the effectiveness of pelvic floor muscle training (PFMT) as a treatment for women with pelvic organ prolapse (POP) or as an adjunct to prolapse surgery.

Methods

Relevant literature sources were searched using databases including PubMed, Ovid, Web of Science, Scopus, ClinicalTrials.gov, EBSCO, CINAHL, the Cochrane Central Register of Controlled Trials, CNKI, VIP, Wanfang, and CBM until 5 July 2015. Eligible studies were restricted to randomized controlled trials (RCT). The available data were pooled using Review Manager version 5.2. For data deemed not appropriate for synthesis, a narrative overview was conducted.

Results

In total, 13 studies with 2,340 patients were included. Our results indicated women receiving PFMT gained a greater improvement than controls in prolapse symptom score [mean difference (MD) −3.07, 95 % confidence interval (CI) −3.91 to −2.23] and POP stages [risk ratio (RR) 1.70, 95 % CI 1.19–2.44]. The number of women who said their prolapse was getting better was higher (RR 5.48, 95 % CI 2.19–13.72) and other discomfort syndromes, such as vaginal, bladder, and rectum, were lower in the PFMT groups than in controls. Meanwhile, women after PFMT had greater improvement in muscle strength and endurance but did not show a significant difference for further treatment needs. In addition, the results evaluating PFMT as an adjunct to prolapse surgery were inconclusive because of the variability in methods of measuring outcome.

Conclusions

Our meta-analysis demonstrated women who received PFMT showed a greater subjective improvement in prolapse symptoms and an objective improvement in POP severity.

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Abbreviations

RCT:

Randomized controlled trial

PFM:

Pelvic floor muscle

PFMT:

Pelvic floor muscle training

BPMT:

Behavioral therapy with pelvic floor muscle training

POP:

Pelvic organ prolapse

POP-SS:

Pelvic organ prolapse syndrome score

POP-Q:

Pelvic Organ Prolapse Quantification

RR:

Risk ratio

MD:

Mean difference

CI:

Confidence interval

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Acknowledgments

We thank Mr. Carlbring in Linköping University and Miss CM Xia in Fudan University for revising our manuscript.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, 536 Changle Road, Shanghai, 200040, China

    Chunbo Li

  2. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai, China

    Yuping Gong

  3. Department of Anesthesia, Zhongshan Hospital, Fudan University, Shanghai, China

    Bei Wang

Authors
  1. Chunbo Li
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  2. Yuping Gong
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  3. Bei Wang
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Correspondence to Chunbo Li.

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Li, C., Gong, Y. & Wang, B. The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. Int Urogynecol J 27, 981–992 (2016). https://doi.org/10.1007/s00192-015-2846-y

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  • DOI: https://doi.org/10.1007/s00192-015-2846-y

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