Forty-seven women participated in a pilot study for a multi-centre randomized controlled trial of the effectiveness of pelvic floor muscle training (PFMT) for women with prolapse. Women with symptomatic stage I or II prolapse [measured by Pelvic Organ Prolapse Quantification (POP-Q)] were randomized to a 16-week physiotherapy intervention (PFMT and lifestyle advice; n = 23) or a control group receiving a lifestyle advice sheet (n = 24). Symptom severity and quality of life were measured via postal questionnaires. Blinded POP-Q was performed at baseline and follow-up. Intervention women had significantly greater improvement than controls in prolapse symptoms (mean score decrease 3.5 versus 0.1, p = 0.021), were significantly more likely to have an improved prolapse stage (45% versus 0%, p = 0.038) and were significantly more likely to say their prolapse was better (63% versus 24%, p = 0.012). The data support the feasibility of a substantive trial of PFMT for prolapse. A multi-centre trial is underway.
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Abrams P, Cardozo L, Khoury S, Wein A (eds) (2005) Incontinence: 3rd International Consultation on Incontinence, 3rd edn. Health Publications Ltd., Paris
Hagen S, Stark D, Cattermole D (2004) A United Kingdom-wide survey of physiotherapy practice in the treatment of pelvic organ prolapse. Physiotherapy 90(1):19–26
Hay-Smith EJC, Dumoulin C (2006) Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, Issue 1. Art. No.:CD005654. doi:10.1002/14651858.CD005654
Hagen S, Stark D, Maher C, Adams E. Conservative management of pelvic organ prolapse in women. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No.: CD003882. doi:10.1002/14651858.CD003882.pub3
Piya-Anant M, Therasakvichya S, Leelaphatanadit C, Techatrisak K (2003) Integrated health research program for the Thai elderly: prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women. J Med Assos Thail 86:509–515
Ghroubi S, Kharrat O, Chaari M, Ben Ayed B, Guermazi M, Elleuch MH (2008) Effect of conservative treatment in the management of low-degree urogenital prolapse. Ann Readapt Med Phys 51:96–102
Bump R, Anders M, Bo K, Brubaker LP, O’Lancey J, Klarskov P, Shull BL, Smith RB (1996) The standardisation of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17
Laycock J, Jerwood D (2001) Pelvic floor muscle assessment: the PERFECT scheme. Physiotherapy 87(12):631–642
Miller JM, Ashton-Miller JA, DeLancey JOL (1998) A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc 46(7):870–874
Bugge C, Hagen S, Glazener C (2005) The POPPY study: a qualitative evaluation of a pelvic organ prolapse outcome questionnaire. ICS(UK), Glasgow
Avery K, Donovan J, Abrams P (2001) Validation of a new questionnaire for incontinence: the International Consultation on Incontinence Questionnaire (ICI-Q). Neurourol Urodyn 20(4):510–512
Abrams P, Avery K, Gardener N, Donovan J, on behalf of the ICIQ Advisory Board (2006) The International Consultation on Incontinence modular questionnaire: www.iciq.net. J Urol 175:1063–1066
Ware JE, Kosinski M, Keller SD (1996) A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care 34(3):220–233
Bo K (2006) Can pelvic floor muscle training prevent and treat pelvic organ prolapse? Acta Obstet Gynecol 85:263–268
Laycock J, Standley A, Crothers E, Naylor D, Garside S, Kiely E, Knight S, Pearson A (2001) Clinical guidelines for the physiotherapy management of females aged 16–65 with stress urinary incontinence. Chartered Society of Physiotherapy, London
National Institute for Health and Clinical Excellence (2006) The management of urinary incontinence in women. NICE, London
Bo K (1995) Pelvic floor muscle exercise for the treatment of stress urinary incontinence: an exercise physiology perspective. Int Urogynecol J 6:282–291
Frawley HC, Galea MP, Phillips BA, Sherburn M, Bo K (2006) Reliability of pelvic floor muscle strength assessment using different test positions and tools. Neurourol Urodyn 25:236–242
Thanks are due to the participants who made the study possible and the staff; in Aberdeen, Chris Bain (Gynaecologist), Lynne Swan (recruitment), Sandra Whyte (intervention physiotherapist), Liz Crothers (intervention physiotherapist); and in Glasgow, Stewart Pringle (Gynaecologist), Sarah Hinks (recruitment), Jackie Montgomery (intervention physiotherapist), June McGourty (intervention physiotherapist) and Philippa Dall (data entry).
This study was funded by the Chief Scientist Office, Scottish Government (CZH/4/95).
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Hagen, S., Stark, D., Glazener, C. et al. A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse. Int Urogynecol J 20, 45–51 (2009). https://doi.org/10.1007/s00192-008-0726-4
- Pelvic floor muscle training
- Pelvic organ prolapse
- pilot study