Skip to main content
SpringerLink
Log in

Pelvic Floor Muscle Training in Prevention and Treatment of Pelvic Organ Prolapse

  • Chapter
Pelvic Floor Disorders

Abstract

This chapter describes the four randomized controlled trials (RCTs) published on the effect of pelvic floor muscle training (PFMT) to treat pelvic organ prolapse (POP) and symptoms of prolapse. The results of all four trials show a significant effect of PFMT. However, to date there is only one full-scale RCT using the gold standard Pelvic Organ Prolapse Quantification (POP-Q) system to evaluate stage of prolapse and a validated symptom questionnaire to assess the results. The same research group also used ultrasound to assess the position of the bladder and the rectal ampulla at rest, in addition to assessment of morphological changes of the pelvic floor muscles. There was a significant reduction in stage of prolapse, symptoms, and bother, and increase in pelvic floor muscle strength. Significant hypertrophy of the pelvic floor muscles, shortening of muscle length, and constriction of the levator hiatus were found in the treatment group only. The four RCTs in this area differ in training dosage such as intensity of the contractions, duration of the training period, and therapist contact, factors that are all known to affect outcome. The results of PFMT in treatment of POP are promising. Further studies are needed to understand differences between responders and non-responders and especially the role of PFMT in primary prevention of POP.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Hunskaar S, Burigo K, Clark A et al. Epidemiology of POP. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence. Health Publication Ltd, Plymouth, 2005, pp 290–298.

    Google Scholar 

  2. Nygaard I, Barber MD, Burgio KL et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA 2008;300:1311–1316.

    Article  CAS  PubMed  Google Scholar 

  3. Tegerstedt G, Maehle-Schmidt M, Nyren O, Hammarstrom M. Prevalence of symptomatic pelvic organ prolapse in a Swedish population. Int Urogynecol J Pelvic Floor Dysfunct 2005;16:497–503.

    Article  PubMed  Google Scholar 

  4. Slieker-Ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ et al. Symptomatic pelvic organ prolapse and possible risk factors in a general population. Am J Obstet Gynecol 2009;200:184–187.

    PubMed  Google Scholar 

  5. Lawrence JM, Lukacz ES, Nager CW et al. Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women. Obstet Gynecol 2008;111:678–685.

    PubMed  Google Scholar 

  6. Mouritsen L. Classification and evaluation of prolapse. Best Pract Res Clin Obstet Gynaecol 2005;19:895–911.

    Article  PubMed  Google Scholar 

  7. Srikrishna S, Robinson D, Cardozo L. Validation of the patient global impression of improvement for urogenital prolapse. Int Urogynecol J 2009;20(suppl 2):S95.

    Google Scholar 

  8. Abrams P, Cardozo L, Fall M et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn 2002;21:167–178.

    Article  PubMed  Google Scholar 

  9. Weber AM, Abrams P, Brubaker L et al. The standardization of terminology for researchers in female pelvic floor disorders. Int Urogynecol J Pelvic Floor Dysfunct 2001;12: 178–186.

    Article  CAS  PubMed  Google Scholar 

  10. Brubaker L, Bump RC, Jacquetin B et al. Pelvic organ prolapse. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence: 2nd International Consultation on Incontinence, 2 edn. Health Publication Ltd, Plymouth, 2002, pp 243–266.

    Google Scholar 

  11. Thakar R, Stanton S. Management of genital prolapse. BMJ 2002;324:1258–1262.

    Article  PubMed  Google Scholar 

  12. Whiteside JL, Weber AM, Meyn LA, Walters MD. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol 2004;191:1533–1538.

    Article  PubMed  Google Scholar 

  13. Olsen AL, Smith VJ, Bergstrom JO et al. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol 1997;89:501–506.

    Article  CAS  PubMed  Google Scholar 

  14. Handa VL, Garrett E, Hendrix S et al. Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women. Am J Obstet Gynecol 2004;190:27–32.

    Article  PubMed  Google Scholar 

  15. Hahn I, Myrhage R. Bekkenbotten. Bygnad, funktion och traning. AnaKomp AB, Goethenburg, 1999, p 39.

    Google Scholar 

  16. Maher C, Baessler K, Glazener CM et al. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev 2007;(3):CD004014.

    Google Scholar 

  17. Hagen S, Stark D, Maher C, Adams E. Conservative management of pelvic organ prolapse in women. Cochrane Database Syst Rev 2006;(4):CD003882.

    Google Scholar 

  18. Dumoulin C, Hay-Smith J. Pelvic floor muscle training versus no treatment for urinary incontinence in women. A Cochrane systematic review. Eur J Phys Rehabil Med 2008; 44:47–63.

    CAS  PubMed  Google Scholar 

  19. Hay Smith J, Berghmans B, Burgio K et al. Adult conservative management. In: Abrams P, Cardozo L, Khoury S, Wein A (eds) Incontinence: 4th International Consultation on Incontinence, 4th edn. Health Publication Ltd, Plymouth, 2009, pp 1025–1108.

    Google Scholar 

  20. Hagen S, Stark D, Cattermole D. A United Kingdom-wide survey of physiotherapy practice in the treatment of pelvic organ prolapse. Physiotherapy 2004;90:19–26.

    Article  Google Scholar 

  21. 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 Pelvic Floor Dysfunct 2009;20:45–51.

    PubMed  Google Scholar 

  22. Ghroubi S, Kharrat O, Chaari M. Effect of conservative treatment in the management of low-degree urogenital prolapse. Ann Readapt Med Phys 2008;51:96–102.

    CAS  PubMed  Google Scholar 

  23. Brækken IH, Majida M, Ellstrom-Engh M, Bø K. Pelvic floor muscle training in treatment of pelvic organ prolapse — A single blind randomised controlled trial. Neurourol Urodyn 2009;28:663–664.

    Article  Google Scholar 

  24. Piya-Anant M, Therasakvichya S, Leelaphatanadit C, Techatrisak K. 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 2003;86:509–515.

    Google Scholar 

  25. Brækken IH, Majida M, Ellstrom-Engh M, Bø K. Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasound: a randomized controlled trial. Obstet Gynecol 2010; 115, Part I: 317–324.

    Article  PubMed  Google Scholar 

  26. Mouritsen, L, Larsen JP. Symptoms, bother and POPQ in women referred with pelvic organ prolapse. Int Urogynecol J 2003;4:122–127.

    Article  Google Scholar 

  27. Bø K, Aschehoug A. Pelvic floor and exercise science — strength training. In: Bo K, Berghmans B, Morkved S, Kampen MV (eds) Evidence-based physical therapy for the pelvic floor. Elsevier, Edinburgh, 2007, pp 119–132.

    Google Scholar 

  28. Bø K. Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? Int Urogynecol J Pelvic Floor Dysfunct 2004;15:76–84.

    Article  PubMed  Google Scholar 

  29. Bø K. Pelvic floor muscle training for stress urinary incontinence. In: Bo K, Berghmans B, Morkved S, Kampen MV (eds) Evidence-based physical therapy for the pelvic floor. Elsevier, Edinburgh, 2007, pp 171–187.

    Google Scholar 

  30. Miller JM, Perucchini D, Carchidi LT et al. Pelvic floor muscle contraction during a cough and decreased vesical neck mobility. Obstet Gynecol 2001;97:255–260.

    Article  CAS  PubMed  Google Scholar 

  31. Peschers UM, Fanger G, Schaer GN et al. Bladder neck mobility in continent nulliparous women. BJOG 2001;108: 320–324.

    Article  CAS  PubMed  Google Scholar 

  32. DeLancey JO. Anatomy and biomechanics of genital prolapse. Clin Obstet Gynecol 1993;36:897–909.

    Article  CAS  PubMed  Google Scholar 

  33. Jarvis SK, Hallam TK, Dietz HP, Vancaille TG. Pre and postoperative physiotherapy intervention for gynaecological surgery: a single blind randomized controlled trial (abstract 65). J Am Assoc Gynecol Laparosc 2004;11(3 suppl):S23.

    Article  Google Scholar 

  34. Frawley HC, Phillips BA, Bø K, Galea MP. Physiotherapy as an adjunct to prolapse surgery: An assessor-blinded randomized controlled trial. Neurourol Urodyn 2009; 8 Oct epub ahead of print.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway

    Kari Bø PhD & Ingeborg Hoff Bræken PhD

Authors
  1. Kari Bø PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ingeborg Hoff Bræken PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Pelvic Floor Unit and Colorectal Service 1st Department of General Surgery, Regional Hospital, Treviso, Italy

    Giulio Aniello Santoro (Head) (Head)

  2. Department of Pediatric Radiology Children’s Teaching Hospital, Skubiszewski Medical University of Lublin, Lublin, Poland

    Andrzej Paweł Wieczorek

  3. Diagnostic Imaging, Princess Grace Hospital, London, UK

    Clive I. Bartram

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag Italia

About this chapter

Cite this chapter

Bø, K., Bræken, I.H. (2010). Pelvic Floor Muscle Training in Prevention and Treatment of Pelvic Organ Prolapse. In: Santoro, G.A., Wieczorek, A.P., Bartram, C.I. (eds) Pelvic Floor Disorders. Springer, Milano. https://doi.org/10.1007/978-88-470-1542-5_73

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1542-5_73

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1541-8

  • Online ISBN: 978-88-470-1542-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation