Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial

• Published in: American journal of obstetrics and gynecology Vol. 203; no. 2; pp. 170.e1 - 170.e7
• Main Authors: Brækken, Ingeborg Hoff, PhD, PT, Majida, Memona, MD, Engh, Marie Ellström, MD, PhD, Bø, Kari, PhD, PT
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.08.2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Confidence Intervals; conservative treatment; Cross-Over Studies; Double-Blind Method; Exercise Therapy - methods; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Hospitals, University; Humans; Medical sciences; Middle Aged; Muscle Contraction - physiology; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - physiology; Norway; Obstetrics and Gynecology; Odds Ratio; Patient Compliance; Pelvic Floor; pelvic floor muscle training; pelvic organ prolapse; Pelvic Organ Prolapse - complications; Pelvic Organ Prolapse - diagnostic imaging; Pelvic Organ Prolapse - rehabilitation; prolapse symptoms; Quality of Life; Reference Values; Risk Assessment; Severity of Illness Index; stage of prolapse; Statistics, Nonparametric; Treatment Outcome; Ultrasonography; Urinary Incontinence, Stress - etiology; Urinary Incontinence, Stress - prevention & control; conservative treatment; pelvic organ prolapse; stage of prolapse; pelvic floor muscle training; prolapse symptoms; Blind; Gynecology; Urogenital system diseases; Perineum; Obstetrics; Prolapse; Prolapsus; Pelvic floor; Symptomatology; Randomization; Pelvic cavity; Clinical trial; Muscle
• DOI: 10.1016/j.ajog.2010.02.037
• ISSN: 0002-9378

Objective The aim of this study was to investigate the effectiveness of pelvic floor muscle training in reversing pelvic organ prolapse and alleviating symptoms. Study Design This assessor-blinded, parallel group, randomized, controlled trial conducted at a university hospital and a physical therapy clinic randomly assigned 109 women with prolapse stages I, II, and III to pelvic floor muscle training (n = 59) or control (n = 50). Both groups received lifestyle advices and learned “the Knack.” In addition, pelvic floor muscle training comprised individual physical therapy sessions and home exercise. Student t test, Mann-Whitney U test, odds ratio, and effect size were used to compare groups. Results Eleven (19%) women in the pelvic floor muscle training group improved 1 Pelvic Organ Prolapse Quantification System stage vs 4 (8%) controls ( P = .035). Compared with controls, the pelvic floor muscle training group elevated the bladder (difference: 3.0 mm; 95% confidence interval, 1.5–4.4; P < .001) and rectum (5.5 mm; 95% confidence interval, 1.4–7.3; P = .022) and reduced frequency and bother of symptoms compared with controls. Conclusion Pelvic floor muscle training is without adverse effects and can be used as treatment for prolapse.