Can pelvic floor muscle training prevent and treat pelvic organ prolapse?

Bø, Kari

doi:10.1080/00016340500486800

Cited by 71 publications

(31 citation statements)

References 46 publications

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“…Apparently, strong PFM alone does not seem to prevent the development of POP; however, we must be careful making these conclusions due to the character of this study. To study the effect of PFM training on the prevention and treatment of POP, Bo [19] reviewed basic research and case–control studies and put forward two hypotheses: (1) women can learn to contract their PFM consciously before and during an increase in IAP and will continue to make such contractions as a behavioral modification in order to prevent descent of the pelvic contents and (2) women can learn to build up ‘muscle tone’ and structural support of the pelvic floor through regular strength training over time. Owing to the lack of high-quality randomized controlled trials on the effect of PFM training in women with POP, neither of the hypotheses could be confirmed.…”

Section: Discussionmentioning

confidence: 99%

Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

et al. 2009

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Introduction and hypothesisThis study aims to examine the relationship between pelvic floor muscle function (PFMF) and pelvic organ prolapse (POP) in a general female population.MethodsCross-sectional study on women aged 45–85 years. Validated questionnaires were used to assess pelvic floor muscle function. POP and PFMF were evaluated with vaginal examination. For statistical analysis chi-squared test for trend and analysis of variance were used.ResultsResponse rate to the questionnaire was 62.7% (1,869/2,979). No significant differences were found in muscle strength and endurance during voluntary muscle contraction between the POP stages. Women with POP stages I and II were significantly less able to achieve effective involuntary muscle contraction during coughing (38.3% and 37.7%) than women without POP (75.2%).ConclusionInvoluntary contraction of the PFM during coughing (that resulted in stabilization of the perineum) was significantly weaker in the women with POP stage I and II than in the women without POP.

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Section: Discussionmentioning

confidence: 99%

Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

et al. 2009

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“…Strength training to increase muscle volume raises the levator plate and decreases the genital hiatus, thereby promoting greater support for the pelvic organs. 10,11 Previous studies have shown that women with pelvic organ prolapse present decreased cross-sectional area (CSA) of the levator ani muscle, increased genital hiatus and decreased muscle strength. 12,13 One way to assess the effect of muscle training is to measure the CSA of the muscle, which correlates directly with muscle hypertrophy caused by exercise.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

et al. 2012

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Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trialEficácia do treinamento da musculatura do assoalho pélvico e de exercícios hipopressivos para o tratamento do prolapso de órgãos pélvicos em mulheres: ensaio clínico randomizado. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS:The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816). CONCLUSIONS:The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle. CLINICAL TRIAL REGISTRATION NUMBER: NCT01196598reSUMO CONTEXTO E OBJETIVO: Estudos anteriores mostraram que mulheres com disfunção do assoalho pélvico possuem diminuição da área de secção transversal (AST) do músculo levantador do ânus. Uma forma de avaliar os efeitos de um programa de treinamento é mensurar a AST do músculo por ultrassonografia. O objetivo foi avaliar a eficácia do treinamento da musculatura do assoalho pélvico e de exercícios hipopressivos no aumento da AST do músculo levantador do ânus em mulheres com prolapso de órgãos pélvicos. TIPO DE ESTUDO E LOCAL: Estudo prospectivo, randomizado e controlado realizado no Ambulatório de Uroginecologia da Universidade Federal de São Paulo. MÉTODOS: Cinquenta e oito mulheres com prolapso de órgãos pélvicos estádio II foram divididas em três grupos para tratamento fisioterapêutico: (GI) grupo de treinamento dos músculos do assoalho pélvico, (GII) grupo de exercícios hipopressivos e (GIII) grupo controle. As pacientes se submeteram a avaliação ultrassonográfica transperineal com transdutor de frequência 4-9 MHz. Foi mensurada a AST do músculo levantador do ânus antes e após 12 semanas de tratamento fisioterapêutico. RESULTADOS: Os grupos foram homogêneos no que se refere a idade, número de gestações, número de partos vaginais, índice de massa corpórea e estado hormonal. Diferença significante foi observada na AST de GI e GII antes e após o tratamento (P < 0,001) e isso não ocorreu com o GIII (P = 0,816). CONCLUSÕES: A AST do músculo levantador do ânus aumentou significativamente com tratamento fisioterapêutico em mulheres com prolapso de órgãos pélvicos. Treinamento dos músculos do assoalho pélvico e exercícios hipopressivos são semelhantes no que se refere ao aumento da AST do...

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“…Bø reviewed basic research and case–control studies and put forward two hypotheses [8]:Women can build up muscle tone and structural support of the PFMs through regular strength training over time.Women can learn to contract their PFMs consciously before and during an increase in intra-abdominal pressure and will continue to make such contractions as a behavioural modification in order to prevent descent of the pelvic contents.…”

Section: Introductionmentioning

confidence: 99%

Pelvic floor muscle training as an adjunct to prolapse surgery: a randomised feasibility study

et al. 2014

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Introduction and hypothesisThere is evidence that in nonsurgical populations, pelvic floor muscle training (PFMT) and lifestyle advice improves symptoms and stage of pelvic organ prolapse (POP). Some women, however, require surgery, after which de novo symptoms can develop or additional surgery is required due to recurrence. Robust evidence is required as to the benefit of perioperative PFMT in the postsurgery reduction of symptoms and POP recurrence. The aim of this study was to assess the feasibility of and collect pilot data to inform sample size (SS) calculation for a multicentre randomised controlled trial (RCT) of perioperative PFMT following surgical intervention for POP.MethodsFifty-seven participants were recruited and randomised to a treatment group (one pre and six postoperative PFMT sessions) or a control group (usual care). The primary outcome measure was the Pelvic Organ Prolapse Symptom Score (POP-SS) at 12 months; secondary outcome measures included measurement of prolapse, the pelvic floor and questionnaires relating to urinary and bowel incontinence. All outcomes were measured at 0, 6 and 12 months.ResultsInformation on recruitment, retention and appropriateness of outcome measures for a definitive trial was gathered, and data enabled us to undertake an SS calculation. When compared with the control group (n = 29), benefits to the intervention group (n = 28) were observed in terms of fewer prolapse symptoms at 12 months [mean difference 3.94; 95 % confidence interval (CI) 1.35–6.75; t = 3.24, p = 0.006]; however, these results must be viewed with caution due to possible selection bias.ConclusionWith modifications to design identified in this pilot study, a multicentre RCT is feasible.Electronic supplementary materialThe online version of this article (doi:10.1007/s00192-013-2301-x) contains supplementary material, which is available to authorized users.

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Can pelvic floor muscle training prevent and treat pelvic organ prolapse?

Cited by 71 publications

References 46 publications

Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse

Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

Pelvic floor muscle training as an adjunct to prolapse surgery: a randomised feasibility study

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