Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review

Abstract

The aim of this systematic review was to explore the effectiveness of pelvic-floor muscle training (PFMT) in the treatment of women with pelvic organ prolapse (POP) who had undergone either surgery or only conservative treatment, based on a selection of randomized clinical trials (RCT). The search was carried out in PubMed, Cochrane, Scopus, CINAHL, and PEDro databases between April 2021 and October 2021 using the following MeSH terms or keywords: “pelvic organ prolapse”, “POP”, “pelvic floor muscle training”, “pelvic floor muscle exercise”, “kegel exercise”, and “surgery”. The methodological quality of the studies was assessed using the PEDro scale. Eighteen RCTs were included in this review. The findings showed improvements in symptoms associated with POP, in pelvic-floor function, and in quality of life in women who performed a PFMT protocol. However, PFMT did not produce significant changes in sexual function, and the results of the change in POP stage were inconclusive. When viewing PFMT as a complementary treatment to surgery, no significant improvements were observed in any of the analyzed variables. In conclusion, a PFMT program is an effective way to improve the pelvic, urinary, and intestinal symptoms associated with POP; function of the pelvic floor; and quality of life. PFMT as an adjunct to surgery does not seem to provide a greater benefit than surgical treatment alone. RCTs of higher methodological quality, with a larger sample size and a longer follow-up, are needed to confirm the results.

Effect of Mayan Abdominal Massage Technique on Sexuality and Quality of Life among Women with Uterine Prolapse

“…As well as, it was in accordance with Espiño-Albela, et al, [32] illustrated that the findings of their review showed a significant improvement in the symptoms associated with pelvic organ prolapse (POP) in women undergoing a pelvic floor muscle training (PFMT) protocol, including pelvic symptoms (pressure in the lower abdomen, feeling of heaviness in the pelvis, and feeling of a bulge in the vagina), urinary symptoms (stress urinary incontinence, urge urinary incontinence, sensation of incomplete bladder emptying, and pain when urinating), and bowel symptoms (constipation, fecal incontinence, gas incontinence, incomplete emptying of the bowel, pain when defecating, urgency, and bulging sensation in the anus). Improvements were also found in pelvic-floor function and in quality of life.…”

Real-world clinical effectiveness of nonsurgical treatments for female with POP-Q stage II cystocele: a retrospective analysis of therapeutic efficacy

“…PFMT helps patients to improve their pelvic floor muscle strength, endurance, power, relaxation, or a combination of these parameters by developing structured and personalized exercise plans ( 23 ). PFMT can be assisted by vaginal cones and electrical muscle stimulation, and so on.…”