A collaboration of physiotherapists in Brazil and Norway recently published just such a trial. Ninety-six women with an indication for POP surgery were enrolled. Half were randomised to an experimental group, which received a 9-week pelvic floor muscle training protocol with four sessions before the surgery and seven sessions after the surgery. Half were randomised to a control group that received surgery only.
There was no substantial difference in POP symptoms between the experimental and control groups at post-surgical day 40 or day 90.
On a scale from 1 (very much better) to 7 (very much worse), the experimental group perceived marginally greater global improvement than the control group; mean difference –0.4 (95% CI –0.8 to –0.1) at Day 90. However, the estimated effect of additional perioperative pelvic floor muscle training was estimated to be not beneficial enough to be considered worthwhile for any other secondary outcomes.
In conclusion, although previous trials have had conflicting results, the results of this study support the existing evidence that perioperative PFMT does not add any worthwhile additional short-term benefit to surgery for POP symptoms.
Given the evidence that PFMT is effective in reducing POP symptoms and improves anatomical POP in POP-Q stages I, II and III, it seems essential that women with POP stage I to III are offered an evidence-based PFMT protocol as first-line treatment before surgery is considered.
> From: Duarte et al., J Physiother 66 (2020) 27-32 . All rights reserved to Australian Physiotherapy Association. Click here for the online summary.
Want to read deeper into this topic? Have a look at the free full text version of this article published in Journal of Physiotherapy!
