Binal Dave*, Keshar Choudhary and Swati Singh

Department of Women’s Health, University of Technology, India

*Corresponding Author: Binal Dave, Department of Women’s Health, University of Technology, India.

Received: January 08, 2024; Published: January 23, 2024

Abstract

Background: Pelvic organ prolapse (POP) is a condition where shortcoming of pelvic floor muscles can cause at least one organs in your pelvis (vagina, uterus, bladder and rectum) to hang. An organ may bulge onto another organ or externally in more severe cases. Pelvic organ prolapse is extremely normal and is related post labor and with expanding age. Ladies with prolapse are in many cases encouraged to do pelvic floor muscle preparing, however proof supporting the advantages of such activities is scant. Our goal was to determine whether individually tailored pelvic floor muscle training reduced prolapse and its symptoms.

Methods: We did an equal gathering, multicentre, randomized controlled preliminary at 2 focuses in India, between July 2017, and December 2023. Female short term patients with recently analyzed, suggestive stage I, II, or III prolapse were haphazardly relegated (1:1), by far off PC distribution with minimsation, to get an individualized program of pelvic floor muscle preparing or a prolapse way of life exhortation pamphlet and no muscle preparing (control bunch). Result assessors, and agents who were gynecologists at preliminary destinations, were veiled to bunch allotment; The statistician wore a mask until the data were analyzed. Our essential endpoint was members' self-report of prolapse side effects at a year.

Findings: 67 eligible patients were randomised to the intervention group (n = 34) or the control group (n = 33). 34 participants completed follow-up for questionnaires at 6 months and 33 participants for questionnaires at 12 months. Women in the intervention group reported fewer prolapse symptoms (i.e., a significantly greater reduction in the pelvic organ prolapse symptom score [POP-SS]) at 12 months than those in the control group (mean reduction in POP-SS from baseline 3·77 [SD 5·62] vs 2·09 [5·39]; adjusted difference 1·52, 95% CI 0·46-2·59; p = 0·0053).

Interpretation: One-to-one pelvic floor muscle training for prolapse is effective for improvement of prolapse symptoms. Long-term benefits should be investigated, as should the effects in specific subgroups.

Funding: No source of funding.

Keywords:Pelvic Organ Prolapse; Obesity, Heavy Lifting

References

1. Hendrix SL., et al. “Pelvic organ prolapse in the Women's Health Initiative: gravity and gravidity”. American Journal of Obstetrics and Gynecology 186 (2002): 1160-1166.
2. Olsen AL., et al. “Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence”. Obstetrics and Gynecology 89 (1997): 501-506.
3. Health and Social Care Information Centre. Hospital episode statistics, admitted patient care—England, 2010-11.
4. Wu JM., et al. “Predicting the number of women who will undergo incontinence and prolapse surgery, 2010 to 2050”. American Journal of Obstetrics and Gynecology 205 (2011): 230.e1-230.e5.
5. Miedel A., et al. “Nonobstetric risk factors for symptomatic pelvic organ prolapse”. Obstetrics and Gynecology 113 (2009): 1089-1097.
6. Slieker-ten Hove MC., et al. “Symptomatic pelvic organ prolapse and possible risk factors in a general population”. American Journal of Obstetrics and Gynecology 200 (2009): 184.e1-184.e7o.
7. Abrams PH., et al. “Incontinence”. 5^th Health Publication Ltd, Plymbridge, UK (2013).
8. Hagen S., et al. “A United Kingdom-wide survey of physiotherapy practice in the treatment of pelvic organ prolapse”. Physiotherapy 90 (2004): 19-26.
9. Dumoulin C and Hay-Smith J. “Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women”. Cochrane Database of Systematic Reviews 1 (2010): CD005654.
10. Hagen S and Stark D. “Conservative prevention and management of pelvic organ prolapse in women”. Cochrane Database of Systematic Reviews 12 (2011): CD003882.
11. Bump RC., et al. “The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction”. American Journal of Obstetrics and Gynecology 175 (1995): 10-17.
12. Hagen S., et al. “A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse”. International Urogynecology Journal and Pelvic Floor Dysfunction 20 (2009): 45-51.
13. Bo K. “Pelvic floor muscle exercise for the treatment of stress urinary incontinence: an exercise physiology perspective”. International Urogynecology Journal 6 (1995): 282-291.
14. National Institute for Health and Clinical Excellence. “Urinary incontinence: the management of urinary incontinence in women”. Clinical guidance 40.NICE, London (2006).
15. Laycock J and Jerwood D. “Pelvic floor muscle assessment: the PERFECT scheme”. Physiotherapy 87 (2001): 631-642.
16. Hagen S., et al. “Psychometric properties of the pelvic organ prolapse symptom score”. BJOG 116 (2009): 25-31.
17. Avery K., et al. “ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence”. Neurourology and Urodynamics 23 (2004): 322-330.
18. Rogers RG., et al. “A short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12)”. International Urogynecology Journal and Pelvic Floor Dysfunction 14 (2003): 164-168.
19. Ware Jr., et al. “A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity”. Medical Care 34 (1996): 220-233.
20. Allahdin S., et al. “A randomised controlled trial evaluating the use of polyglactin mesh, polydioxanone and polyglactin sutures for pelvic organ prolapse surgery”. Journal of Obstetrics and Gynaecology 28 (2008): 427-431.
21. Diggle PJ., et al. “Analysis of longitudinal data”. 2^nd Oxford University Press Inc, Clarendon (2002).
22. Rubin DB. “Multiple imputation for nonresponse in surveys”. John Wiley and Sons, New York (1987).
23. R Development Core Team. “R: a language and environment for statistical computing”. R Foundation for Statistical Computing, Vienna (2012).
24. Su Y-S., et al. “Multiple imputation with diagnostics (mi) in R: opening windows into the black box”. Journal of Statistical Software 45 (2011): 1-31.
25. Curtis L. “Unit costs of health and social care 2009”. University of Kent, Kent (2009).
26. Information Services Division. Scottish health service costs year ended 31 March 2010. NHS National Services Scotland, Edinburgh (2010).
27. Joint Formulary Committee. British National Formulary. 61^st British Medical Association and Royal Pharmaceutical Society of Great Britain, London (2011).
28. C&G Medicare. Club pessary (2010).
29. Hagen S., et al. “Further properties of the pelvic organ prolapse symptom score: minimally important change and test-retest reliability”. Neurourology and Urodynamics 29 (2010): 1055-1056.
30. Ghroubi S., et al. “Effect of conservative treatment in the management of low-degree urogenital prolapse”. Annales de Réadaptation et de Médecine Physique 51 (2008): 96-102.
31. Stüpp L., et al. “Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial”. International Urogynecology Journal and Pelvic Floor Dysfunction 22 (2011): 1233-1239.
32. Piya-Anant M., et al. “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”. Journal of the Medical Association of Thailand 86 (2003): 509-515.
33. Brækken IH., et al. “Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial”. American Journal of Obstetrics and Gynecology 203 (2010): 170e1-170e7.
34. Kashyap R., et al. “Comparative effect of 2 packages of pelvic floor muscle training on the clinical course of stage I-III pelvic organ prolapse”. International Journal of Gynecology and Obstetrics 121 (2013): 69-73.
35. Ellerkmann RM., et al. “Correlation of symptoms with location and severity of pelvic organ prolapse”. American Journal of Obstetrics and Gynecology 185 (2001): 1332-1337.
36. Mouritsen L and Larsen JP. “Symptoms, bother and POPQ in women referred with pelvic organ prolapse”. International Urogynecology Journal14 (2003): 122-127.
37. Handa VL., et al. “Progression and remission of pelvic organ prolapse: a longitudinal study of menopausal women”. American Journal of Obstetrics and Gynecology 190 (2002): 27-32.
38. Bradley CS., et al. “Natural history of pelvic organ prolapse in postmenopausal women”. Obstetrics and Gynecology 109 (2007): 848-854.
39. Miedel A., et al. “Short-term natural history in women with symptoms indicative of pelvic organ prolapse”. International Urogynecology Journal 22 (2011): 461-468.

Citation

Citation: Binal Dave., et al. “Pelvic Floor Muscle Training in Women with Pelvic Organ Prolapse: A Randomised Controlled Trial".Acta Scientific Women's Health 6.2 (2024): 30-38.

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Copyright: © 2024 Binal Dave., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.