Lifestyle advice with or without pelvic floor muscle training for pelvic organ prolapse: a randomized controlled trial
Abstract
Introduction and hypothesis We evaluated the effect of adding pelvic floor muscle training (PFMT) to a structured lifestyle advice program.Methods This was a single-blinded randomized trial of women with symptomatic pelvic organ prolapse (POP) stage ≥ II. Participants were randomized to a structured lifestyle advice program with or without PFMT. Both groups received similar lifestyle advice in six separate group sessions. The combined group performed group PFMT after an individual assessment. Primary outcome was a global improvement scale at six-month follow-up. Secondary outcomes were the global scale and objective POP at three-month follow-up, symptoms and quality of life including sexuality, at three and six-month follow-up. A clinically relevant change of symptoms was defined as ≥ 15 %.Results We included 109 women. Eighty-nine women (82 %) completed three months follow-up; 85 (78 %) completed six-month follow-up. At both follow-ups, significantly more women in the combined group reported improvement in the global scale. At the three-month follow-up, the combined group only had significant improvement of POP symptoms while only the lifestyle advice group had significant improvement of quality of life. Change in objective POP and sexuality was nonsignificant. The symptom score improved 17 % in the combined group and 14 % in the lifestyle advice group (P = 0.57). Significantly more women in the lifestyle advice group had sought further treatment at the six-month follow-up.Conclusion Adding PFMT to a structured lifestyle advice program gave superior results in a global scale and for POP symptoms. Overall effect of either intervention barely reached clinical relevance.
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The studies with no effect on POP-Q stage had a lower training dosage compared with studies finding statistically significant improvement in anatomical POP.
“The studies with no effect on POP-Q stage had a lower training dosage compared with studies finding statistically significant improvement in anatomical POP [45, 49, 51].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [49]
PFMT was taught individually in all but one trial, which did group training.
“PFMT was taught individually in all but one trial [49], who did group training.”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [49]
For short-term effect, RCTs showed PFMT to be effective in treating POP, demonstrating statistically significant improvement in POP symptoms and/or anatomical POP assessed by POP-Q stage compared to the comparison group.
“For short-term effect of PFMT, the RCTs showed PFMT to be effective in treating POP, demonstrating statistically significant improvement in POP symptoms [41–46, 48, 49] and/or anatomical POP, assessed by POP-Q stage [40, 42–44, 46, 48] compared to the comparison group.”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [49]
Frawley et al. (2012), Due et al. (2016) and Ahadi et al. (2017) did not find a significant change in POP stage, but significant improvements were found in some individual POP-Q measurements (Ap and Bp) in Frawley et al. (2012).
“Frawley et al., (2012) [45], Due et al. (2016) [49] and Ahadi et al. (2017) [51] did not find a significant change in POP stage, but significant improvements were found in some of the individual POP-Q measurements (POP-Q points Ap and Bp) in the study by Frawley et al. (2012) [45].”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [49]
In Due et al.-16, there were significantly better results in global improvement scale and POP symptoms in PFMT, but no difference in POP-Q stage.
“Significantly better results in global improvement scale and POP symptoms in PFMT. No difference in POP-Q stage”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [49]
If there was no short-term effect of a PFMT program, long-term effects are unlikely.
“Furthermore, if there was no short-term effect of a PFMT program [49, 50, 62, 67, 71, 75], then long-term effects are unlikely.”
From International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training (2022) · cites this paper as [49]
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References 29 · Cited by 36
- Authors
- Due, U., Brostrøm, S., & Lose, G.
- Affiliations
- Herlev Hospital (DK)
- National Board of Health (DK)
- University of Copenhagen (DK)
- Corresponding author
- Due, Ulla
- Venue
- International Urogynecology Journal
- Published
- 2015-10-06
- Volume
- 27
- Issue
- 4
- Pages
- 555-563
- ISSN
- 0937-3462 (ISSN-L)
- 1433-3023
- OpenAlex
- W1886045368
- Cited by
- 36
- References
- 29
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 3 · 2016: 3
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- International Urogynecology Journal (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Astellas Pharma
- Topics
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
- Keywords
- pelvic organ prolapse, pelvic floor muscle training, lifestyle advice, group exercise intervention, prolapse symptoms, quality of life, sexuality, women's health
- MeSH terms
- Adult, Aged, Combined Modality Therapy, Exercise Therapy, Follow-Up Studies, Humans, Life Style, Middle Aged, Quality of Life, Severity of Illness Index, Single-Blind Method, Pelvic Floor, Sexuality, Directive Counseling, Pelvic Organ Prolapse, Symptom Assessment
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