Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial

Brækken, Ingeborg Hoff; Majida, Memona; Engh, Marie Ellström; Bø, Kari

doi:10.1016/j.ajog.2010.02.037

Cited by 241Pelvic floor disorders treatmentsSexual function and dysfunction studiesUterine Myomas and Treatments

Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial

Brækken, Ingeborg Hoff, Majida, Memona, Engh, Marie Ellström, Bø, Kari·2010·American Journal of Obstetrics and Gynecology

DOI 10.1016/j.ajog.2010.02.037

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Abstract

Objective The aim of this study was to investigate the effectiveness of pelvic floor muscle training in reversing pelvic organ prolapse and alleviating symptoms.Study design This assessor-blinded, parallel group, randomized, controlled trial conducted at a university hospital and a physical therapy clinic randomly assigned 109 women with prolapse stages I, II, and III to pelvic floor muscle training (n = 59) or control (n = 50). Both groups received lifestyle advices and learned "the Knack." In addition, pelvic floor muscle training comprised individual physical therapy sessions and home exercise. Student t test, Mann-Whitney U test, odds ratio, and effect size were used to compare groups.Results Eleven (19%) women in the pelvic floor muscle training group improved 1 Pelvic Organ Prolapse Quantification System stage vs 4 (8%) controls (P = .035). Compared with controls, the pelvic floor muscle training group elevated the bladder (difference: 3.0 mm; 95% confidence interval, 1.5-4.4; P < .001) and rectum (5.5 mm; 95% confidence interval, 1.4-7.3; P = .022) and reduced frequency and bother of symptoms compared with controls.Conclusion Pelvic floor muscle training is without adverse effects and can be used as treatment for prolapse.

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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 [43]
In Brækken et al.-10, bladder neck elevation was ↑2.3 mm vs ↓0.6 mm; difference 3.0 mm (95% CI 1.5-4.4), p < 0.001.
“Elevation of the bladder neck: ↑2.3 mm vs ↓0.6 mm; diff. 3.0 mm (95% CI: 1.5–4.4), p < 0.001”
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 [43]
In Brækken et al.-10, PFMT improved PFM strength by ↑13.1 cmH2O vs control ↑1.1 cmH2O (p < 0.01).
“PFM strength (p < 0.01):PFMT: ↑13.1 cmH2O (95% CI: 10.6–15.5); Control: ↑1.1 cmH2O (95% CI: 0.4–2.7).”
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 [43]
In Brækken et al.-10, POP-Q stage improved one stage in 11 (19%) PFMT vs 4 (8%) controls (p = 0.04).
“POP-Q stage: 11 (19%) in the PFMT vs 4 (8%) controls improved one stage (p = 0.04)”
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 [43]
The effect of PFMT in the general female population with POP showed overall positive short-term results on POP symptoms, and in most of the studies measuring anatomical POP, the prolapse improved one stage.
“The effect of PFMT in the general female population with POP showed overall positive short-term results on POP symptoms, and in most of the studies measuring anatomical POP, the prolapse improved one stage [40, 42–44, 46, 48].”
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 [43]

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Authors: Brækken, I. H., Majida, M., Engh, M. E., & Bø, K.
Affiliations: Norwegian School of Sport Sciences (NO)
Akershus University Hospital (NO)
University of Oslo (NO)
Corresponding author: Brækken, Ingeborg Hoff
ORCID: Brækken, Ingeborg Hoff
Engh, Marie Ellström
Bø, Kari
Venue: American Journal of Obstetrics and Gynecology
Publisher: Elsevier BV
Published: 2010-08
Volume: 203
Issue: 2
Pages: 170.e1-170.e7
ISSN: 0002-9378 (ISSN-L)
DOI: 10.1016/j.ajog.2010.02.037
OpenAlex: W2068925803
Cited by: 241
References: 44
Citations by year: 2026: 7 · 2025: 8 · 2024: 11 · 2023: 15 · 2022: 10 · 2021: 16 · 2020: 20 · 2019: 16 · 2018: 12 · 2017: 19 · 2016: 19 · 2015: 14 · 2014: 17 · 2013: 24 · 2012: 14
FWCI: 11.82
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Journal of Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Funders: Norske Kvinners Sanitetsforening
EkstraStiftelsen Helse og Rehabilitering
Topics: Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
Keywords: pelvic floor muscle training, pelvic organ prolapse, prolapse symptoms, cystocele, rectal prolapse, pelvic floor physiotherapy, home-based exercise, lifestyle advice, women's health
MeSH terms: Adult, Double-Blind Method, Exercise Therapy, Female, Follow-Up Studies, Hospitals, University, Humans, Middle Aged, Muscle Contraction, Norway, Patient Compliance, Quality of Life, Reference Values, Severity of Illness Index, Ultrasonography, Urinary Incontinence, Stress, Confidence Intervals, Odds Ratio, Treatment Outcome, Pelvic Floor, Muscle, Skeletal, Risk Assessment, Cross-Over Studies, Statistics, Nonparametric, Pelvic Organ Prolapse

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Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial

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