Postpartum pelvic floor muscle training and pelvic organ prolapse—a randomized trial of primiparous women

Bø, Kari; Hilde, Gunvor; Stær-Jensen, Jette; Siafarikas, Franziska; Tennfjord, Merete Kolberg; Engh, Marie Ellstrøm

doi:10.1016/j.ajog.2014.06.049

Cited by 84Pelvic floor disorders treatmentsPregnancy-related medical researchSexual function and dysfunction studies

Postpartum pelvic floor muscle training and pelvic organ prolapse—a randomized trial of primiparous women

Bø, Kari, Hilde, Gunvor, Stær-Jensen, Jette, Siafarikas, Franziska, Tennfjord, Merete Kolberg, Engh, Marie Ellstrøm·2015·American Journal of Obstetrics and Gynecology

DOI 10.1016/j.ajog.2014.06.049

Open this paper in CoChat — free account

Abstract

Objective Pelvic organ prolapse (POP) is a common and distressing condition. The aim of the present study was to evaluate the effect of pelvic floor muscle training (PFMT) on prevention and treatment of symptoms and signs of POP in primiparous postpartum women.Study design This was a parallel group assessor blind randomized controlled trial. One hundred seventy-five primiparous postpartum women, mean age 29.8 years (standard deviation 4.1), stratified on major levator ani defects or no defect diagnosed by 3-/4-dimensional ultrasound, participated in a 4-month PFMT starting at 6-8 weeks' postpartum or control. All participants had thorough individual instruction and assessment of ability to perform correct pelvic floor muscle contractions. The PFMT group followed a supervised, weekly group training program and performed 3 sets of 8-12 daily maximal contractions at home. Main outcome was POP stage II or greater assessed by POP quantification and bladder neck position assessed by 3-/4- dimensional transperineal ultrasonography. Secondary outcome was symptoms of vaginal bulge using International Consultation on Incontinence Vaginal Symptoms questionnaire.Results Ninety-six percent of the intervention group adhered to ≥80% of both group and home training sessions. At postintervention, there was no significant risk difference in POP (rational ratio, 1.62; 95% confidence interval, 0.55-4.75), bladder neck position or symptoms of vaginal bulging.Conclusion No effect was found of postpartum PFMT on POP in primiparous women. More randomized controlled trials are needed before strong conclusions can be drawn on the effect of PFMT on POP in the particular population.

Integrity signals

Registry

Crossref · 10.1016/j.ajog.2014.06.049

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

In a secondary analysis of an assessor-blinded RCT, no effect was found on symptoms of bulging, bladder neck position or POP-Q stage after 4 months of group PFMT plus everyday PFMT home training starting at 6 weeks postpartum.
“No effect was found in symptoms of bulging, bladder neck position or POP-Q stage after 4 months of group PFMT + everyday PFMT home training, starting at 6 weeks postpartum.”
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 [54]
Three RCTs reported on PFMT for POP symptoms and were included in a meta-analysis.
“Three RCTs [54–56] reported on PFMT for POP symptoms (dichotomous outcome; presence/absence of bothersome vaginal bulging) and were included in a meta-analysis.”
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 [54]
The training dosage and level of supervision might have been too low in the Glazener study (2001) but was quite high in the study by Bø et al. (2015).
“The training dosage and level of supervision might have been too low in the Glazener study (2001) [58] but was quite high in the study by Bø et al. (2015) [54].”
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 [54]
The evidence for a positive effect in the postpartum period is not supported by results from Bø et al. (2015) or the 12-year follow-up of conservative management of postnatal urinary and fecal incontinence and POP outcomes by Glazener et al. (2014).
“Additionally, the evidence for a positive effect in the postpartum period is not supported by results from Bø et al. (2015) [54] or the 12-year follow-up of conservative management of postnatal urinary and fecal incontinence and POP outcomes by Glazener et al. (2014) [57].”
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 [54]
The primary outcome of Bø et al. and Glazener et al.'s RCTs was UI, and both studies included women with and without POP; thus, the sample size may have been too small to detect significant differences for POP.
“However, the primary outcome of Bø et al. [54] and Glazener et al.’s [58] RCTs was UI, and both studies included women with and without POP; thus, the sample size may have been too small to detect significant differences for POP.”
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 [54]

The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction
Bump, R. C., Mattiasson, A., Bø, K., Brubaker, L. P., DeLancey, J. O. L., Klarskov, P., Shull, B. L., & Smith, A. R. B. (1996) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(96)70243-0 · Cited by 4,275 · see citing works
Self-citation
An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction
Haylen, B. T., de Ridder, D., Freeman, R. M., Swift, S. E., Berghmans, B., Lee, J., Monga, A., Petri, E., Rizk, D. E., Sand, P. K., et al. (2010) · International Urogynecology Journal · doi:10.1007/s00192-009-0976-9 · Cited by 2,237 · see citing works
Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women
Bø, K., Talseth, T., & Holme, I. (1999) · BMJ · doi:10.1136/bmj.318.7182.487 · Cited by 682 · see citing works
Self-citation
Levator trauma is associated with pelvic organ prolapse
Dietz, H., & Simpson, J. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01751.x · Cited by 515 · see citing works
Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: III. Effects of two different degrees of pelvic floor muscle exercises
Bø, K., Hagen, R. H., Kvarstein, B., Jørgensen, J. J., Larsen, S. E., & Burgio, K. L. (1990) · Neurourology and Urodynamics · doi:10.1002/nau.1930090505 · Cited by 345 · see citing works
Self-citation
Minimal criteria for the diagnosis of avulsion of the puborectalis muscle by tomographic ultrasound
Dietz, H. P., Bernardo, M. J., Kirby, A. C., & Shek, K. L. (2010) · International Urogynecology Journal · doi:10.1007/s00192-010-1329-4 · Cited by 343 · see citing works
Pelvic floor muscle training during pregnancy to prevent urinary incontinence: a single-blind randomized controlled trial
Mørkved, S. (2003) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(02)02711-4 · Cited by 324 · see citing works
Adult conservative management
Dumoulin, C. L., Adewuyi, T. E., Booth, J., Bradley, C., Burgio, K. L., Hagen, S., Hunter, K. F., Imamura, M., Morin, M., Mørkved, S., et al. (2017) · Newcastle University ePrints (Newcastle Univesity) · doi:10.25405/ncl.34323708 · Cited by 298 · see citing works
Perineal ultrasound for evaluating the bladder neck in urinary stress incontinence
Schaer, G. N., Koechli, O. R., Schuessler, B., & Haller, U. (1995) · Obstetrics and Gynecology · doi:10.1016/0029-7844(94)00369-o · Cited by 271 · see citing works
Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction
Bø, K., Kvarstein, B., Hagen, R., & Larsen, S. E. (1990) · Neurourology and Urodynamics · doi:10.1002/nau.1930090504 · Cited by 267 · see citing works
Self-citation
Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): A multicentre randomised controlled trial
Hagen, S., Stark, D., Glazener, C., Dickson, S., Barry, S., Elders, A., Frawley, H., Galea, M. P., Logan, J., McDonald, A., et al. (2014) · The Lancet · doi:10.1016/s0140-6736(13)61977-7 · Cited by 258 · see citing works
Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapse symptoms? An assessor-blinded, randomized, controlled trial
Brækken, I. H., Majida, M., Engh, M. E., & Bø, K. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2010.02.037 · Cited by 241 · see citing works
Self-citation
Epidemiology of urinary incontinence (UI) and other lower urinary tract symptoms (LUTS), pelvic organ prolapse (POP) and anal incontinence (AI)
Milsom, I., Altman, D., Cartwright, R., Lapitan, M. C., Nelson, R. S., Sillén, U., & Tikkinen, K. A. O. (2013) · Cited by 213 · see citing works
Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ‐VS
Price, N., Jackson, S., AVERY, K. N. L., Brookes, S., & Abrams, P. (2006) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.00938.x · Cited by 212 · see citing works
Morphological Changes After Pelvic Floor Muscle Training Measured by 3-Dimensional Ultrasonography: A Randomized Controlled Trial
Hoff Brækken, I., Majida, M., Engh, M. E., & Bø, K. (2010) · Obstetrics & Gynecology · doi:10.1097/aog.0b013e3181cbd35f · Cited by 168 · see citing works
Self-citation
Tomographic ultrasound imaging of the pelvic floor: which levels matter most?
Dietz, H. P., & Shek, K. L. (2009) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.6403 · Cited by 117 · see citing works
Pelvic floor muscle exercise for the treatment of female stress urinary incontinence: I. Reliability of vaginal pressure measurements of pelvic floor muscle strength
Bø, K., Kvarstein, B., Hagen, R., & Larsen, S. E. (1990) · Neurourology and Urodynamics · doi:10.1002/nau.1930090503 · Cited by 112 · see citing works
Self-citation
The effect of postpartum pelvic floor muscle exercise in the prevention and treatment of urinary incontinence
Mørkved, S., & Bø, K. (1997) · International Urogynecology Journal · doi:10.1007/bf02765817 · Cited by 110 · see citing works
Self-citation
Pathophysiology of urinary incontinence and pelvic organ prolapse
Hilton, P., & Dolan, L. (2004) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2004.00458.x · Cited by 104 · see citing works
Postpartum Pelvic Floor Muscle Training and Urinary Incontinence
Hilde, G., Stær-Jensen, J. E., Siafarikas, F., Engh, M. E., & Bø, K. (2013) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000000012 · Cited by 93 · see citing works
Self-citation
Complications of pelvic organ prolapse surgery and methods of prevention
de Tayrac, R., & Sentilhes, L. (2013) · International Urogynecology Journal · doi:10.1007/s00192-013-2177-9 · Cited by 80 · see citing works
Pressure measurements during pelvic floor muscle contractions: The effect of different positions of the vaginal measuring device
Bø, K. (1992) · Neurourology and Urodynamics · doi:10.1002/nau.1930110205 · Cited by 70 · see citing works
Self-citation
Effect of childbirth on pelvic organ support and quality of life: a longitudinal cohort study
Elenskaia, K., Thakar, R., Sultan, A. H., Scheer, I., & Onwude, J. L. (2012) · International Urogynecology Journal · doi:10.1007/s00192-012-1932-7 · Cited by 48 · see citing works
Pelvic organ prolapse surgery
Maher, C., Baeßler, K., Barber, M. D., Cheon, C., Deitz, V., de Tayrac, R., Gutman, R. E., Sentilhes, L., & Karram, M. M. (2013) · Cited by 47 · see citing works
The recovery of pelvic organ support during the first year postpartum
Chen, Y., Li, F., Lin, X., Chen, J., Chen, C., & Guess, M. K. (2013) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.12369 · Cited by 43 · see citing works
Pelvic floor muscle injuries 6 weeks post partum—an intra‐ and inter‐rater study
Stær-Jensen, J. E., Siafarikas, F., Hilde, G., Brækken, I. H., Bø, K., & Engh, M. E. (2012) · Neurourology and Urodynamics · doi:10.1002/nau.22337 · Cited by 22 · see citing works
Self-citation

Flagged first, then by citations

Sorted by citations

Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women
Woodley, S. J., Boyle, R., Cody, J. D., Mørkved, S., & Hay-Smith, J. E. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007471.pub3 · Cited by 489 · see citing works
Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women
Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J. D., Mørkved, S., Kernohan, A., & Hay-Smith, E. J. C. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007471.pub4 · Cited by 347 · see citing works
The efficacy of pelvic floor muscle training for pelvic organ prolapse: A systematic review and meta-analysis
Li, C., Gong, Y., & Wang, B. (2016) · International Urogynecology Journal · doi:10.1007/s00192-015-2846-y · Cited by 154 · see citing works
Exercise and pregnancy in recreational and elite athletes: 2016/17 evidence summary from the IOC Expert Group Meeting, Lausanne. Part 3—exercise in the postpartum period
Bø, K., Artal, R., Barakat, R., Brown, W. J., Davies, G., Dooley, M., Evenson, K. R., Haakstad, L. A. H., Kayser, B., Kinnunen, T. I., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-097964 · Cited by 142 · see citing works
Self-citation
Pelvic floor muscle training for secondary prevention of pelvic organ prolapse (PREVPROL): a multicentre randomised controlled trial
Hagen, S., Glazener, C., McClurg, D., Macarthur, C., Elders, A., Herbison, P., Wilson, D., Toozs-Hobson, P., Hemming, C., Hay-Smith, J., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(16)32109-2 · Cited by 90 · see citing works
Effect of postpartum pelvic floor muscle training on vaginal symptoms and sexual dysfunction—secondary analysis of a randomised trial
Tennfjord, M. K., Hilde, G., Stær-Jensen, J. E., Siafarikas, F., Engh, M. E., & Bø, K. (2015) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.13823 · Cited by 85 · see citing works
Self-citation
Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum Periods
Romeikienė, K. E., & Bartkevičienė, D. (2021) · Medicina · doi:10.3390/medicina57040387 · Cited by 88 · see citing works
Physical, Complementary, and Alternative Medicine in the Treatment of Pelvic Floor Disorders
Arnouk, A., De, E., Rehfuss, A. W., Cappadocia, C., Dickson, S., & Lian, F. (2017) · Current Urology Reports · doi:10.1007/s11934-017-0694-7 · Cited by 78 · see citing works
Pelvic Floor Muscle Training Versus Watchful Waiting and Pelvic Floor Disorders in Postpartum Women: A Systematic Review and Meta-analysis
Wu, Y. (., McInnes, N., & Leong, Y. (2018) · Female Pelvic Medicine & Reconstructive Surgery · doi:10.1097/spv.0000000000000513 · Cited by 71 · see citing works
Change in pelvic organ support during pregnancy and the first year postpartum: a longitudinal study
Reimers, C., Stær-Jensen, J. E., Siafarikas, F., Benth, J. Š., Bø, K., & Engh, M. E. (2015) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.13432 · Cited by 71 · see citing works
Self-citation
International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training
Bø, K., Anglès-Acedo, S., Batra, A., Brækken, I. H., Chan, Y. L., Jorge, C. H., Kruger, J., Yadav, M., & Dumoulin, C. (2022) · International Urogynecology Journal · doi:10.1007/s00192-022-05324-0 · Cited by 64 · see citing works
“(2015) [54] or the 12-year follow-up of conservative management of postnatal urinary and fecal incontinence and POP outcomes by Glazener et al.”
BackgroundMethodInfluentialSelf-citation
Prevalence and trends of pelvic floor disorders in late pregnancy and after delivery in a cohort of Israeli women using the PFDI-20
Yohay, D., Weintraub, A. Y., Mauer-Perry, N., Peri, C., Kafri, R., Yohay, Z., & Bashiri, A. (2016) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2016.02.037 · Cited by 53 · see citing works
Impact of Pelvic Floor Physical Therapy on Quality of Life and Function After Obstetric Anal Sphincter Injury: A Randomized Controlled Trial
Oakley, S. H., Ghodsi, V. C., Crisp, C. C., Estanol, M. V., Westermann, L. B., Novicki, K., Kleeman, S. D., & Pauls, R. N. (2016) · Urogynecology · doi:10.1097/spv.0000000000000255 · Cited by 38 · see citing works
Pelvic organ prolapse management
Fleischer, K., & Thiagamoorthy, G. (2020) · Post Reproductive Health · doi:10.1177/2053369120937594 · Cited by 34 · see citing works
The Effect of Commonly Performed Exercises on the Levator Hiatus Area and the Length and Strength of Pelvic Floor Muscles in Postpartum Women
Siff, L. N., Hill, A. J., Walters, S. J., Walters, G., & Walters, M. D. (2018) · Urogynecology · doi:10.1097/spv.0000000000000590 · Cited by 32 · see citing works
The Effect of Pelvic Floor Muscle Training on Pelvic Floor Dysfunction in Pregnant and Postpartum Women
Ren, S., Gao, Y., Yang, Z., Li, J., Xuan, R., Liu, J., Chen, X., & Thirupathi, A. (2020) · Physical Activity and Health · doi:10.5334/paah.64 · Cited by 27 · see citing works
Quantification of 3/4D ultrasound pelvic floor changes induced by postpartum muscle training in patients with levator ani muscle avulsion: a parallel randomized controlled trial
Sainz‐Bueno, J. A., Bonomi, M. J., Suárez-Serrano, C., Medrano-Sánchez, E. M., Sánchez, A. A., Fernández-Palacín, A., & García‐Mejido, J. A. (2022) · Quantitative Imaging in Medicine and Surgery · doi:10.21037/qims-21-877 · Cited by 24 · see citing works
Pelvic floor muscle strength in primiparous women according to the delivery type: cross-sectional study
Mendes, E. D. P. B., de Oliveira, S. M. J. V., Caroci, A. D. S., Francisco, A. A., Oliveira, S. G., & da Silva, R. L. (2016) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.0926.2758 · Cited by 22 · see citing works
Evaluation of Postpartum Pelvic Floor Physical Therapy on Obstetrical Anal Sphincter Injury: A Randomized Controlled Trial
Bargen, E. V., Haviland, M. J., Chang, O. H., McKinney, J. L., Hacker, M. R., & Elkadry, E. A. (2020) · Urogynecology · doi:10.1097/spv.0000000000000849 · Cited by 21 · see citing works
Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review
Giagio, S., Innocenti, T., Salvioli, S., Lami, A., Meriggiola, M. C., Pillastrini, P., & Gava, G. (2021) · Neurourology and Urodynamics · doi:10.1002/nau.24712 · Cited by 19 · see citing works
Defining “normal recovery” of pelvic floor function and appearance in a high-risk vaginal delivery cohort
Fairchild, P. S., Low, L. K., Kowalk, K. M., Kolenic, G. E., DeLancey, J. O. L., & Fenner, D. E. (2019) · International Urogynecology Journal · doi:10.1007/s00192-019-04152-z · Cited by 19 · see citing works
The pilates method in the function of pelvic floor muscles: Systematic review and meta-analysis
Lemos, A. Q., Brasil, C. A., Valverde, D., Ferreira, J. D. S., Lordêlo, P., & Sá, K. N. (2018) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2018.07.002 · Cited by 17 · see citing works
New Method for Assessment of Levator Avulsion Injury: A Comparative Elastography Study
Maßlo, K., Möllers, M., de Murcia, K. O., Klockenbusch, W., & Schmitz, R. (2018) · Journal of Ultrasound in Medicine · doi:10.1002/jum.14810 · Cited by 17 · see citing works
Impact of pelvic floor muscle training in pelvic organ prolapse
Basnet, R. (2021) · International Urogynecology Journal · doi:10.1007/s00192-020-04613-w · Cited by 15 · see citing works
Management of levator ani avulsion: a systematic review and narrative synthesis
Doxford‐Hook, E., Slemeck, E., Downey, C. L., & Marsh, F. A. (2023) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-023-06955-4 · Cited by 16 · see citing works
Entrenamiento muscular del suelo pélvico en el tratamiento del prolapso de órganos pélvicos: un metaanálisis de ensayos controlados aleatorizados
Ge, J., Wei, X. J., Zhang, H. Z., & Fang, G. Y. (2021) · Actas Urológicas Españolas · doi:10.1016/j.acuro.2020.01.012 · Cited by 16 · see citing works
A review of levator ani avulsion after childbirth: Incidence, imaging and management
Doxford‐Hook, E., Downey, C. L., Gibson, J., & Marsh, F. A. (2022) · Midwifery · doi:10.1016/j.midw.2022.103494 · Cited by 15 · see citing works
Effects of an 8‐week pelvic core stability and nutrition community programme on maternal health outcomes
Walton, L. M., Raigangar, V. L., Abraham, M. S., Buddy, C., Hernandez, M., Krivak, G., & Caceras, R. (2019) · Physiotherapy Research International · doi:10.1002/pri.1780 · Cited by 14 · see citing works
Effect of structured pelvic floor muscle training on pelvic floor muscle contraction and treatment of pelvic organ prolapse in postpartum women: ultrasound and clinical evaluations
Zhao, H. M., Liu, X., & Liu, L. (2023) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-023-07226-y · Cited by 14 · see citing works
Association between vaginal bulge and anatomical pelvic organ prolapse during pregnancy and postpartum: an observational study
Reimers, C., Stær-Jensen, J. E., Siafarikas, F., Bø, K., & Engh, M. E. (2017) · International Urogynecology Journal · doi:10.1007/s00192-017-3407-3 · Cited by 11 · see citing works
Self-citation
Pelvic floor muscle training: a practical guide
Okeahialam, N. A., Oldfield, M., Stewart, E., Bonfield, C., & Carboni, C. (2022) · BMJ · doi:10.1136/bmj-2022-070186 · Cited by 11 · see citing works
Mitofusin2 regulates the proliferation and function of fibroblasts: The possible mechanisms underlying pelvic organ prolapse development
Wang, X., Wang, X., Zhou, Y., Peng, C., Chen, H., & Lu, Y. F. (2019) · Molecular Medicine Reports · doi:10.3892/mmr.2019.10501 · Cited by 11 · see citing works
Pelvic floor symptoms from first pregnancy up to 8 years after the first delivery: a longitudinal study
Siafarikas, F., Halle, T. K., Benth, J. Š., Stær-Jensen, J. E., Reimers, C., Bø, K., & Engh, M. E. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.06.020 · Cited by 10 · see citing works
Self-citation
Relationship between low back pain and stress urinary incontinence at 3 months postpartum
Mutaguchi, M., Murayama, R., Takeishi, Y., Kawajiri, M., Yoshida, A., Nakamura, Y., Yoshizawa, T., & Yoshida, M. (2022) · Drug Discoveries & Therapeutics · doi:10.5582/ddt.2022.01015 · Cited by 10 · see citing works
Postpartum pelvic organ prolapse and pelvic floor muscle training: secondary analysis of a randomized controlled trial of primiparous women
Sigurðardóttir, Þ., Steingrímsdóttir, Þ., Geirsson, R. T., Halldorsson, T. I., Aspelund, T., & Bø, K. (2023) · International Urogynecology Journal · doi:10.1007/s00192-023-05502-8 · Cited by 10 · see citing works
Self-citation
Association Between Genital Hiatus Size 8 Weeks Postpartum and Pelvic Organ Prolapse 1 Year After the First Vaginal Delivery
Rosett, H. A., Allshouse, A. A., Nygaard, I., Hill, A. J., & Swenson, C. W. (2023) · Urogynecology · doi:10.1097/spv.0000000000001354 · Cited by 11 · see citing works
Pelvic floor muscle training in the treatment of pelvic organ prolapse: A meta-analysis of randomized controlled trials
Ge, J., Wei, X. J., Zhang, H. Z., & Fang, G. Y. (2020) · Actas Urológicas Españolas (English Edition) · doi:10.1016/j.acuroe.2020.12.002 · Cited by 9 · see citing works
Does the type of pushing at delivery influence pelvic floor function at 2 months postpartum? A pragmatic randomized trial—The EOLE study
Barasinski, C., Debost‐Legrand, A., Savary, D., Bouchet, P., Curinier, S., & Vendittelli, F. (2022) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14461 · Cited by 8 · see citing works
Examen pelvien en gynécologie et obstétrique : recommandations pour la pratique clinique
Deffieux, X., Rousset‐Jablonski, C., Gantois, A., Brillac, T., Maruani, J., Maitrot‐Mantelet, L., Mignot, S., Gaucher, L., Athiel, Y., Baffet, H., et al. (2023) · Gynécologie Obstétrique Fertilité & Sénologie · doi:10.1016/j.gofs.2023.04.001 · Cited by 9 · see citing works
Systematic Review of Evidence for Conservative Management of Pelvic Organ Prolapse in Younger Women
Brown, C. A., Toong, P. J., Kearney, R., Hagen, S., & McPeake, J. (2025) · International Urogynecology Journal · doi:10.1007/s00192-024-05995-x · Cited by 7 · see citing works
Physiotherapy and Pelvic Floor Muscle Exercises for the Prevention and Treatment of Pregnancy-Related Pelvic Floor Dysfunctions: A Systematic Review and Meta-analysis
Khorasani, F., Ghaderi, F., Sarbakhsh, P., Ahadi, P., Khorasani, E., Ansari, F., & Vahed, N. (2019) · International Journal of Women s Health and Reproduction Sciences · doi:10.15296/ijwhr.2020.20 · Cited by 7 · see citing works
Surgical Management of Pelvic Organ Prolapse
Hundley, A. F., & Nekkanti, S. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108178594.025 · Cited by 7 · see citing works
Evaluation of pelvic floor muscle function (PFMF) in cervical cancer patients with Querleu–Morrow type C hysterectomy: a multicenter study
Wang, S., Gao, L., Wen, H., Gao, Y., Lv, Q., Li, H., Wang, S., Wang, Y., Liu, Q., Han, J., et al. (2021) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-021-06290-6 · Cited by 6 · see citing works
Pelvic floor muscle training in women with urinary incontinence and pelvic organ prolapse: A protocol study
de Carvalho, M. L. A. S., Bezerra, L. O., de Oliveira, J. M. P., de Oliveira, M. C. E., & Micussi, M. T. A. B. C. (2024) · PLoS ONE · doi:10.1371/journal.pone.0308701 · Cited by 7 · see citing works
Levator ani muscle avulsion and subsequent vaginal delivery: 8‐year longitudinal follow‐up
Siafarikas, F., Stær-Jensen, J. E., Reimers, C., Bø, K., & Engh, M. E. (2024) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.27599 · Cited by 5 · see citing works
Self-citation
A Study on 10-Week Combined Aerobic and Resistance Training Exercise Prescription for Female Patients with Pelvic Floor Dysfunction
Zhang, L., He, J., Zhang, Q., & Wang, L. (2025) · Healthcare · doi:10.3390/healthcare13060592 · Cited by 4 · see citing works
Effect of pelvic floor muscle training on pelvic floor muscle morphometry in subjects with pelvic organ prolapse: a systematic review and meta-analysis
ShahAli, S., Bø, K., Hejazi, A., Hashemi, H. M., & Kharaji, G. (2025) · BMC Women s Health · doi:10.1186/s12905-025-04095-2 · Cited by 4 · see citing works
Self-citation
Investigating the Efficacy of an 18-Week Postpartum Rehabilitation and Physical Development Intervention on Occupational Physical Performance and Musculoskeletal Health in UK Servicewomen: Protocol for an Independent Group Study Design
Elliott-Sale, K. J., Bostock, E. L., Jackson, T., Wardle, S. L., O’Leary, T. J., Greeves, J. P., & Sale, C. (2022) · JMIR Research Protocols · doi:10.2196/32315 · Cited by 4 · see citing works
Validation and cross-cultural adaptation of the Brazilian Portuguese version of the questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and postpartum
Vieira, R. C. M. D. S., da Silva, J. B., Cavalli, R. D. C., & Driusso, P. (2022) · International Urogynecology Journal · doi:10.1007/s00192-022-05101-z · Cited by 4 · see citing works
Impact des lésions obstétricales du levator ani sur la continence anale
Perrin, S., & Billecocq, S. (2022) · The French Journal of Urology · doi:10.1016/j.purol.2022.09.017 · Cited by 4 · see citing works
Accuracy of MRI, ultrasound and vaginal assessment for the diagnosis of levator ani muscle avulsion in women
van Gruting, I. M. A., van Delft, K. W. M., Thakar, R., IntHout, J., & Sultan, A. H. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011900 · Cited by 4 · see citing works
Ein neues Konzept in der postpartalen Pessartherapie
Beilecke, K., & Tunn, R. (2017) · gynäkologie + geburtshilfe · doi:10.1007/s15013-017-1244-6 · Cited by 4 · see citing works
Efficacy of pelvic floor magnetic stimulation combined with electrical stimulation on postpartum pelvic organ prolapse: a retrospective study
ZHANG, L., LV, X. J., & Tang, J. (2021) · Pelviperineology · doi:10.34057/ppj.2020.39.01.004 · Cited by 3 · see citing works
ESTRATÉGIA DE TELEMONITORAMENTO PARA EXTENSÃO UNIVERSITÁRIA
Eufrásio, L. S., Anunciação, J. D. O., Silva, T. A. A., & Magalhães, A. G. (2020) · Revista Extensão & Sociedade · doi:10.21680/2178-6054.2020v12n1id20662 · Cited by 3 · see citing works
Update on Diagnosis and Treatment for Levator Avulsion
Yang, J.-M., & Huang, W. (2025) · Journal of Medical Ultrasound · doi:10.4103/jmu.jmu-d-25-00013 · Cited by 2 · see citing works
Dynamic Visualization of the Female Pelvic Floor Function
Constantinou, C. E. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-803228-2.00012-x · Cited by 2 · see citing works
Pelvic Floor Trauma and Its Relationship to Pelvic Organ Prolapse
Barenberg, B. J., & Quiroz, L. H. (2015) · Current Obstetrics and Gynecology Reports · doi:10.1007/s13669-015-0119-x · Cited by 2 · see citing works
Estudos experimentais no período gestacional: panorama da produção científica
Dantas, S. L. D. C., de Oliveira, G. Y. M., Costa, K. F. D. L., Barros, A. A., Chaves, E. M. C., & de Carvalho, R. E. F. L. (2018) · Revista da Escola de Enfermagem da USP · doi:10.1590/s1980-220x2017024403325 · Cited by 2 · see citing works
Ultrasound Diagnosis of Levator Ani Hiatus Enlargement and Cystocele in Standing and Supine Positions in the Postpartum Period
Coppola, C., Fochesato, C., Esposito, G., Ferrazzi, E. M., & Orsi, M. (2024) · Journal of Ultrasound in Medicine · doi:10.1002/jum.16627 · Cited by 1 · see citing works
Women’s experiences of life and healthcare after levator ani avulsion: a qualitative interview study
Estendahl, K., & Danielsson, L. (2025) · BMC Women s Health · doi:10.1186/s12905-025-03892-z · Cited by 1 · see citing works
Insulin Resistance as a Biomarker for Pelvic Organ Prolapse in Gestational Diabetes Mellitus: Stratification by Delivery Modes
Jiao, Y., Dai, Y., He, L., & Fei, Z. (2025) · International Journal of General Medicine · doi:10.2147/ijgm.s529756 · Cited by 1 · see citing works
Post-partum Problems and the Perineal Clinic
Thakar, R., Sultan, A. H., & Lewicky‐Gaupp, C. (2024) · Springer eBooks · doi:10.1007/978-3-031-43095-4_10 · Cited by 1 · see citing works
Pelvic Floor Muscle Training and Prolapse: Prevention or Treatment?
Biroli, A., & Lamberti, G. (2018) · Urodynamics, neurourology and pelvic floor dysfunctions · doi:10.1007/978-3-319-59195-7_6 · Cited by 1 · see citing works
The impact of awareness program on the knowledge and practice of women about pelvic organ prolapse
Goda, A. A., & Elmonem, A. S. A. (2019) · Journal of Health, Medicine and Nursing · doi:10.7176/jhmn/61-11 · Cited by 1 · see citing works
Efeitos do treinamento muscular do assoalho pélvico em mulheres com prolapso de órgãos pélvicos: uma revisão sistemática
Cordeiro, A. L. L., Pedra, A. C., Brasileiro, P., & Silva, T. (2020) · Ciência em Movimento · doi:10.15602/1983-9480/cm.v22n44p21-29 · Cited by 1 · see citing works
Mini-review: Modern Concept of Pelvic Organ Prolapse
Aitbayeva, B., Саятович, И. С., & Kenzhebekovna, S. L. (2022) · Open Access Macedonian Journal of Medical Sciences · doi:10.3889/oamjms.2022.8804 · Cited by 1 · see citing works
EFEITOS DOS EXERCÍCIOS DE KEGEL NA MELHORA DOS DISTÚRBIOS DO ASSOALHO PÉLVICO DE PUÉRPERAS: UMA REVISÃO SISTEMÁTICA
de Souza, V. C., & Leite, M. E. F. (2023) · Congresso Nacional Multidisciplinar da Saúde da Mulher · doi:10.51161/conasm2023/21259 · Cited by 1 · see citing works
Força muscular do assoalho pélvico de primíparas segundo o tipo de parto: estudo de coorte
Oliveira, S. G. (2018) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/d.7.2018.tde-27042018-112045 · Cited by 1 · see citing works
A Practical Approach to Pelvic Floor Dysfunctions After Childbirth: Diagnostic and Therapeutic Flowcharts
Biroli, A. (2015) · Springer eBooks · doi:10.1007/978-3-319-18197-4_15
Urogenital Health: Optimizing Healthy Aging
Harnisch, B. A., Soyster, M., & Smith, P. P. (2019) · Springer eBooks · doi:10.1007/978-3-030-06200-2_9
Urogynecologic pelvic floor problems: Across the entire spectrum of women’s lives
Davila, G. W. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13282
Geriatric clinical pharmacology: basic and clinical considerations. Pt. 1
Ndele, J. K. (1996)
The benefits of Kegel’s exercises during pregnancy
(2021) · International Egyptian Journal of Nursing Sciences and Research · doi:10.21608/ejnsr.2021.181227
Evaluation of Pelvic Floor Muscle Function(PFMF) in Cervical Cancer Patients with Querleu-Morrow type C Hysterectomy：A Multicenter StudyPreprint
Wang, S., Wen, H., Gao, Y., Lv, Q., Li, H., Wang, S., Wang, Y., Liu, Q., Han, J., Wang, H., et al. (2020) · doi:10.21203/rs.3.rs-116903/v1
Physical therapy treatment for pelvic floor strengthening in women after vaginal delivery: A systematic review
Bairrada, I. L., Bardin, M. G., Ferrari, R. B., do Amaral, M. T. P., & Zanetti, M. R. D. (2023) · Seven Editora eBooks · doi:10.56238/innovhealthknow-053
Actualización de los efectos de la fisioterapia en el manejo de prolapsos de órganos pélvicos. Una revisión sistemática
Rivadulla-Lorenzo, D., Carrera, I. D. C., Alonso-Calvete, A., Tomé-Lage, D., & López-País, M. (2026) · Clínica e Investigación en Ginecología y Obstetricia · doi:10.1016/j.gine.2025.101086
Prolapse Management in Elderly and Frail Patients
Srirangapatanam, S., & Kuiken, M. E. V. (2026) · Current Bladder Dysfunction Reports · doi:10.1007/s11884-025-00799-1
Pratiques obstétricales maïeutiques lors de l'accouchement : État des lieux et évaluation des types de poussée
Barasinski, C. (2017) · doi:10.70675/b760f593z58e6z4e9aza701z976035091654
Effects of Pelvic Floor Muscle Training in Pregnant and Postpartum Women: A Systematic Review
Jin, S., & Lee, H. (2026) · International Urogynecology Journal · doi:10.1007/s00192-026-06647-y
Prolapse Management in Patients in Childbearing Age
Zein, M., Mansour, M., Trump, T., & Roberts, L. H. (2026) · Current Bladder Dysfunction Reports · doi:10.1007/s11884-025-00803-8
Multidisciplinary Pelvic Floor Intervention in Women over 55: A Comparison Between Supervised and Reduced-Supervision Models
Velasco-Carrasco, M. C., Cordellat, A., Sales, A., Pinazo‐Clapés, C., Hernandis, S. P., & Blasco-Lafarga, C. (2026) · Women · doi:10.3390/women6030048
Long‐Term Effects of Pelvic Floor Muscle Training Combined With Electrical Stimulation Biofeedback Among Women With Symptomatic Pelvic Organ Prolapse: A Randomised Controlled Trial
Li, M., Yuhan, L., Li, P., Liang, Y., Gai, T., Lyu, Q., Huang, S., Liang, L., Yu, Y., & Zhang, X. (2026) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.70313
Urogenital Health: Optimizing Healthy Aging
Matz, A., Smith, P. P., & Harnisch, B. A. (2026) · Springer eBooks · doi:10.1007/978-3-032-21928-2_9
Conservative and Nonsurgical Management of Pelvic Organ Prolapse
Hong, C. X., & LaCross, J. A. (2026) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0000000000001061

Postpartum pelvic organ prolapse and pelvic floor muscle training: secondary analysis of a randomized controlled trial of primiparous women
Sigurðardóttir, Þ., Steingrímsdóttir, Þ., Geirsson, R. T., Halldorsson, T. I., Aspelund, T., & Bø, K. (2023) · International Urogynecology Journal · doi:10.1007/s00192-023-05502-8 · Cited by 10 · see citing works
Self-citation
Postpartum pelvic organ prolapse and pelvic floor muscle training Results from a randomized controlled trial of primiparous womenPreprint
Sigurðardóttir, Þ., Steingrímsdóttir, Þ., Geirsson, R. T., Halldorsson, T. I., Aspelund, T., & Bø, K. (2022) · doi:10.22541/au.165581289.96035977/v1
Self-citation
Effect of structured pelvic floor muscle training on pelvic floor muscle contraction and treatment of pelvic organ prolapse in postpartum women: ultrasound and clinical evaluations
Zhao, H. M., Liu, X., & Liu, L. (2023) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-023-07226-y · Cited by 14 · see citing works
Effect of preoperative pelvic floor muscle training on pelvic floor muscle contraction and symptomatic and anatomical pelvic organ prolapse after surgery: Randomized controlled trial
Nyhus, M. Ø., Mathew, S., Salvesen, Ø., Salvesen, K. Å., Stafne, S., & Volløyhaug, I. (2020) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.22007 · Cited by 27 · see citing works
EFFECT OF POSTPARTUM STRUCTURED PELVIC FLOOR MUSCLE TRAINING ON PELVIC ORGAN PROLAPSE
Hui, Z. H. A. O. (2025) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2025.11.498

Authors: Bø, K., Hilde, G., Stær-Jensen, J., Siafarikas, F., Tennfjord, M. K., & Engh, M. E.
Affiliations: Akershus University Hospital (NO)
University of Oslo (NO)
Corresponding author: Bø, Kari
ORCID: Bø, Kari
Hilde, Gunvor
Siafarikas, Franziska
Tennfjord, Merete Kolberg
Venue: American Journal of Obstetrics and Gynecology
Publisher: Elsevier BV
Published: 2015-01
Volume: 212
Issue: 1
Pages: 38.e1-38.e7
ISSN: 0002-9378 (ISSN-L)
DOI: 10.1016/j.ajog.2014.06.049
OpenAlex: W2062330104
Cited by: 84
References: 26
Citations by year: 2026: 8 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 11 · 2021: 6 · 2020: 10 · 2019: 6 · 2018: 8 · 2017: 6 · 2016: 5 · 2015: 6
FWCI: 4.70
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)
Topics: Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy-related medical research
Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
Keywords: pelvic floor muscle training, pelvic organ prolapse, postpartum women, primiparous women, bladder neck position, pelvic floor rehabilitation, postpartum pelvic floor dysfunction
MeSH terms: Adult, Exercise Therapy, Female, Humans, Parity, Pregnancy, Single-Blind Method, Pelvic Floor, Postpartum Period, Pelvic Organ Prolapse

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Postpartum pelvic floor muscle training and pelvic organ prolapse—a randomized trial of primiparous women

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks