Pelvic floor muscle training for urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life after hysterectomy: a systematic review with meta-analyses
Open accessAbstract
Background After hysterectomy, women could experience pelvic floor dysfunction and negative impact on quality of life, which could be improved by pelvic floor muscle training.Objective To investigate effects of pelvic floor muscle training on urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life after hysterectomy.Methods Systematic review with meta-analyses of randomized controlled trials. Trials with pelvic floor muscle training in women after hysterectomy were included. The outcomes measures were urinary symptoms, vaginal prolapse, sexual function, pelvic floor muscle strength, and quality of life. Quality of evidence was assessed by adopting the GRADE approach.Results Six trials, involving 776 participants, were included. The mean PEDro score of trials was 5.5. Moderate-quality evidence suggested that pelvic floor muscle training improves sexual function by 5 points (95% CI: 4, 6) on the Female Sexual Function Index, compared with no intervention. It might affect strength (SMD 0.5; 95% CI: -0.4, 1.3), quality of life (SMD 0.5 points out of 108, 95% CI: -0.1, 0.9), urinary symptoms (RD -0.02; 95% CI: -0.06, 0.1); however, the estimates were too imprecise. In addition, it produces no or negligible effects on vaginal prolapse (RD 0; 95% CI: -0.1, 0.1). Long-term effects remain uncertain.Conclusion This systematic review provides moderate-quality evidence that pelvic floor muscle training is effective for improving women's sexual function after hysterectomy, in comparison with no intervention. Benefits on urinary symptoms, pelvic floor muscle strength, quality of life, and vaginal prolapse remains unclear. Also, the effects beyond the intervention period remains uncertain.
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Pelvic surgery may temporarily impair the structural and functional integrity of the pelvic floor muscles and connective tissues that support the bladder and organs.
“Pelvic surgery may temporarily impair the structural and functional integrity of the pelvic floor muscles and connective tissues that support the bladder and organs [48].”
From Pelvic Floor Muscle Training Following Surgery for Pelvic Organ Prolapse: Recommendation from Scientific Literature (2026) · cites this paper as [48]
The Introduction says pelvic surgeries may damage or affect the function of pelvic floor muscles and connective tissue that support the bladder and reproductive organs. It does not say that this impairment is temporary; no page number is supplied for the passage. (LLM, conf=0.85)
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- Authors
- de Oliveira, N. F. F., Santuzzi, C. H., da Conceição, T. V., Freitas, J. M. V., Liberato, F. M. G., & Nascimento, L. R.
- Affiliations
- Universidade Federal do Espírito Santo (BR)
- ORCID
- Venue
- Brazilian Journal of Physical Therapy
- Publisher
- Elsevier BV
- Published
- 2024-09
- Volume
- 28
- Issue
- 5
- Pages
- 101122
- ISSN
- 1413-3555 (ISSN-L)
- PMC
- PMC11513449
- OpenAlex
- W4403310088
- Cited by
- 3
- References
- 59
- Citations by year
- 2026: 2 · 2025: 1
- FWCI
- 0.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brazilian Journal of Physical Therapy (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Federal University of Espirito Santo
- 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 floor muscle training, hysterectomy, urinary symptoms, vaginal prolapse, sexual function, female sexual function, pelvic floor muscle strength, quality of life
- MeSH terms
- Exercise Therapy, Female, Humans, Hysterectomy, Quality of Life, Uterine Prolapse, Pelvic Floor, Muscle Strength
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