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Cited by 4Pelvic floor disorders treatmentsSexual function and dysfunction studiesUterine Myomas and Treatments

Adherence to Perioperative Behavioral Therapy With Pelvic Floor Muscle Training in Women Receiving Vaginal Reconstructive Surgery for Pelvic Organ Prolapse

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Borello-France, Diane, Newman, Diane K, Markland, Alayne D, Propst, Katie, Jelovsek, J Eric, Cichowski, Sara, Gantz, Marie G, Balgobin, Sunil +82 more·2023·Physical Therapy
DOI 10.1093/ptj/pzad059PMC PMC10476875
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Abstract

Objective: The objective of this study was to describe adherence to behavioral and pelvic floor muscle training in women undergoing vaginal reconstructive surgery for organ prolapse and to examine whether adherence was associated with 24-month outcomes. Methods: Participants were women ≥18 years of age, with vaginal bulge and stress urinary incontinence symptoms, planning to undergo vaginal reconstructive surgery for stages 2 to 4 vaginal or uterine prolapse. They were randomized to either sacrospinous ligament fixation or uterosacral ligament suspension and to perioperative behavioral and pelvic floor muscle training or usual care. Measurements included anatomic failure, pelvic floor muscle strength, participant-reported symptoms, and perceived improvement. Analyses compared women with lower versus higher adherence. Results: Forty-eight percent of women performed pelvic floor muscle exercises (PFMEs) daily at the 4- to 6-week visit. Only 33% performed the prescribed number of muscle contractions. At 8 weeks, 37% performed PFMEs daily, and 28% performed the prescribed number of contractions. No significant relationships were found between adherence and 24-month outcomes. Conclusion: Adherence to a behavioral intervention was low following vaginal reconstructive surgery for pelvic organ prolapse. The degree of adherence to perioperative training did not appear to influence 24-month outcomes in women undergoing vaginal prolapse surgery. Impact: This study contributes to the understanding of participant adherence to PFMEs and the impact that participant adherence has on outcomes at 2, 4 to 6, 8, and 12 weeks and 24 months postoperatively. It is important to educate women to follow up with their therapist or physician to report new or unresolved pelvic symptoms.

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Authors
Borello-France, D., Newman, D. K., Markland, A. D., Propst, K., Jelovsek, J. E., Cichowski, S., Gantz, M. G., Balgobin, S., Jakus-Waldman, S., Korbly, N., Mazloomdoost, D., Burgio, K. L., for The NICHD Pelvic Floor Disorders Network, Korbly, N., Barber, M. D., Frick, A., O’Dougherty, B., Propst, K., Pung, L., Ridgeway, B. M., Williams, C., Eric Jelovsek, J., Amundsen, C. L., Harm-Ernandes, I., Raynor, M., Siddiqui, N. Y., Visco, A. G., Weidner, A. C., Wu, J. M., Jakus-Waldman, S., Diwadkar, G., Dyer, K. Y., Hall, L. M., Mackinnon, L. M., Menefee, S. A., Nguyen, J. N., Tan-Kim, J., Zazueta-Damian, G., Brubaker, L., Mueller, E., Tulke, M., Borello-France, D., Cichowski, S., Gantz, M., Warren, L. K., Matthews, D., Grey, S., Shaffer, A., Terry, T. T., Thornberry, J., Wallace, D., Whitworth, R. E., Wilson, K. A., Hartmann, K., Ballard, A., Burge, J., Burgio, K. L., Carter, K., Goode, P. S., Markland, A. D., Pair, L. S., Parker-Autry, C., Richter, H. E., Edward Varner, R., Wilson, T. S., Albo, M. E., Grimes, C., Lukacz, E. S., Nager, C. W., Casher, Y. W., Chen, Y.-H., DiFranco, D., Marchant, B., Spino, C., Wei, J. T., Newman, D., Baker, J., Hsu, Y., Masters, M., Orr, A., Atnip, S., Balgobin, S., Moore, E. K., Rahn, D., Schaffer, J., Wai, C., Meikle, S. F., Burgio, K. L., Markland, A. D., & Grey, S.
Affiliations
  • University of Pennsylvania (US)
  • Duke University Department of Obstetrics & Gynecology, , Durham, North Carolina, USA
  • RTI International Department of Biostatistics and Epidemiology, , Triangle Park, North Carolina, USA
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
ORCID
Venue
Physical Therapy
Publisher
Oxford University Press (OUP)
Published
2023-06-15
Volume
103
Issue
9
ISSN
  • 0031-9023 (ISSN-L)
  • 1538-6724
DOI
10.1093/ptj/pzad059
PMC
PMC10476875
OpenAlex
W4380730779
Cited by
3
References
37
Citations by year
2026: 1 · 2025: 1 · 2024: 1
FWCI
0.63
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • Physical Therapy (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health (NIH) Office of Research on Women’s Health (U10 HD54241, U01 HD069031, U10 HD54215, U10 HD54214, U10 HD54136, U10 HD41267, U10 HD41261, U10 HD41250)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (U01 HD41249)
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, behavior therapy, medication adherence, pelvic organ prolapse, vaginal reconstruction, sacrospinous ligament fixation, uterosacral ligament suspension, stress urinary incontinence, pelvic floor muscle strength, postoperative outcomes
MeSH terms
Behavior Therapy, Female, Humans, Uterine Prolapse, Treatment Outcome, Pelvic Floor, Plastic Surgery Procedures, Pelvic Organ Prolapse

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