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Cited by 17Pelvic floor disorders treatmentsSexual function and dysfunction studiesUrinary Bladder and Prostate Research

Predictors of Success for Pelvic Floor Muscle Training in Pelvic Organ Prolapse

Open access
Wiegersma, Marian, Panman, Chantal M C R, Hesselink, Liesbeth C, Malmberg, Alec G A, Berger, Marjolein Y, Kollen, Boudewijn J, Dekker, Janny H·2019·Physical Therapy
DOI 10.1093/ptj/pzy114
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Abstract

Background: Although the effectiveness of pelvic floor muscle training in women with prolapse has been demonstrated in several studies, there seem to be subgroups of responders and nonresponders. Objective: The objective of this study was to identify factors that predict treatment success in women receiving pelvic floor muscle training for prolapse. Design: The design was a secondary analysis of data from 2 randomized controlled trials comparing conservative prolapse treatments. Methods: After 12 months, 172 women subjectively assessed treatment success ("better") or failure ("the same" or "worse"). Potential predictors were identified by a literature search and by consultation with experts in the field of urogynecology and pelvic floor muscle training. The relationship between potential predictors and treatment success was explored using logistic regression analysis. Results: Treatment was successful in 94 women (55%) and unsuccessful in 78 women (45%). The presence of ≥1 indicators of obstetric trauma (eg, high birth weight, episiotomy, perineal laceration during vaginal delivery, forceps delivery, or vacuum extraction) (odds ratio = 4.4; 95% CI = 1.6–12.0) and younger age (odds ratio = 0.94 per year; 95% CI = 0.9–1.0) independently predicted treatment success. The area under the receiver operating characteristic curve for the final model was 0.65 (95% CI = 0.57–0.74), and the model explained 11.7% of the variance. Limitations: Although attempts were made to include all relevant predictors, the selection or operationalization of variables could have been incomplete or insufficient. Conclusions: Identifying women who have prolapse and are likely to benefit most from pelvic floor muscle training is of great importance to clinical practice. In this study, 2 factors that independently predicted favorable outcomes were identified with this management approach. However, further research is needed to identify other predictive factors and to validate a new model in another population.

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Authors
Wiegersma, M., Panman, C. M. C. R., Hesselink, L. C., Malmberg, A. G. A., Berger, M. Y., Kollen, B. J., & Dekker, J. H.
Affiliations
  • University Medical Center Groningen (NL)
  • University of Groningen (NL)
Corresponding author
Dekker, Janny H
ORCID
Venue
Physical Therapy
Publisher
Oxford University Press (OUP)
Published
2018-10-17
Volume
99
Issue
1
Pages
109-117
ISSN
  • 0031-9023 (ISSN-L)
  • 1538-6724
DOI
10.1093/ptj/pzy114
OpenAlex
W2896493478
Cited by
17
References
34
Citations by year
2026: 2 · 2025: 4 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 1 · 2019: 2
FWCI
1.06
Type
journal article
Language
en
Open access
Licence
Locations
  • Physical Therapy (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
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, pelvic organ prolapse, predictors of treatment success, obstetric trauma, episiotomy, perineal tears, forceps delivery, vacuum extraction, high birth weight, age, women's health
MeSH terms
Aged, Aged, 80 and over, Exercise Therapy, Female, Humans, Middle Aged, Regression Analysis, Odds Ratio, Treatment Outcome, Pelvic Floor, Area Under Curve, Pelvic Organ Prolapse

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