Pelvic Floor Physical Therapy: Impact on Quality of Life 6 Months After Vaginal Reconstructive Surgery
Abstract
OBJECTIVES: Pelvic floor physical therapy (PFPT) is often used as a treatment of pelvic floor disorders and may improve function after pelvic reconstructive surgery. However, the long-term impact of this modality is not understood. METHODS: This randomized controlled trial compared PFPT to the standard care in women undergoing vaginal reconstruction. The intervention group received PFPT biweekly until 12 weeks postoperatively, in conjunction with a physician assessment. Control subjects underwent a physician assessment alone at all postoperative intervals. The final follow-up was at 24 weeks. Physical examinations (pelvic organ prolapse quantification assessment), intravaginal electromyography, voiding diaries, and validated questionnaires were completed by all subjects. The primary outcome was change in the World Health Organization Quality of Life-BREF. RESULTS: Forty-nine women completed the study, 24 in the PFPT group and 25 in the control group. Although electromyography measures showed better muscular function in PFPT subjects after 12 weeks, at 6 months after surgery, this was no longer noted. However, quality of life parameters improved for the entire sample at 24 weeks, with no difference between groups. Positive change from 12 to 24 weeks was also documented in scores on the Pelvic Floor Distress Inventory-20 (P = 0.04) and Pelvic Floor Impact Questionnaire-7 (P = 0.018), corresponding with continued improvement in bladder symptoms. Finally, Prolapse and Incontinence Sexual Questionnaire-12 and Female Sexual Function Index scores improved between 12 and 24 weeks, suggesting better sexual function overall with time elapsed from surgery. CONCLUSIONS: Quality of life improves in all subjects after vaginal reconstructive surgery, with ongoing benefit between 3 and 6 months. Nevertheless, standardized PFPT was not associated with differences at 24 weeks in this cohort of women.
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The short-term improvement of PISQ-12 and FSFI scores described by Pauls et al. (2013) was lost after 24 weeks.
“The short-term improvement of Pelvic Organ Prolapse Incontinence Sexual Questionnaire-12 (PISQ-12) and Female sexual function index (FSFI) scores described by Pauls et al. (2013) [75] was lost after 24 weeks [71].”
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 [71]
Only two RCTs showed some positive effects of PFMT on sexual function of women with POP.
“We found that only two RCTs which showed some positive effects of PFMT on sexual function of women with POP [71, 74].”
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 [71]
Eleven full publications or meeting abstracts published from 2005 until 2021 were included in the review of PFMT in connection with POP surgery.
“Eleven full publications or meeting abstracts which were published from 2005 until 2021 [62–72] were included.”
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 [71]
If there was no short-term effect of a PFMT program, long-term effects are unlikely.
“Furthermore, if there was no short-term effect of a PFMT program [49, 50, 62, 67, 71, 75], then long-term effects are unlikely.”
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 [71]
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- Authors
- Pauls, R. N., Crisp, C. C., Novicki, K., Fellner, A. N., & Kleeman, S. D.
- Affiliations
- Good Samaritan Hospital (US)
- Corresponding author
- Pauls, Rachel N.
- Crisp, Catrina C.
- Kleeman, Steven D.
- Venue
- Female Pelvic Medicine & Reconstructive Surgery
- Published
- 2014-11
- Volume
- 20
- Issue
- 6
- Pages
- 334-341
- ISSN
- 2151-8378 (ISSN-L)
- OpenAlex
- W2074213683
- Cited by
- 19
- References
- 34
- Citations by year
- 2024: 3 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 2 · 2017: 1 · 2015: 1
- FWCI
- 0.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Urogynecology (publishedVersion)
- PubMed (publishedVersion)
- 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 physiotherapy, vaginal reconstruction, pelvic organ prolapse, pelvic floor dysfunction, postoperative rehabilitation, quality of life, pelvic floor muscle function, urinary incontinence, sexual function
- MeSH terms
- Arousal, Electromyography, Female, Humans, Middle Aged, Orgasm, Postoperative Care, Preoperative Care, Quality of Life, Sexual Behavior, Sexual Dysfunction, Physiological, Vagina, Treatment Outcome, Patient Satisfaction, Pelvic Floor, Physical Therapy Modalities, Pelvic Organ Prolapse
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