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Cited by 71Pelvic floor disorders treatmentsPregnancy-related medical researchSexual function and dysfunction studies

Pelvic Floor Muscle Training Versus Watchful Waiting and Pelvic Floor Disorders in Postpartum Women: A Systematic Review and Meta-analysis

Wu, You (Maria), McInnes, Natalia, Leong, Yvonne·2018·Female Pelvic Medicine & Reconstructive Surgery
DOI 10.1097/spv.0000000000000513
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Abstract

Objectives: Pelvic floor muscle training (PFMT) is often recommended to treat postpartum urinary incontinence (UI). However, the role of postpartum PFMT in pelvic organ prolapse (POP), sexual function, and anal incontinence (AI) remains unclear. We therefore aim to assess the efficacy of postpartum PFMT on these pelvic floor disorders. Methods: This study is a meta-analysis consisting of randomized controlled trials (RCTs). We searched databases including CENTRAL, MEDLINE, EMBASE, CINAHL, and PEDro. We also sought after grey literature including conference proceedings. We included RCTs comparing PFMT versus watchful waiting in women with stage II or less POP within 1 year postpartum. Two authors independently performed study screening, risk of bias assessments, and data extraction. Results: Fifteen RCTs (3845 patients) were included. Women undergoing PFMT less likely report bothersome POP symptoms (risk ratio [RR], 0.48 [0.30–0.76]; very low-quality evidence). There is no significant difference in the number of women with stage II or greater POP (RR, 0.74 [0.45–1.24]; moderate-quality evidence). Fewer women receiving PFMT report the presence of sexual dysfunction (RR, 0.48 [0.30–0.77]; low-quality evidence). There is no significant difference in AI symptoms (RR, 1.11 [0.82–1.51]), but PFMT may be more beneficial for women with anal sphincter injuries (standardized mean differencein AI scores, −0.57 [−1.12 to −0.02]; low-quality evidence). Women receiving PFMT less likely report UI (RR, 0.44 [0.25–0.75]; moderate-quality evidence) with a more pronounced effect on stress UI (SUI). Conclusions: At present, it remains uncertain whether postpartum PFMT improves POP symptoms because of very low-quality evidence, and more high-quality RCTs are needed in this area. The POP staging will likely not change with postpartum PFMT. The PFMT may result in improved postpartum sexual function compared to watchful waiting, and may provide benefit for AI in women with anal sphincter injuries. Postpartum PFMT likely reduces the risk of UI, particularly stress urinary incontinence symptoms. There is currently little evidence about postpartum PFMT and long-term pelvic floor function.

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Authors
Wu, Y. (., McInnes, N., & Leong, Y.
Affiliations
Western University (CA)
Corresponding author
  • Wu, You (Maria)
  • Leong, Yvonne
ORCID
McInnes, Natalia
Venue
Female Pelvic Medicine & Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2018-03
Volume
24
Issue
2
Pages
142-149
ISSN
2151-8378 (ISSN-L)
DOI
10.1097/spv.0000000000000513
OpenAlex
W2792756350
Cited by
71
References
35
Citations by year
2026: 6 · 2025: 7 · 2024: 11 · 2023: 14 · 2022: 9 · 2021: 10 · 2020: 8 · 2019: 4 · 2018: 2
FWCI
1.00
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 › 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, postpartum women, pelvic organ prolapse, expectant management, urinary incontinence, stress urinary incontinence, anal incontinence, sexual dysfunction, anal sphincter injury, pelvic floor dysfunction, postpartum recovery, exercise therapy, sexual function, postpartum urinary incontinence
MeSH terms
Exercise Therapy, Fecal Incontinence, Female, Humans, Muscle Contraction, Postnatal Care, Sexual Dysfunction, Physiological, Urinary Incontinence, Randomized Controlled Trials as Topic, Treatment Outcome, Patient Satisfaction, Pelvic Floor, Watchful Waiting, Pelvic Floor Disorders

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