Is Pelvic Muscle Strengthening Effective Following Pelvic Surgery for Prolapse and Incontinence?
BACKGROUND AND PURPOSE:
Perioperative behavioral therapy with pelvic floor muscle training (BPMT) has been used in patients recovering from transvaginal reconstructive surgery for prolapse
Weidner et al. (Physical Therapy 2017) evaluated the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI)
Secondary report of the OPTIMAL study
OPTIMAL trial was a multicenter RCT of women with stage 2-4 POP and SUI using double (2×2) randomization
Sacrospinous ligament fixation (SSLF) and uterosacral ligament suspension (ULS) were compared
Perioperative BPMT versus usual care were compared
Data collection: Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores
Data was collected from 137 BPMT participants and 146 of usual care participants at 24 months
There were no statistically significant differences between groups in PFIQ, SF- 36, PGII, PISQ-12, or body image scale measures
Authors recognize the following limitations
Findings may not apply to vaginal prolapse procedures not addressed in this study
There were differing levels in BPMT expertise
The use of perioperative BPMT following vaginal surgery for POP and SUI provided no additional improvement in HRQOL or sexual function
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This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
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presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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