Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Search Strategy
2.3. Inclusion and Exclusion Criteria
2.4. Study Selection
2.5. Methodological Quality Assessment
3. Results
3.1. POP-Q
3.2. Pelvic-Floor Distress Inventory (PFDI-20) and Subscales
3.3. POP-SS
3.4. Sexual Function (PISQ-12 and Specific Questionnaire)
3.5. Pelvic-Floor Function by Manual Assessment, EMG, or Manometry
3.6. Quality of Life (P-QOL, ICIQ-VS, PFIQ-7, and Subscales)
3.7. Impression of Global Improvement in Patients and Change in Symptoms Reported by Patients
3.8. Surgery vs. Surgery + PFMT
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Database | Search Strategy |
---|---|
PubMed | ((“Pelvic Organ Prolapse” [Mesh] OR “POP”) AND (“pelvic floor muscle training” OR “pelvic floor muscle exercise” OR “kegel exercise”) AND (“surgery”)) |
SCOPUS | (TITLE-ABS ((“pelvic organ prolapse” OR “pop”)) AND TITLE-ABS ((“pelvic floor muscle training” OR “pelvic floor muscle exercise” OR “kegel exercise”))) AND TITLE-ABS (“surgery”)) |
Cochrane | (“Pelvic Organ Prolapse” OR “POP”) AND (“pelvic floor muscle training” OR “pelvic floor muscle exercise” OR “kegel exercise”) AND (“surgery”) in Record Title |
Cinahl | AB (pelvic organ prolapse or pop) AND AB (pelvic floor muscle training or pelvic floor muscle exercise or kegel exercise) AND AB surgery |
PEDro | Pelvic organ prolapse AND pelvic floor muscle training AND surgery |
Studies | Age | Population | N Patients | Applied Therapy | F-U | |||
---|---|---|---|---|---|---|---|---|
C | I | C | I | C | I | |||
Alves et al. [16] 2015 | 65.67 | 66.11 | Women POP I/II/III | 10 | 18 | Global exercise program without PFMT | Global exercise program (12 sessions) PFMT (home): 30 min × 2 times/wk, 6 wk | 6 wk |
Resende et al. [17] 2012 | 58.7 | 51.9 | Women POP II | 16 | 21 | Lifestyle advice | PFMT (home): 3x8-12 rep MVC + 3 FC day, 3 months Lifestyle advice | 3 months |
Braekken et al. [18] 2015 | 48.3 | 49.4 | Women POP I/II/III | 50 | 59 | Lifestyle advice | PFMT (supervised + home): 18 sessions + 3x8-12rep near MVC day, 6 months Lifestyle advice | 6 months |
Wiegersma et al. [19] 2014 | 64.0 | 64.5 | Women POP I/II | 142 | 145 | Watchful waiting | PFMT with physiotherapist PFMT (home): 2–3 times/day, individual protocol, 3–5 times/wk, 3 months Lifestyle advice | 3 months |
Hagen et al. [20] 2014 | 57.50 | 56.20 | Women POP I/II/III | 222 | 224 | Lifestyle advice | PFMT with physiotherapist 5 sessions PFMT (home): 3x10-50 FC a day, 16 wk Lifestyle advice | 6 and 12 months |
Due et al. [21] 2015 | 58 | 60 | Women POP II/III | 53 | 56 | 6 group sessions (Lifestyle advice) | 6 group sessions + 6 PFMT with physiotherapist PFMT (home): 3x10 MVC maintained 10 sec, 5 days/wk, 12 wk Lifestyle advice | 3 and 6 months |
Hagen et al. [14] 2017 | 46.6 | 46.4 | Women POP I/II/III | 206 | 206 | Lifestyle advice | 5 sessions PFMT with physiotherapist PFMT (home): 3x10-50 FC a day, 16 wk Lifestyle advice | 2 years |
Stüpp et al. [22] 2011 | 58.12 | 52.95 | Women POP II | 16 | 21 | Lifestyle advice | 7 sessions PFMT with physiotherapist PFMT (home): 3x8-12 maintained contractions 6–10 sec, 12 wk Lifestyle advice | 14 wk |
Due et al. [23] 2016 | - | - | Women POP II/III | 43 | 40 | 6 group sessions (Lifestyle advice) | 6 group sessions + 6 PFMT with physiotherapist PFMT (home): 3x10 MVC maintained 10 sec, 5 days/wk, 12 wk Lifestyle advice | 12 months |
Panman et al. [24] 2016 | 64.0 | 64.5 | Women POP I/II | 142 | 145 | Watchful waiting | PFMT with physiotherapist PFMT (home): 2–3 times/day, individual protocol, 3–5 times/wk, 2 years | 12 months 2 years |
Barber et al. [25] 2014 | 56.9 | 57.5 | Women POP II/III/IV | 188 | 186 | Surgery + routine perioperative care | Surgery + PFMT (supervised + home) PRE: 1 session, POST: 4 sessions HOME: individualized protocol 3x45-60 rep 1–10 sec contraction, at 3 months 15 contractions daily max duration, 24 months | 6 months and 2 years |
Liang et al. [26] 2019 | 63.3 | 61.6 | - | 43 | 47 | Surgery + Lifestyle advice | Surgery + PFMT (supervised + home): PRE: 1 session, POST: 3 sessions HOME: 2–3x15–30 min 10 sec contraction-10 sec rest + FC daily, 60 days | 42 and 60 days |
Nyhus et al. [27] 2020 | 60.6 | 60.1 | Women POP ≥ II | 76 | 75 | Surgery | Surgery + PFMT PRE (home): 3x8-12 maintained contractions 6–8 sec daily Group option 1 day/wk 22 wk | 6 months |
Jelovsek et al. [28] 2018 | 57.4 | 57 | Women POP II/III/IV | 144 | 141 | Surgery + routine pre-operative care | Surgery + PFMT (supervised + home) PRE: 1 session, POST: 4 sessions HOME: individualized protocol 3x45-60 rep 1–10 sec contraction, at 3 months 15 contractions daily max duration, 24 months | 5 years |
Weidner et al. [29] 2017 | 56.9 | 57.5 | Women POP II/III/IV | 188 | 186 | Surgery + routine pre-operative care | Surgery + PFMT (supervised + home) PRE: 1 session, POST: 4 sessions HOME: individualized protocol 3x45-60 rep 1–10 sec contraction, at 3 months 15 contractions daily max duration, 24 months | 6 and 12 months 2 years |
Duarte et al. [30] 2020 | - | - | Women POP II/III/IV | 46 | 48 | Surgery | Surgery + PFMT (supervised + home): PRE: 2 times/wk, 2 wk, POST: 7 sessions HOME: 3 days/wk, 4x10 MVC 7 sec contraction 7 sec rest + 5 FC | 40 and 90 days |
Mathew et al. [31] 2021 | 60.6 | 60.1 | Women POP ≥ II | 76 | 75 | Surgery | Surgery + PFMT (home): 3x8-12 maintained contractions 6–8 sec daily. Group option 1 day/wk 22 wk | 6 months |
McClurg et al. [32] 2013 | 60 | 60 | Women POP I/II/III | 29 | 28 | Surgery + routine pre-operative care | Surgery + PFMT: PRE (home): 3x10 MVC held up to 10 sec and 4 sec rest POST (supervised + home): 5 sessions/wk, 12 wk, individualized protocol with BFB, EE and exercise balls if necessary | 6 and 12 months |
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Espiño-Albela, A.; Castaño-García, C.; Díaz-Mohedo, E.; Ibáñez-Vera, A.J. Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review. J. Pers. Med. 2022, 12, 806. https://doi.org/10.3390/jpm12050806
Espiño-Albela A, Castaño-García C, Díaz-Mohedo E, Ibáñez-Vera AJ. Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review. Journal of Personalized Medicine. 2022; 12(5):806. https://doi.org/10.3390/jpm12050806
Chicago/Turabian StyleEspiño-Albela, Andrea, Carla Castaño-García, Esther Díaz-Mohedo, and Alfonso Javier Ibáñez-Vera. 2022. "Effects of Pelvic-Floor Muscle Training in Patients with Pelvic Organ Prolapse Approached with Surgery vs. Conservative Treatment: A Systematic Review" Journal of Personalized Medicine 12, no. 5: 806. https://doi.org/10.3390/jpm12050806