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Pelvic floor muscle training improves pelvic organ prolapse

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) Pelvic floor muscle training (PFMT) during individual physical therapy sessions and home exercise can improve pelvic organ prolapse, researchers from Norway report in the April 30th American Journal of Obstetrics & Gynecology.

After 6 months, women in the PFMT group had significantly greater cranial elevation of the bladder and rectum, compared with women in the control group. They also had reduced prolapse symptoms and greater improvement in pelvic floor muscle strength and endurance.

A recent Cochrane review concluded there is insufficient evidence to understand the role PFMT might play in reducing pelvic organ prolapse; the Cochrane reviewers called for high-quality randomized controlled trials. In response, Dr. Ingeborg Hoff Braekken from Norwegian School of Sport Sciences, Oslo, and colleagues conducted the current study.

They assigned 59 women to PFMT and 50 women to a control group that received similar lifestyle advice without PFMT. Women in the PFMT group did 3 sets of 8-12 close-to-maximum pelvic floor muscle contractions daily. They received supervision from a physical therapist once weekly during the first 3 months and once biweekly during the second 3 months, and they received a booklet and a DVD showing the exercise program.

Women in the PFMT group completed 89% of the prescribed home exercises and 86% of the physical therapy training sessions, and they reported no adverse effects.

With assessors unaware of the study group assignments, the authors found that 11 women (19%) in the PFMT group and 4 (8%) in the control group improved by 1 stage of the Pelvic Organ Prolapse Quantification System (POP-Q) (p = 0.035).

In the PFMT group, the rate of improvement by 1 POP-Q stage was linked with severity of pelvic organ prolapse, from 0% for stage l to 16.7% for stage II and 35.7% for stage III.

The researchers don