INTRODUCTIONPelvic organ prolapse (POP) is a common condition for women globally and is one of the most widespread reproductive health problems in Nepal.1,2 POP occurs when the pelvic floor muscles (PFM) and supporting tissues are stretched, weakened or damaged allowing the bladder, uterus or bowel to descend into the vagina. 3Women who have weak or damaged PFMs have 4-11 times the risk of developing a POP when compared to women with good PFM function. 4 Strengthening the PFMs is the first line conservative treatment option for POP and can improve symptoms, quality of life (QOL) and severity.5 However, teaching women to correctly exercise their PFMs is challenging and up to 50% may still do it incorrectly even after verbal instruction. 6 The aim of this pilot study was to investigate whether brief verbal instruction in conjunction with an illustrated leaflet resulted in Nepali women being able to correctly contract their PFMs. METHODSIn February 2016, a pilot study of parous women aged 18 years and above was conducted. The women were attending two gynecology outpatient clinics run by the Public Health Concern Trust: Kathmandu Model Hospital and Kirtipur Hospital, Nepal.Women attending the hospital outpatient clinics were invited to participate in the study by their doctor. Initially, the doctor performed the Pelvic Organ Prolapse Quantification scale (POP-Q) to assess for POP. Following their clinical examination, a demographic questionnaire containing questions about their age, educational Background: Pelvic organ prolapse is a common disorder for women in Nepal causing symptoms and reduced quality of life. Pelvic floor muscle exercise is a conservative treatment option for pelvic organ prolapse but the effective way to teach women in Nepal is not known. The objective of this pilot study was to determine if an illustrative leaflet with brief verbal instruction could teach Nepali women to correctly contract their pelvic floor muscles. Methods:Fifteen parous women attending two outpatient gynecology clinics in Kathmandu Valley were interviewed to assess their knowledge of pelvic organ prolapse and pelvic floor muscles exercise. Following verbal instruction and an illustrative leaflet on how to contract their pelvic floor muscles, the transabdominal real time ultrasound was applied to assess the muscle contraction. Results:The median age of 15 participants was 45 years (range 18-75 years) and 10 women had pelvic organ prolapse. Some of the participants (9/15) knew about pelvic organ prolapse but none were aware of the pelvic floor muscles. After being taught how to contract their pelvic floor muscle, only 4 of 14 correctly contracted the pelvic floor muscle. Conclusions:This study highlighted the low knowledge of the pelvic floor muscle, and brief verbal instruction with an illustrative leaflet is also not sufficient in teaching Nepali women how to correctly contract their pelvic floor muscle. Further research is needed to determine how to teach a correct pelvic floor muscle contraction for women with low...
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