Perioperative pelvic floor muscle training did not improve outcomes in women undergoing pelvic organ prolapse surgery: a randomised trial

Duarte, Thaiana Bezerra; Bø, Kari; Brito, Luiz Gustavo Oliveira; Bueno, Sabrina M; Barcelos, Thays Mr; Bonacin, Marília A. P.; Ferreira, Carmen V.

doi:10.1016/j.jphys.2019.11.013

Cited by 11 publications

(15 citation statements)

References 31 publications

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“…This review included both genders and varying treatment durations from 1 to 12 months, thus making it difficult to generalize [ 11 ]. Our results are consistent with previous studies on women with severe POP where peri- and postoperative PFMT did not alter symptoms of urinary and colorectal-anal distress [ 14 , 15 ]. A recent study by Duarte et al included a preoperative intervention period of 2 weeks and reported an overall improvement in symptoms and quality of life (using PFDI-20, PFIQ-7 and subscales) for all women scheduled for POP surgery, without clear advantage from PFMT in the intervention group, which agrees with our findings [ 14 ].…”

Section: Discussionsupporting

confidence: 93%

“…A recent study by Duarte et al included a preoperative intervention period of 2 weeks and reported an overall improvement in symptoms and quality of life (using PFDI-20, PFIQ-7 and subscales) for all women scheduled for POP surgery, without clear advantage from PFMT in the intervention group, which agrees with our findings [14]. The study excluded women with previous POP surgery and covered a shorter postoperative follow-up of 90 days [14]. In contrast, 10% of the women in the current study had prior POP surgery, and they were followed 6 months to observe any durable effects.…”

Section: Discussionsupporting

confidence: 92%

“…However, most studies have either examined women in the immediate postpartum period or women with isolated stress urinary incontinence [10,12]. Other studies of women undergoing POP surgery have mainly focused on the effect of peri-or postoperative PFMT on urinary and colorectal-anal symptoms, and one study found marginal effects of PFMT on quality of life [14][15][16][17]. Previous studies with < 100 participants have included women scheduled for surgery because of different conditions (POP, urinary incontinence and hysterectomy for other reasons), and it is unclear whether the positive effect of peri-and postoperative PFMT was found in women with POP [15,16,18].…”

Section: Introductionmentioning

confidence: 99%

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The effect of preoperative pelvic floor muscle training on urinary and colorectal-anal distress in women undergoing pelvic organ prolapse surgery—a randomized controlled trial

et al. 2021

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Introduction and hypothesis Pelvic floor muscle training (PFMT) improves urinary incontinence and mild pelvic organ prolapse (POP). We aimed to investigate the effect of preoperative PFMT on urinary and colorectal-anal distress and related quality of life (QoL) in women with severe POP scheduled for surgery. Methods Randomized controlled trial of 159 women scheduled for POP surgery (intervention = 81, controls = 78). Intervention consisted of daily PFMT from inclusion to the day of surgery. Symptoms and QoL were assessed at inclusion, day of surgery and 6 months postoperatively using the Urinary Distress Inventory (UDI-6), Colorectal-Anal Distress Inventory (CRADI-8), Urinary Impact Questionnaire (UIQ) and Colorectal-Anal Impact Questionnaire (CRAIQ) (range 0–100). Mixed model statistical analyses were used. Results One hundred fifty-one (95%) women completed the study (intervention = 75, controls = 76). Mean waiting times until surgery and follow-up were 22 and 28 weeks. There was no difference in mean postoperative symptom and QoL scores (95% CI) between the intervention and control group: UDI-6 16 (12–21) vs. 17 (13–22), CRADI-8 15 (11–18) vs. 13 (10–16), UIQ 11 (7–15) vs. 10 (6–13) and CRAIQ 5 (2–7) vs. 6 (4–9), all p > 0.05. Overall mean scores were reduced from baseline to postoperative follow-up: UDI-6 37 (33–41) vs. 17 (14–20), CRADI-8 22 (19–25) vs. 14 (11–16); UIQ 28 (24–32) vs. 10 (7–13) and CRAIQ 16 (12–19) vs. 5 (3–7), all p < 0.01. Conclusions We found no added effect of preoperative PFMT on symptoms or QoL related to urinary and colorectal-anal distress in women scheduled for POP surgery. They achieved symptomatic improvement postoperatively regardless of PFMT. Clinical trial registration The study was registered in clinicaltrials.gov: NCT 03,064,750.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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The effect of preoperative pelvic floor muscle training on urinary and colorectal-anal distress in women undergoing pelvic organ prolapse surgery—a randomized controlled trial

et al. 2021

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“…Of the 3918 studies identified by the initial literature searches, 3891 were excluded and 26 RCTs published in English were included. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 The reasons for exclusion and the corresponding references are reported in the online supplementary file (Supplementary File 2 ). A complete overview of the study selection process is provided in the PRISMA flow diagram (Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review

Giagio

Innocenti

Salvioli

et al. 2021

Neurourology and Urodynamics

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This systematic review aimed to assess the completeness of exercise reporting in randomized controlled trials (RCTs) on pelvic floor muscle training (PFMT) for women with pelvic organ prolapse (POP). Methods: MEDLINE, Cochrane Central, CINHAL, Embase, SCOPUS, and PEDro databases were searched up to October 2020. Full-text RCTs comparing PFMT to any type of intervention among women with any type and stage of POP were eligible for inclusion. Completeness of intervention was evaluated with t20he template for intervention description and replication (TIDieR) and the consensus on exercise reporting template (CERT). Inter-rater agreement for each item of the tools was calculated. Results: Twenty-six RCTs were included. None of the studies completely reported all intervention descriptors. On average 57.1% (6.8 ± 2.4; out of 12) of the overall TIDieR items and 35.3% (6.7 ± 2.9; out of 19) of the CERT were well described. In particular, 7 and 5 items were completely reported more than 50% of the time for the TIDieR and CERT, respectively. Frequent shortcomings were the undetailed reporting of information regarding tailoring and modifications of exercises and their adherence. Detailed descriptions of exercise repetitions to enable replication were missing in 53.8%. According to the CERT, only 11.5% of the RCTs sufficiently described the main providers' characteristics. Conclusion:The completeness of PFMT reporting for women with POP is still below desirable standards and it is insufficient to ensure transferability into practice. The present results may add relevant knowledge and contribute to improving adequate reporting of exercise.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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“…Facilities for virtual communication can vary and include telephone/ video conferencing. If prolapse is mild, patient should be advised to perform pelvic floor muscle training since there is no strong evidence that it can reduce POP, it may increase pelvic consciousness (10). On the other hand, if there is a large bulge affecting bladder and bowel emptying and/or in presence of ulceration, a face-to-face appointment will be required.…”

Section: Pelvic Organ Prolapse (Pop)mentioning

confidence: 99%

Impact of COVID-19 in Female Urology

2020

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This review discusses the impact of COVID-19 in Female Urology, revises the most important disorders in this field and how their diagnosis and treatment may be modified due to the current pandemic. The text also discusses new options such as telemedicine and what clinical situations within Female Urology should be of utmost importance for the urologist to be careful about. We also discuss how surgeries are being postponed are resumed according to the local scenario.

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Perioperative pelvic floor muscle training did not improve outcomes in women undergoing pelvic organ prolapse surgery: a randomised trial

Cited by 11 publications

References 31 publications

The effect of preoperative pelvic floor muscle training on urinary and colorectal-anal distress in women undergoing pelvic organ prolapse surgery—a randomized controlled trial

The effect of preoperative pelvic floor muscle training on urinary and colorectal-anal distress in women undergoing pelvic organ prolapse surgery—a randomized controlled trial

Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review

Impact of COVID-19 in Female Urology

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