Abstract
Pelvic organ prolapse (POP), the descent of the pelvic organs due to deficiencies in the pelvic support system, is a very common problem. Up to 40% of women aged 45–85 years have at least stage II POP according to POP-Q staging [1], even though only 10–20% of them seek medical care [2]. Pelvic floor muscle training has been proposed for its prevention and treatment.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Slieker-ten Hove MC, Pool-Goudzwaard AL, Eijkemans MJ, et al. The prevalence of pelvic organ prolapse symptoms and signs and their relation with bladder and bowel disorders in a general female population. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(9):1037–45.
Rodriguez-Mias N, Martinez-Franco E, Aguado J, et al. Pelvic organ prolapse and stress urinary incontinence, do they share the same risk factors? Eur J Obstet Gynecol Reprod Biol. 2015;190:52–7.
Nygaard I, Barber MD, Burgio KL, et al. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6.
Zhang FW, Wei F, Wang HL, et al. Does pelvic floor muscle training augment the effect of surgery in women with pelvic organ prolapsed? A systematic review of randomized controlled trials. Neurourol Urodyn. 2016;35(6):666–74.
Lakeman MM, Koops SE, Berghmans BC, et al. Peri-operative physiotherapy to prevent recurrent symptoms and treatment following prolapsed surgery: supported by evidence or not? Int Urogynecol J. 2013;24(3):371–5.
De Lancey JO, Morgan D, Fenner DE, et al. Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapsed. Obstet Gynecol. 2007;109:295–302.
Diez-Itza I, Arrue M, Ibanez L, et al. Postpartum impairment of pelvic floor muscle function: factors involved and association with prolapsed. Int Urogynecol J. 2011;22:1505–11.
Dumoulin C, Hunter KF, Moore K, et al. Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence. Neurourol Urodyn. 2016;35(1):15–20.
Bo K. Can pelvic floor muscle training prevent and treat pelvic organ prolapsed? Acta Obstet Gynecol Scand. 2006;85(3):263–8.
Miller JM, Perucchini D, Carchidi LT, et al. Pelvic floor muscle contraction during a cough and decreased vesical neck mobility. Obstet Gynecol. 2001;97(2):255–60.
Moore K, Domoulin C, Bradley C, et al. Adult conservative management. In: Abrams P, Cardozo L, Khouri AE, Wein A, editors. International consultation on urinary incontinence. 5th ed. Plymbridge: Health Publications Ltd; 2013. p. 1101–95.
Hay-Smith J, Herderschee R, Dumoulin C, et al. Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women: an abridged Cochrane systematic review. Eur J Phys Rehabil Med. 2012;48(4):689–705.
Balmforth JR, Mantle J, Bidmead J, et al. A prospective observational trial of pelvic floor muscle training for female stress urinary incontinence. BJU Int. 2006;98(4):811–7.
Braekken IH, Majida M, Engh ME, et al. Can pelvic floor muscle training reverse pelvic organ prolapse and reduce prolapsed symptoms? An assessor-blinded, randomized, controlled trial. Am J Obstet Gynecol. 2010;203:170e1–7.
Frawley HC, Phyllips BA, Bo K, et al. Physiotherapy as an adjunct to prolapsed surgery: an assessor-blinded randomized controlled trial. Neurourol Urodyn. 2010;29:719–25.
Calais-Germain B. Le périnée feminine et l’accouchement. Désiris ed. Paris; 2000.
Lind LR, Lucente V, Kohn N. Thoracic kyphosis and the prevalence of advanced uterine prolapse. Obstet Gynecol. 1996;87(4):605–9.
Nguyen J, Lind R, Choe J, McKindesy F, et al. Lumbosacral spine and pelvic inlet changes associated with pelvic organ prolapsed. Obstet Gynecol. 2000;95:332–6.
Sapsford R. Rehabilitation of pelvic floor muscles utilizing trunk stabilization. Man Ther. 2004;9(1):3–12.
De Gasquet B. Abdominaux: arretez le massacre. Marabout ed. Paris, 2005.
Bump RC, Mattiasson A, Bo K, et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175(1):10–7.
Di Gesu GA, Khullar V, Cardozo L, et al. P-QOL: a validated questionnaire to assess the symptoms and quality of life of women with urogenital prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2005;16(3):176–81.
Biroli A. Prolasso genitale e riabilitazione: quale rapporto? Ital J Rehab Med MR. 2006;20:269–75.
Bø K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapse and sexual dysfunction. World J Urol. 2012;30:437–43.
Aponte MM, Rosenblum N. Repair of pelvic organ prolapse: what is the goal? Curr Urol Rep. 2014;15:385.
Samuelsson EC, Victor FT, Tibblin G, et al. Signs of genital prolapse in a Swedish population of women 20 to 59 years of age and possible related factors. Am J ObstetGynecol. 1999;180:299–305.
Ashton-Miller JA, DeLancey JO. Functional anatomy of the female pelvic floor. In: Bo K, Berghmans B, Morkved S, Kampen MV, editors. Evidence-based physical therapy for the pelvic floor. St Louis: Elsevier; 2007. p. 19–33.
Slieker-ten Hove M, Pool-Goudzwaard A, Eijkemans M, et al. Pelvic floor muscle function in a general population of women with and without pelvic organ prolapse. Int Urogynecol J. 2010;21:311–9.
DeLancey JO. The hidden epidemic of pelvic floor dysfunction: achievable goals for improved prevention and treatment. Am J Obstet Gynecol. 2005;192:1488–95.
Chen L, Ashton-Miller JA, Hsu Y, et al. Interaction among apical support, levator ani impairment, and anterior vaginal wall prolapse. Obstet Gynecol. 2006;108:324–32.
Alas AN, Anger JT. Management of apical pelvic organ prolapse. Curr Urol Rep. 2015;16:33.
Culligan PJ. Nonsurgical management of pelvic organ prolapse. Obstet Gynecol. 2012;119:852–60.
Piya-Anant M, Therasakvichya S, Leelaphatanadit C, et al. Integrated health research program for the Thai elderly: prevalence of genital prolapse and effectiveness of pelvic floor exercise to prevent worsening of genital prolapse in elderly women. J Med Assoc Thai. 2004;85:509–15.
Ghroubi S, Kharrat O, Chaari M, et al. Effect of conservative treatment in the management of low-degree urogenital prolapse. Ann Readapt Med Phys. 2008;51:96–102.
Hagen S, Stark D, Glazener C, et al. A randomized controlled trial of pelvic floor muscle training for stages I and II pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(1):45–51.
Stüpp L, Resende AP, Oliveira E, et al. Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial. Int Urogynecol J. 2011;22:1233–9.
Alves FK, Riccetto C, Adami DB, et al. A pelvic floor muscle training program in postmenopausal women: a randomized controlled trial. Maturitas. 2015;81:300–5.
Brækken IH, Majida M, Ellström Engh M, et al. Can pelvic floor muscle training improve sexual function in women with pelvic organ prolapse? A randomized controlled trial. J Sex Med. 2015;12:470–80.
Wiegersma M, Panman CM, Kollen BJ, et al. Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse: randomised controlled trial in primary care. BMJ. 2014;349:g7378.
Kashyap R, Jain V, Singh A. Comparative effect of 2 packages of pelvic floor muscle training on the clinical course of stage I-III pelvic organ prolapsed. Int J Gynecol Obstet. 2013;121:69–73.
Miedel A, Tegerstedt G, Maehle-Schmidt M, et al. Non obstetric risk factors for symptomatic pelvic organ prolapse. Obstet Gynecol. 2009;113:1089–97.
Saks EK, Harvie HS, Asfaw TS, et al. Clinical significance of obstructive defecatory symptoms in women with pelvic organ prolapse. Int J Gynaecol Obstet. 2010;111(3):237–40.
Braekken IH, Majida M, Ellstrom Engh M, et al. Pelvic floor function is independently associated with pelvic organ prolapse. BJOG. 2009;116:1706–14.
Whitcomb EL, Lukacz ES, Lawrence JM, et al. Prevalence and degree of bother from pelvic floor disorders in obese women. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(3):289–94.
Washington BB, Erekson EA, Kassis NC, et al. The association between obesity and stage II or greater prolapse. Am J Obstet Gynecol. 2010;202:503.
Braekken I, Majida M, Engh ME, et al. Morphological changes after pelvic floor muscle training measured by 3-dimensional ultrasonography. Obstet Gynecol. 2010;115:317–24.
Panman C, Wiegersma M, Kollen BJ, et al. Two-year effects and cost-effectiveness of pelvic floor muscle training in mild pelvic organ prolapse: a randomised controlled trial in primary are. BJOG. 2016. https://doi.org/10.1111/1471-0528.13992.
Hagen S, Stark D, Glazener C, et al. Individualised pelvic floor muscle training in women with pelvic organ prolapse (POPPY): a multicentre randomised controlled trial. Lancet. 2014;383:796–806.
Li C, Gong Y, Wang B. The efficacy of pelvic floor muscle training for pelvic organ prolapse: a systematic review and meta-analysis. Int Urogynecol J. 2016;27(7):981–92.
Bø K, Hilde G, Stær-Jensen J, et al. Postpartum pelvic floor muscle training and pelvic organ prolapse—a randomized trial of primiparous women. Am J Obstet Gynecol. 2015;212(1):38.e1–7.
Glazener CMA, McArthur C, Hagen S, et al. Twelve-year follow-up of conservative management of postnatal urinary and fecal incontinence and prolapsed outcomes: randomised controlled trial. BJOG. 2014;121:112–20.
Hullfish KL, Bovbjerg VE, Gurka MJ, et al. Surgical versus nonsurgical treatment of women with pelvic floor dysfunction: patient centered goals at 1 year. J Urol. 2008;179(6):2280–5.
Barber MD, Brubaker L, Burgio KL, et al. Comparison of 2 transvaginal surgical approaches and perioperative behavioral therapy for apical vaginal prolapse: the OPTIMAL randomized trial. JAMA. 2014;311:1023–34.
Pauls R, Crisp CC, Novicki K, et al. Pelvic floor physical therapy: impact on quality of life 6 months after vaginal reconstructive surgery. Female Pelvic Med Reconstr Surg. 2013;1:34–9.
McClurg D, Hilton P, Dolan L, et al. Pelvic floor muscle training as an adjunct to prolapse surgery: a randomised feasibility study. Int Urogynecol J. 2014;25:883–91.
Hagen S, Stark D. Conservative prevention and management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2011;12:CD003882.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Biroli, A., Lamberti, G.F. (2018). Pelvic Floor Muscle Training and Prolapse: Prevention or Treatment?. In: Li Marzi, V., Serati, M. (eds) Management of Pelvic Organ Prolapse. Urodynamics, Neurourology and Pelvic Floor Dysfunctions. Springer, Cham. https://doi.org/10.1007/978-3-319-59195-7_6
Download citation
DOI: https://doi.org/10.1007/978-3-319-59195-7_6
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59194-0
Online ISBN: 978-3-319-59195-7
eBook Packages: MedicineMedicine (R0)