OBJECTIVES: Although pelvic floor physical therapy (PFPT) can be beneficial for complaints after vaginal reconstructive surgery, it is not routinely offered to all patients.
We sought to evaluate the role of perioperative PFPT in improving quality of life and function after prolapse repairs.
METHODS: This randomized controlled trial compared PFPT to standard care after vaginal reconstructive surgery. The intervention group received PFPT 2 weeks preoperatively and 2, 4, 6, 8, and 12 weeks postoperatively, as well as a physician assessment. Control subjects underwent a physician's assessment alone at the same time points postoperatively. Both groups completed pelvic organ prolapse quantification examinations, intravaginal electromyography (EMG), voiding diaries, and validated questionnaires at baseline and 12 weeks. The primary outcome was change in the World Health Organization Quality of Life-BREF scale after surgery.
RESULTS: Forty-nine women completed the study: 24 women in the PFPT group and 25 women in the control group. At 12 weeks, condition-specific questionnaires improved for the entire sample, confirming effectiveness of surgery. Nevertheless, no significant differences were noted between the groups despite therapy with PFPT. However, intravaginal EMG measures were notably affected by the intervention. The PFPT group showed significantly lower averages across all measurements of rest, indicating positive impact on muscle function. Pearson correlations revealed associations with better scores on the World Health Organization Quality of Life-BREF physical domain and greater EMG relaxation, supporting effects from PFPT on quality of life.
CONCLUSIONS: Pelvic symptoms improved in all subjects after vaginal reconstructive surgery. Whereas PFPT did not result in detectable subjective differences in this short-term study, superior muscular function suggested benefit from the intervention.
Written by:
Pauls RN, Crisp CC, Novicki K, Fellner AN, Kleeman SD. Are you the author?
Division of Urogynecology and Reconstructive Pelvic Surgery,Department of Obstetrics and Gynecology, TriHealth Good Samaritan Hospital; Center for Core and Pelvic Floor Physical Therapy, Sports Therapy Inc; and Hatton Institute for Research and Education, TriHealth Inc, Cincinnati, OH.
Reference: Female Pelvic Med Reconstr Surg. 2013 Sep-Oct;19(5):271-7.
doi: 10.1097/SPV.0b013e31829c64ea
PubMed Abstract
PMID: 23982575
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