Study Shows No Benefit of PFMT for Prolapse

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An intensive pelvic floor muscle training (PFMT) program did not improve pelvic organ prolapse (POP) in primiparous women following vaginal delivery, a study of 175 women found. 

The 4-month program also did not prompt improvement in bladder neck support or vaginal bulge symptoms in the study population. The researchers had hoped to replicate findings of other studies that have shown that PFMT could help reduce symptoms of POP in middle-aged women.

Key Points:

- An intensive PFMT program did little to help postpartum women ward of POP following vaginal delivery.

- The researchers said clinicians should not discount the importance of pelvic floor exercises for postpartum women and instead urged additional studies that could pinpoint how to best teach the exercises.

The randomized controlled trial included 87 women in the intervention group, who were asked to attend a weekly group training session and perform 3 sets of 8 to 12 daily maximal contractions at home (96% adhered to at least 80% of home and group training sessions) and 88 women in the control group. There were no statistically significant differences between the groups of women. 

While the researchers were unable to show a benefit to providing women with intervention to improve their pelvic floor function, they were not ready to discount the importance of teaching postpartum women to do pelvic floor exercises.

“Given the disparity between our results and those in populations of middle-aged women, we suggest that in future trials PFMT should include supervised individual training rather than, or in addition to, group training,” the authors concluded in calling for additional randomized controlled trials. “Given the high prevalence of POP in the general female population, early prevention and treatment should have high priority.”

The study authors also suggested that PFMT may be more beneficial to women who have more severe POP, since none of the study participants had POP-Q stage III.

The study results were published in the January issue of the American Journal of Obstetrics and Gynecology.