The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse.

Abstract

We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. This study was a 12-month follow up of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. Data were available from 83 (76%) of the 109 originally included women. At the 12-month follow up, 34/83 (41%) had not sought further treatment, 13/43 (30%) in the lifestyle group and 21/40 (52%) in the training and lifestyle group, and these could be included for analysis. The lifestyle group had significantly improved bladder symptoms compared with baseline on single-item analysis (p = 0.01). The training and lifestyle group had significantly improved pelvic organ prolapse symptoms on single-item analysis (p = 0.02) and of bowel-related quality of life (p = 0.04). No significant between-group differences were found in the symptom and quality of life scores. All together 49 women (59%) had sought further treatment, 70% in the lifestyle group, and 48% in the training and lifestyle group (p = 0.05). Twenty-six in the lifestyle group, and 15 in the training and lifestyle group had sought conservative treatment. Four women in each group had received surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were limited.