Treatment Of Pelvic Floor Dysfunction Research Articles

Pelvic floor dysfunction in rural postpartum mothers in the United States: prevalence, severity, and psychosocial correlates

ABSTRACT Pelvic floor dysfunction (PFD) is a common gynecological problem; however, women residing in rural communities may refrain from seeking treatment for PFD. The purpose of this study was to characterize severity of PFD among postpartum women residing in rural communities (<50,000 residents) in the United States and explore the demographic and psychosocial correlates of PFD. Methods: A survey packet comprised of the Pelvic Floor Disability Index (PFDI-20) and Prolapse and Incontinence Knowledge Questionnaire (PIKQ) as well as the Edinburgh Perinatal Depression Screening (EPDS), items from the Canadian Sexual Health Indicator (CSHI) survey, and demographic questions were distributed via electronic link following recruitment using social media. Descriptive statistics were calculated, and multivariate logistic regression was used to assess the factors associated with PFDI-20 score. Results: Participants (n = 383) have limited pelvic health knowledge (PIKQ) despite self-reporting moderate symptoms of dysfunction (PFDI-20). Over half of women scored ≥14 on the EPDS, indicating probable depression. Women with high scores on the EPDS had greater odds of reporting moderate/severe PFD. Women that identified as Black and/or having a college degree were more likely to report moderate/severe PFD. Conclusion: Rural women require further support to improve their physical and psychological health in the postpartum period.

Current practice in animal models for pelvic floor dysfunction.

The objective was to explore the current practice of using animal models for female pelvic floor dysfunction (PFD). By applying PFD and animal models as the keywords, we made a computerized search using PubMed, Ovid-Medline and Ovid-Embase from 2000 to 2022. The publications on the construction and application of animal models for PFD were included, and the results are presented in narrative text. Studies on PFD primarily use rodents, large quadrupeds, and nonhuman primates (NHPs). NHPs are closest to humans in anatomy and biomechanics of the pelvic floor, followed by large quadrupeds and rodents. Rodents are more suitable for studying molecular mechanism, histopathology of PFD, and mesh immune rejection. Large quadrupeds are adaptable to the study of pelvic floor biomechanics and the development of new surgical instruments for PFD. NHPs are suitable for studying the occurrence and pathogenesis of pelvic organ prolapse. Among modeling methods, violent destruction of pelvic floor muscles, regulation of hormone levels, and denervation were used to simulate the occurrence of PFD. Gene knockout can be used to study both the pathogenesis of PFD and the efficacy of treatments. Other methods such as abdominal wall defect, vaginal defect, and in vitro organ bath system are more frequently used to observe wound healing after surgery and to verify the efficacy of treatments. The rat is currently the most applicable animal type for numerous modeling methods. Vaginal dilation is the most widely used modeling method for research on the pathogenesis, pathological changes, and treatment of PFD.

Platelet-rich Plasma Promotes Restoration of the Anterior Vaginal Wall for the Treatment of Pelvic Floor Dysfunction in Rats

To determine the efficacy of using platelet-rich plasma (PRP) for vaginal wall repair in rats with vaginal wall impairment induced by vaginal distension (VD). A single-blind, randomized study. A certified animal research facility. Twenty-four female Sprague Dawley rats. Female Sprague Dawley rats were divided into sham (n=8), VD (n=8), and VD+PRP (n=8) groups. Vaginal tissues from the VD group were dissected at 28-day post injury. VD+PRP rats received vaginal PRP injections on the 1st, 7th, 14th, and 21st day after VD and sacrificed on the 28th day. Urodynamic tests were performed in all rats. Immunohistochemistry was used to evaluate matrix metalloprotease-2 (MMP-2) and matrix metalloprotease-9 (MMP-9). Masson's staining was used to evaluate collagen fibers and calculate collagen volume fraction. Collagen fiber damage was confirmed in the VD group, evidenced by thinner and sparse distribution of collagen fibers, with significantly higher MMP-2 and MMP-9 expression than the sham group (p <.05). The collagen fiber damage in the vaginal wall likely led to pelvic floor dysfunction (PFD), evidenced by significantly decreased bladder leak-point pressure (p <.01) and abdominal leak-point pressure (p <.01) in the VD group compared with the sham group. After completion of the PRP treatment, a significantly higher collagen volume fraction (p <.01) and significantly increased bladder leak-point pressure (p <.05) and abdominal leak-point pressure (p <.01) were achieved in the VD+PRP compared with the VD group, thus indicating repair of the vaginal wall and improvement of PFD. PRP injections facilitate the regeneration of vaginal wall tissue, particularly collagen fiber, after VD, leading to functional improvement of PFD. Findings support the feasibility of using PRP as a novel treatment for PFD.

Knowledge, Attitude, and Practice of Pregnant Women in Jazan, Saudi Arabia Concerning Pelvic Floor Muscle Exercises.

IntroductionWeaknesses of the pelvic floor muscles in females can lead to pelvic floor dysfunction thus increasing the risk of urinary and fecal incontinence. Furthermore, its weakness can lead to reproductive organ prolapse and sexual dysfunction, and influence sexual arousal and orgasm. There is limited evidence concerning the awareness of Saudi women regarding the importance of physical activity in the prevention and treatment of pelvic floor dysfunction. The current investigation aims to assess the knowledge, attitude, and practice of pelvic floor muscle exercises in the women of Jazan, Saudi Arabia. Materials and methodsThis investigation was a cross-sectional study targeting pregnant women in the Jazan region. Data was collected via an Arabic self-administered questionnaire. The questionnaire was composed of four main components measuring demographic data, presence of pelvic floor dysfunction symptoms, knowledge, attitude, and practice of the participants concerning pelvic floor muscle training. Chi-squared test was used to test the association between measured demographic factors and level of knowledge.ResultsA total of 183 pregnant women were recruited. The mean age of the participants was 27.4 years (standard deviation (SD): 5.3). The median number of pregnancies was 2 (interquartile range (IQR): 1-3), and the mean duration of current pregnancy was 20.9 (SD:11.1). The majority of pregnant women complained of lower abdomen pain with variable degrees. Nearly half of the sample complained of having either urinary or fecal incontinence with variable degrees of severity. The mean score of knowledge was 5 out of 12 and the scores varied between 1 and 11. Only 71 women (38.8%) were confident that pregnant women can exercise pelvic floor muscles. Furthermore, knowledge of the recruited mothers concerning the nature of the pelvic floor muscle exercise was relatively low in comparison to other items. Nearly one-third of the sample either believed that the exercise had no effect or had a worsening effect. Half the sample reported not performing any pelvic floor exercises. Only the practice of the exercise was statistically associated with the level of knowledge, indicating a higher proportion of women with a higher level of knowledge among those who regularly or occasionally perform the exercise. This may suggest that women with a higher level of knowledge are more motivated to exercise (<0.001).ConclusionSeveral deficiencies in knowledge about pelvic floor muscle exercise were detected among the recruited sample. Though the majority of the sample had an attitude favoring pelvic floor muscle exercise, nearly one-third did not believe pelvic floor muscle exercise can be beneficial. Finally, less than 10% of the sample indicated regular practice of pelvic floor muscle exercise. These findings indicate a need to increase the awareness and adherence of women in Jazan.

Tissue-engineered repair material for pelvic floor dysfunction.

Pelvic floor dysfunction (PFD) is a highly prevalent urogynecology disorder affecting many women worldwide, with symptoms including pelvic organ prolapse (POP), stress urinary incontinence (SUI), fecal incontinence, and overactive bladder syndrome (OAB). At present, the clinical treatments of PFD are still conservative and symptom-based, including non-surgical treatment and surgery. Surgical repair is an effective and durable treatment for PFD, and synthetic and biological materials can be used to enforce or reinforce the diseased tissue. However, synthetic materials such as polypropylene patches caused a series of complications such as mesh erosion, exposure, pain, and inflammation. The poor mechanical properties and high degradation speed of the biomaterial meshes resulted in poor anatomical reduction effect and limitation to clinical application. Therefore, the current treatment options are suboptimal. Recently, tissue-engineered repair material (TERM) has been applied to repair PFD and could markedly improve the prognosis of POP and SUI repair surgery in animal models. We review the directions and progression of TERM in POP and SUI repair. Adipose-derived stem cells (ADSCs) and endometrial mesenchymal stem cells (eMSCs) appear to be suitable cell types for scaffold seeding and clinical implantation. The multidisciplinary therapy approach to tissue engineering is a promising direction for tissue repair. More and longer follow-up studies are needed before determining cell types and materials for PFD repair.

Recent advances in the pelvic floor assessment and rehabilitation of Women with Pelvic Floor Dysfunction.

Pelvic Floor Dysfunctions (PFDs) are a group of disorders characterized by inter-related symptoms of urology, gynaecology, colorectal or general pelvic pain. These mainly cause voiding or defecation disorders, pelvic organ prolapses, sexual dysfunctions and pelvic pain. PFDs adversely impact various domains of women's life including psychological, physical, social and sexual well-being. Pelvic Floor Rehabilitation (PFR) has been recommended as part of a multidisciplinary approach for evaluation and management of the multiple PFDs. The assessment of PFD has improved with utilization of new measurement tools and specific outcome measures for PFDs. PFR is a first-line treatment approach effective for PFDs. However, robust research is needed to test standardised assessment and physical therapy treatment protocols with long term efficacy. In this review, we discuss a range of PFDs, impairment-based classification, recent updates, and advances in the evaluation of PFDs, physical therapy tools and techniques for the treatment of PFDs.

Perineometer- An equipment used for measuring the strength of voluntary contractions of pelvic floor muscles- A Review

Pelvic floor dysfunction (PFD) is an umbrella term used for disorders like, Urinary Incontinence, Pelvic Organ Prolapse, Urgency etc. There are many evaluation and treatment tools available for pelvic floor assessment. The purpose of this review was to know the effectiveness and usage of perineometer for the evaluation and treatment of PFD in women, with focus on the usage in current clinical practice.&#x0D; Electronic databases searched- PubMed, Google scholar and Cochrane&#x0D; Search Terms used- Perineometer, pressure manometer, pelvic floor muscle trainer, clinical application&#x0D; Method and Methodology- Inclusion criteria- Studies used Perineometer as evaluation/treatment method for any PFD in female population, Full text articles, ­ case study, case control study, cross sectional, RCTs paper published between 2000-2022.&#x0D; Exclusion criteria- Articles published in other than English.&#x0D; Conclusion- Perineometer is an effective tool for evaluation and treatment of PFD but it’s usage in clinical practice needs to be enhanced for better objectivity of evaluation and treatment.&#x0D; Keywords- Pelvic Floor Dysfunction, pressure manometer, pelvic floor muscle trainer

The effectiveness of eHealth interventions on female pelvic floor dysfunction: a systematic review and meta-analysis.

Introduction and hypothesiseHealth interventions represent a promising novel strategy in pelvic floor management for women. Nevertheless, the effectiveness of eHealth interventions among women with or at risk of pelvic floor dysfunction (PFD) has not been adequately discussed to date. This study aimed to determine the effectiveness of eHealth interventions in preventing and treating PFD among women.MethodsEleven electronic databases were searched for randomized controlled trials (RCTs) from inception until August 28, 2021.ResultsTwenty-four RCTs were included in this meta-analysis that included 3691 women. The meta-analysis showed that eHealth interventions were not only vital for preventing PFD (pregnant women: pooled OR = 0.25, 95% CI: 0.14 to 0.45, p < 0.001; postnatal women: pooled OR = 0.19, 95% CI: 0.06 to 0.60, p = 0.005), but also for reducing the severity of PFD (pooled SMD = -0.63, 95% CI: -1.20 to -0.06, p = 0.031). In addition, compared with traditional care, eHealth interventions showed significant positive effects on several outcome indicators, including quality of life (pooled SMD = 0.49, 95% CI: 0.19 to 0.80, p = 0.002), pelvic floor type I muscle strength (pooled OR = 1.92, 95% CI: 1.30 to 2.82, p = 0.001), pelvic floor type II muscle strength (pooled OR = 2.04, 95% CI: 1.38 to 3.01, p < 0.001), sexual function (pooled SMD = 0.51, 95% CI: 0.29 to 0.73, p < 0.001), satisfaction (pooled OR = 3.93, 95% CI: 2.73 to 5.66, p < 0.001), and self-efficacy (pooled SMD = 2.62, 95% CI: 2.12 to 3.13, p < 0.001).ConclusionseHealth interventions are an effective emerging treatment and preventive modality for female PFD. Higher quality, larger scale, and strictly designed RCTs are warranted to evaluate the effectiveness of eHealth interventions on female pelvic floor management.

Efficacy of vaginal weights in pelvic floor dysfunction: A systematic review and meta-analysis

Pelvic floor dysfunction (PFD) affects women's quality of life because the pelvic floor muscles are unable to contract and relax properly. Kegel exercise is the first line of treatment for PFD, while vaginal cones with weights have recently been used for pelvic floor strengthening. When compared to alternative treatments, various studies have evaluated the effectiveness of vaginal weights or cones in treating PFD. However, there are controversial conclusions reached when the effectiveness of vaginal weights is compared in various ways. The purpose of this study was determine the effectiveness of vaginal weights compared with other interventions in reducing the symptoms of PFD. Using various databases, an extensive literature search was conducted, and a randomised control trial examining the usefulness of vaginal weights in PFD was identified. PRISMA guidelines were used to synthesize the data. The risk of bias tools were used to assess the quality of the selected studies. Results suggest that vaginal cones are effective in treating PFD. However, when it was compared with other treatment modalities, no significant differences were found. Hence, the results are equivocal and cannot be generalized.

Effect of conservative treatment of pelvic floor dysfunctions in women: An umbrella review

Due to their high worldwide prevalence, pelvic floor dysfunctions (PFD's) are a public health problem. There is high heterogeneity in the types and effectiveness of conservative treatment. The objective was to analyze the scientific evidence on conservative treatment of PFDs in women. Umbrella review, covering MEDLINE (1950-2019), Scopus (1960-2019), Web of Science (1980-2019), and Cochrane Library (2000-2019). Inclusion criterion: review on conservative treatments about pelvic floor disorders in the adult women, in Spanish or English; exclusion criterion: studies about other urological, gynecological, and coloproctological pathologies, among others. Thirty-two reviews (2000-2019) and 12 meta-analyses were included. 53.1% showed an improvement on urinary incontinence. Pelvic floor muscle training worked on 70.6% of them, followed by electrical stimulation and estrogen (11.7%), and weight loss (5.9%). 6.3% of reviews and meta-analyses fulfilled all items in PRISMA, and 93.7% of them fulfilled more than 60% of the checklist. 60% de los ítems. PFMT and weight loss are the most effective treatments for UI, but there is no evidence for other PFDs. The methodological quality of conservative treatments must be improved for a more effective treatment of PFDs in women. Pelvic floor muscle training and weight loss are the most effective treatments for urinary incontinence. Only 6.3% of the reviews fulfilled all PRISMA ítems.

What Influences Women to Adhere to Pelvic Floor Exercises after Physiotherapy Treatment? A Qualitative Study for Individualized Pelvic Health Care.

Conservative treatment of pelvic floor dysfunction (PFD) includes therapeutic exercise for pelvic floor muscle (PFM) training or other complementary exercise modalities, such as hypopressive exercises. However, the long-term effectiveness of the conservative treatment depends on a patient’s adherence to the exercises and the integration of professional health advice into their daily life. The objective of this study was to establish the adherence experience of women with diagnosed PFD in home-based exercises after an intensive face-to-face physiotherapy treatment. A qualitative study from an interpretive paradigm was developed. Semi-structured individual and group interviews were performed 6 months after finishing individual physiotherapy treatment. The interviews were recorded, fully transcribed and analyzed thematically by creating categories. Thirty-one women were interviewed. The women reported that their adherence to home PFM exercises depended on the exercise program itself, its efficacy, their personal experiences with the exercises, intrinsic factors such as self-awareness or beliefs, and extrinsic factors, such as professional or instrumental feedback. Thus, therapeutic adherence could be more likely with effective physiotherapy programs that include mutually agreed home exercises and simple movements women can build into their daily lives. Improving awareness and knowledge of the pelvic region and the importance of PFM treatment as well as consideration for potential worsening of PFD will also encourage women to adhere to the exercises.

Melt-extrusion 3D printing of resorbable levofloxacin-loaded meshes: Emerging strategy for urogynaecological applications

Current surgical strategies for the treatment of pelvic floor dysfunctions involve the placement of a polypropylene mesh into the pelvic cavity. However, polypropylene meshes have proven to have inadequate mechanical properties and have been associated to the arising of severe complications, such as infections. Furthermore, currently employed manufacturing strategies are unable to produce compliant and customisable devices. In this work, polycaprolactone has been used to produce resorbable levofloxacin-loaded meshes in two different designs (90° and 45°) via melt-extrusion 3D printing. Drug-loaded meshes were produced using a levofloxacin concentration of 0.5% w/w. Drug loaded meshes were successfully produced with highly reproducible mechanical and physico-chemical properties. Tensile test results showed that drug-loaded 45° meshes possessed a mechanical behaviour close to that of the vaginal tissue (E ≃ 8.32 ± 1.85 MPa), even after 4 weeks of accelerated degradation. Meshes released 80% of the loaded levofloxacin in the first 3 days and were capable of producing an inhibitory effect against S. Aureus and E. coli bacterial strains with an inhibition zone equal to 12.8 ± 0.45 mm and 15.8 ± 0.45 mm respectively. Thus, the strategy adopted in this work holds great promise for the manufacturing of custom-made surgical meshes with antibacterial properties.

Transvaginal single-port laparoscopic-assisted vaginal sacral fixation

: It is estimated that the incidence of pelvic floor dysfunction disease in women over 50 years old is 50%. The aim of treatment for pelvic floor dysfunction is to alleviate symptoms and reconstruct the normal pelvic anatomy in order to improve the quality of life. The surgical methods are various and can be divided into traditional surgery and reconstruction surgery. Reconstruction surgery includes sacral fixation, sacrospinal ligament fixation, high uterosacral ligament suspension, and pelvic floor reconstruction with synthetic mesh. In addition to these, sacrocolpopexy has been widely used in clinical treatment for apical compartment prolapse as one of the classic methods. At present, it is usually completed using an abdominal or laparoscopic method with mesh, but the mesh is a foreign body, which may lead to many complications arising from mesh exposure and erosion. We have been performing transvaginal vaginal sacral fixation with 2 absorbable sliding lines instead of the patch to suspend the vaginal stump on the anterior longitudinal ligament in front of the sacrum. However, due to the need to establish a special surgical position, the use of special lengthening instruments, and the high requirements of teamwork, a limited number of these operations have been completed over the past few years. Recently, different surgical approaches have emerged, especially single-port laparoscopy. With the popularity of the minimally invasive concept and the continuous development of single-port laparoscopic technology, minimal invasiveness, good aesthetic appearance, rapid recovery, and maintaining treatment effectiveness, are the new requirements for our operations. Therefore, we aimed to complete the operation with the aid of transvaginal single-port laparoscopy. The combination of vaginal surgery and laparoscopic surgery avoids the drawbacks in vaginal surgery of a small visual field and exposure difficulties and allows for laparoscopy to be performed under direct vision, which improves the safety of the operation. Furthermore, no scar is left on the body surface, operation-related pain is reduced, the appearance of the body is improved, and rapid recovery is promoted. Here, we describe transvaginal single-port laparoscopic-assisted vaginal sacral fixation.

Comparing the Differences in Children’s Perceptions of Parental Conflict, Self-Differentiation and Being Triangulated in Individuals with and without Functional Constipation Due to Pelvic Floor Dysfunction

Conflicting family relationships in childhood lead to poor health in adulthood and can be a risk factor for diseases. Pelvic Floor Dysfunction (PFD) is one of the functional diseases that can originate from psychological conditions. This study compared children’s perceptions of parental conflict, self-differentiation and triangulation in patients with PFD type of functional constipation and non-infected counterparts. Results indicated the rate of parental conflict and triangulation is high in PFD patients and they have low self-differentiation. These results could help design therapeutic protocols to accelerate the treatment of PFD, and the use of psychological therapies in addition to drug therapies.

Cluster randomised control trial of the effect on attendance and outcomes of multi-disciplinary teams involving psychologists during pelvic floor muscle training for pelvic floor dysfunction

Pelvic floor muscle training (PFMT) is effective, acceptable to patients, and cost efficient as a treatment for Pelvic Floor Dysfunction (PFD). However, PFMT outcomes are mediated by patient variables, such as depression, anxiety, motivation, and health values. The current study examined whether multi-disciplinary provision of PFMT involving a psychologist would improve attendance and outcomes (Clinical Trial Registration: NCT02549157). 88 consecutively referred patients (age 28 − 85 years), with a variety of PFD, were randomised into two groups: PFMT treatment as usual (n = 47), and PFMT with a psychologist involved (n = 41). Patients received 6-month out-patient physiotherapy. More patients with the psychologist completed the course, and there were significantly greater improvements in subjective symptoms (Queensland scale), quality of life (EQ-5D), and anxiety (HADS), although not in objective measures (Oxford Grading) or depression (HADS). These results suggest that an MDT including a psychologist during PFMT intervention treatment may help some patients. IMPACT STATEMENT What is already known on this subject? Pelvic floor muscle training (PFMT) is effective, acceptable to patients, and cost efficient as a treatment for Pelvic Floor Dysfunction (PFD). However, PFMT outcomes are mediated by patient variables, such as depression, anxiety, motivation, and health values. The effectiveness of a multi-disciplinary team delivering both PFMT and psychological support simultaneously to women undergoing PFMT for PFD is unknown. What do the results of this study add? Psychological support delivered alongside PFMT increased patient attendance, improved subjective ratings of pelvic floor functioning, health-related quality of life, and reduced anxiety. This is one of the first demonstrations that this can be achieved through a multi-disciplinary team delivering their support simultaneously to the patients. What are the implications of these findings for clinical practice and/or further research? Improving subjective functioning and reducing attrition rates in PFD patients has cost implications in terms of reduced need for surgery, and making future surgery more effective. The inclusion of brief, easily delivered psychological support, integrated into the PFMT sessions in a multidisciplinary way may represent an extremely cost effective method of improving the service for these patients.

Quo Vadis Urogynecology 2020 - Innovative Treatment Concepts for Urinary Incontinence and Pelvic Organ Prolapse.

The current treatment for urinary incontinence and pelvic organ prolapse includes a wide range of innovative options for conservative and surgical therapies. Initial treatment for pelvic floor dysfunction consists of individualized topical estrogen therapy and professional training in passive and active pelvic floor exercises with biofeedback, vibration plates, and a number of vaginal devices. The method of choice for the surgical repair of stress urinary incontinence consists of placement of a suburethral sling. A number of different methods are available for the surgical treatment of pelvic organ prolapse using either a vaginal or an abdominal/endoscopic approach and autologous tissue or alloplastic materials for reconstruction. This makes it possible to achieve optimal reconstruction both in younger women, many of them affected by postpartum trauma, and in older women later in their lives. Treatment includes assessing the patientʼs state of health and anesthetic risk profile. It is important to determine a realistically achievable patient preference after explaining the individualized concept and presenting the alternative surgical options.

Group Physiotherapy for Treatment of Pelvic Floor Dysfunction: A Consumer’s Perspective

Introduction: Level 1 grade A evidence exists to support physiotherapy as a first line treatment of women with stress urinary incontinence and pelvic organ prolapse (POP). A novel way to provide care for women with pelvic floor dysfunction in a tertiary hospital setting is to mandate attendance at an introductory group education session prior to offering an individual physiotherapy consultation. There is minimal research to date examining the consumer perspective of group physiotherapy for treatment of pelvic floor dysfunction. This study aims to evaluate the consumer experience with a view to determining if this model of care meets the needs and expectations of the consumer. Objective: To evaluate the consumer perspective of an educational and practical pelvic floor class prior to offering an individual physiotherapy appointment for women with pelvic floor dysfunction. Method: Over a 6-month period, 39 women completed a voluntary, anonymous survey to evaluate their experience of attending a physiotherapy pelvic floor class. Results: Respondents reported that the information delivered was appropriate, relevant, and engaging and felt more informed and less alone in their symptoms after attending the pelvic floor class. Women reported that they had received the necessary education and practical skills required to begin implementing practical changes that addressed their pelvic floor dysfunction. Conclusion: By providing a consistent, informative, and practical group session for women referred with pelvic floor dysfunction as a baseline entry point to individual care, treatment can be commenced that is acceptable to the consumer. The acceptability of this method of service delivery serves as a basis for further important research evaluating the efficiency and effectiveness of group physiotherapy treatment.

Pelvic floor muscle training as a method supporting the treatment of pelvic floor dysfunctions in women

Pelvic floor muscle training as a method supporting the treatment of pelvic floor dysfunctions in women

The Effect of Pelvic Floor Muscle Training on Pelvic Floor Dysfunction in Pregnant and Postpartum Women

<strong>Background:</strong> Pelvic floor dysfunction (PFD) seriously affects the patients’ quality of life, and its incidence is closely related to pregnancy and delivery. Pelvic floor muscle training (PFMT) is a conservative treatment of PFD. For decades, different researchers have conducted PFMT research on different female groups. However, the efficacy of PFMT for pregnant and postpartum women is controversial. Therefore, this article aimed to systematic review the efficacy of PFMT for them. This article reviewed the relationship between the occurrence and development of PFD during pregnancy and delivery, and the effect of PFMT on PFD in pregnant and postpartum women. <strong>Method:</strong> We used the keywords of “pelvic floor dysfunction” and “pelvic floor muscles training”, and focused on the study of PFMT during pregnancy and postpartum. Finally, 54 related studies were selected, including randomized controlled trials, quasi experimental trials, observational studies, longitudinal cohort studies, cross-sectional studies, and systematic reviews. <strong>Result:</strong> During pregnancy, PFMT can prevent the occurrence of PFD in late pregnancy and early postpartum, and in the early postpartum period, PFMT can improve the symptoms of PFD. PFMT has a protective effect on the pelvic floor without obvious negative effects. However, PFMT has not been popularized in pregnant and postpartum women. And its beneficial effects cannot be maintained for a long time if women cannot insist on it for a long time. <strong>Conclusion:</strong> The popularization and standard guidance of PFMT during the pregnancy and postpartum period should be strengthened vigorously in hospital. The development of a personalized PFMT program according to the individual situation of pregnant and postpartum women can improve the pelvic floor symptoms and their quality of life of women.

Impact of patient motivation on compliance and outcomes for incontinence

ObjectivesPhysiotherapeutic treatment of pelvic floor dysfunction in women has variable outcomes, and identification of the predictors of outcomes is important in developing service provision and treatment planning. This study explored whether patient motivation affects treatment compliance and outcomes of physiotherapeutic treatment in a cohort of patients with pelvic floor dysfunction. Design, setting and participantsA prospective observational study of 141 adult female patients referred consecutively to the physiotherapy clinic of an urogynaecological outpatients unit at a UK hospital. InterventionA 6-month (one group session per month) pelvic floor muscle training programme, which included a home exercise programme. Main outcome measuresModified Oxford Grading System and Queensland Pelvic Floor Questionnaire ratings of pelvic floor function were taken pre- and post-intervention, and the University of Rhode Island Change Assessment Scale assessed patient motivation to change pre-intervention. ResultsMotivation to change predicted attendance at the intervention sessions and patient-rated improvements in function. Patients with higher baseline motivation to change also reported greater improvements in pelvic symptoms, given the same pelvic floor muscle strength improvement. ConclusionsPatient motivation affects physiotherapeutic treatment adherence and outcomes, and should be considered as part of future assessment/screening procedures. Clinical Trial RegistrationNCT02549157.