Can pelvic floor muscle training prevent and treat pelvic organ prolapse?
METHODS
Pelvic floor muscle dysfunction may cause urinary and fecal incontinence, pelvic organ prolapse (POP), pain, and sexual disturbances. The aim of the present study is to review the literature on the effectiveness of pelvic floor muscle training (PFMT) to prevent and treat POP, and the possible theories and mechanisms on how PFMT could prevent or reverse prolapse.


RESULTS
No studies were found on prevention of POP. One uncontrolled study and one low-quality RCT were found in the treatment of prolapse. The results showed a positive effect of PFMT in severe, but not in mild prolapse. A review is presented of the main hypothesis of mechanisms on how PFMT may be effective. The two mechanisms are morphological changes occurring after strength training and use of a conscious contraction during increase in abdominal pressure in daily activities.


CONCLUSIONS
In addition to the theory of functional anatomy and exercise science, one randomized controlled trial (RCT) is supportive for a positive effect of PFMT in the treatment of POP. There is an urgent need for more RCT with high methodological quality, use of valid and reproducible methods to assess degree of prolapse, and appropriate training protocols to evaluate the effect of PFMT in the prevention and treatment of POP.
Department of Sports Medicine, Norwegian School of Sports Sciences, A Specialized University, Ullevål Stadion, Oslo, Norway. kari.bo@nih.no
Kari
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D005081:Exercise Therapy; D005242:Fecal Incontinence / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D017773:Pelvic Floor / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology / Q000517:prevention & control; D014596:Uterine Prolapse / Q000517:prevention & control*