title: Pelvic floor physical therapy: impact on quality of life 6 months after vaginal reconstructive surgery.
abstract: OBJECTIVE
  Pelvic floor physical therapy (PFPT) is often used as a treatment of pelvic floor disorders and may improve function after pelvic reconstructive surgery. However, the long-term impact of this modality is not understood.
  
  
  METHODS
  This randomized controlled trial compared PFPT to the standard care in women undergoing vaginal reconstruction. The intervention group received PFPT biweekly until 12 weeks postoperatively, in conjunction with a physician assessment. Control subjects underwent a physician assessment alone at all postoperative intervals. The final follow-up was at 24 weeks. Physical examinations (pelvic organ prolapse quantification assessment), intravaginal electromyography, voiding diaries, and validated questionnaires were completed by all subjects. The primary outcome was change in the World Health Organization Quality of Life-BREF.
  
  
  RESULTS
  Forty-nine women completed the study, 24 in the PFPT group and 25 in the control group. Although electromyography measures showed better muscular function in PFPT subjects after 12 weeks, at 6 months after surgery, this was no longer noted. However, quality of life parameters improved for the entire sample at 24 weeks, with no difference between groups. Positive change from 12 to 24 weeks was also documented in scores on the Pelvic Floor Distress Inventory-20 (P = 0.04) and Pelvic Floor Impact Questionnaire-7 (P = 0.018), corresponding with continued improvement in bladder symptoms. Finally, Prolapse and Incontinence Sexual Questionnaire-12 and Female Sexual Function Index scores improved between 12 and 24 weeks, suggesting better sexual function overall with time elapsed from surgery.
  
  
  CONCLUSIONS
  Quality of life improves in all subjects after vaginal reconstructive surgery, with ongoing benefit between 3 and 6 months. Nevertheless, standardized PFPT was not associated with differences at 24 weeks in this cohort of women.
authors.affiliation: From the *Division of Urogynecology and Reconstructive Pelvic Surgery, TriHealth Good Samaritan Hospital, †Center for Pelvic Floor and Core Rehabilitation, and ‡Hatton Institute for Research and Education, TriHealth, Cincinnati, OH.
authors.forename: Rachel N
authors.initials: RN
authors.lastname: Pauls
authors.forename: Catrina C
authors.initials: CC
authors.lastname: Crisp
authors.forename: Kathleen
authors.initials: K
authors.lastname: Novicki
authors.forename: Angela N
authors.initials: AN
authors.lastname: Fellner
authors.forename: Steven D
authors.initials: SD
authors.lastname: Kleeman
mesh_terms: D001143:Arousal / Q000502:physiology; D004576:Electromyography; D005260:Female; D006801:Humans; D008875:Middle Aged; D009948:Orgasm / Q000502:physiology; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000502:physiology; D056887:Pelvic Organ Prolapse / Q000534:rehabilitation / Q000601:surgery*; D026741:Physical Therapy Modalities / Q000523:psychology*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011788:Quality of Life; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*