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. 2021 Jun 11;74(2):126-138.
doi: 10.3138/ptc-2020-0053. eCollection 2022 May.

Postoperative Physiotherapy in Women Undergoing Pelvic Floor Reconstructive Surgery: A Randomized Controlled Clinical Trial

Corlia Brandt  1 , E C Janse van Vuuren  2
Affiliations

Postoperative Physiotherapy in Women Undergoing Pelvic Floor Reconstructive Surgery: A Randomized Controlled Clinical Trial

Corlia Brandt et al. Physiother Can. .

Abstract
in English, French

Purpose: Postoperative physiotherapy in conjunction with pelvic organ prolapse (POP) surgery is still under-investigated and controversial. In this randomized controlled trial, pelvic floor muscle training (PFMT) and abdominal training were compared with a control condition (standard in-hospital treatment). Method: Eighty-one women were randomized to one of three groups. The Prolapse Quality of Life questionnaire, two-dimensional ultrasound, Pelvic Organ Prolapse Quantification System scale, the PERFECT (power, endurance, repetitions, fast contractions, every contraction timed) scheme, electromyography, Sahrmann scale, and pressure biofeedback unit (PBU) were used to measure quality of life (QOL), POP, and pelvic floor and abdominal muscle function. A mixed-model analysis of variance and the Kruskal-Wallis test was used for analysis. Results: Beneficial effects (p < 0.05) were found for the PFMT group - increased power, number of fast contractions, amount of movement, endurance, and Sahrmann and PBU measures - compared with the control group. Abdominal training led to a significant (p < 0.05) increase in bulging and discomfort, number of pelvic floor muscle contractions, and Sahrmann and PBU measures compared with the control condition; both groups showed significantly increased urinary frequency (p < 0.05). Conclusions: Postoperative physiotherapy did not have a beneficial effect on QOL or POP symptoms. PFMT and abdominal training had beneficial effects on pelvic floor muscle function and abdominal muscle measures. Additional abdominal training led to increased symptoms.

Objectif : la physiothérapie postopératoire, conjuguée à une chirurgie du prolapsus (CP), est encore sous-évaluée et controversée. Le présent essai aléatoire et contrôlé compare la rééducation périnéale et pelvienne (RPP) à l’entraînement abdominal auprès d’un groupe témoin. Méthodologie : les chercheurs ont réparti 81 femmes en trois groupes. Ils ont utilisé le questionnaire sur la qualité de vie liée au prolapsus, l’échographie bidimensionnelle, le système de classification pour quantifier le prolapsus, l’échelle PERFECT (puissance, endurance, répétitions, rapidité des contractions, durée de chaque contraction), l’électromyographie, l’échelle de Sahrmann et l’unité de rétroaction par pression (URP) pour mesurer la qualité de vie (QdV), la CP et la fonction du plancher pelvien et des muscles abdominaux. Ils ont utilisé un modèle mixte d’analyse de variance et le test de Kruskal-Wallis pour procéder à l’analyse. Résultats : les chercheurs ont constaté des effets bénéfiques (p < 0,05) dans le groupe RPP (puissance, nombre de contractions rapides, quantité de mouvements, endurance et mesures de Sahrmann et d’URP) par rapport au groupe témoin. L’entraînement abdominal a suscité une augmentation significative (p < 0,05) du gonflement et de l’inconfort, du nombre de contractions en RPP et des mesures de Sahrmann et d’URP par rapport au groupe témoin. Les deux groupes ont accru la fréquence de leurs mictions de manière significative (p < 0,05). Conclusion : la physiothérapie postopératoire n’avait pas d’effet bénéfique sur la QdV ou les symptômes de la CP. L’entraînement abdominal et la RPP avaient des effets bénéfiques sur la fonction des muscles pelviens et les mesures des muscles abdominaux. Un entraînement abdominal supplémentaire provoquait une augmentation des symptômes.

Keywords: abdominal muscles; pelvic organ prolapse; postoperative care; quality of life.

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Consolidated Standards of Reporting Trials flow diagram and study outline.
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