Comment: The quality of evidence is downgraded by study limitations and (lack of/unclear allocation concealment) and by imprecise results (few patients for each comparison).
A Cochrane review included 6 studies with a total of 975 subjects. Greater improvement in symptoms was shown in the pelvic floor muscle training (PFMT) group compared to the control group. Pooling data on severity of prolapse from two trials indicated that PFMT increases the chance of an improvement in prolapse stage by 17% compared to no PFMT. The two trials which measured pelvic floor muscle function found better function (or improvement in function) in the PFMT group compared to the control group; measurements were not known to be blinded. Two out of three trials which measured urinary outcomes (urodynamics, frequency and bother of symptoms, or symptom score) reported differences between groups in favour of the PFMT group. The largest most rigorous trial to date suggests that 6 months of supervised PFMT has benefits in terms of anatomical and symptom improvement (if symptomatic) immediately post-intervention. One trial reported bowel outcomes, showing less frequency and bother with symptoms in the PFMT group compared to the control group. When comparing PFMT supplementing surgery vs surgery alone, pelvic floor muscle function findings differed between the trials: one found no difference between trial groups in muscle strength, whilst the other found a benefit for the PFMT group in terms of stronger muscles (2 small trials).
Date of latest search: 6 May 2010