Relapse Prophylaxis and Early Recognition of Pelvic Organ Prolapse in Primary Medical Care Organizations - Randomized Controlled Trial

2023

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DOI 10.13189/ujph.2023.110402
Data confidence 70 medium
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Abstract

Background: Due to the high incidence of genital prolapse surgery in women, the relapse rate, and the lack of clear recommendations for postoperative management, the approach of pelvic floor rehabilitation has had to be developed. Material and methods: A randomized controlled trial has enrolled sixty patients with grade II anterior and posterior vaginal prolapse and grade III stress urinary incontinence. The patients of both groups have undergone surgical treatment in the form of anterior and posterior colpotomy, colporrhaphy with perineolevatoroplasty. In the main group, thirty patients underwent a 6-month course of pelvic floor training in 2 months after surgery to assess the effect of this regimen on muscle contractile strength and a muscle strength thresholding to predict recurrence in primary care organizations; furthermore, all patients followed the general recommendations. Thirty patients in the control group had only surgical treatment and general recommendations. Results: At 8 months after surgery, the strength of the pelvic floor muscles and early manifestations of prolapse were statistically different between the groups. Statistically significant inverse correlations between pelvic floor muscle strength and prolapse symptoms were established. The threshold value of pelvic floor muscle strength at the cut-off point tots up to 62.5 mm Hg. Conclusions: The regular training of the pelvic floor muscles after surgery resulted in a significant increase in pelvic floor muscle strength, which served a protective function in preventing relapse. The threshold value of pelvic floor muscle strength can be employed in clinical practice to assess the risk of prolapse recurrence in women after surgery.