Clinical Commentary: Pelvic Organ Prolapse and Incontinence: Theoretical Basis and Case Description of a Novel Conservative Treatment Approach Using Pelvic Muscle Exercise and Pelvic Inversion

Evaluation of the effect of a new method on the pelvic organ prolapse symptoms

OBJECTIVE

Previous studies of treatment for prolapse, patients have undergone pelvic floor muscle training (PFMT), but no exercises were performed for the hip muscles. Accordingly, this study investigated a new conservative treatment approach that was hypothesized to improve prolapse symptoms more than PFMT.

METHODS

Forty women with Stage 2 or 3 prolapse were randomly assigned to either the control or intervention group (n = 20 in each). In this study, patients are treated for 12 sessions (4 weeks and 3 sessions each week). In the control group, the pelvic floor muscle training is applied in for treatment. In the intervention group, in addition to pelvic floor muscle training, postural or positional inversion exercises are included in training.

RESULTS

There was a significant difference between the control and intervention groups in only three domains of the Prolapse Quality of Life questionnaire, namely general health (P = 0.010), physical limitation (P = 0.038), and social limitation (P = 0.010). Furthermore, International Consultation of Incontinence (ICIQ) scores for filling symptoms and bother scale differed significantly between the two groups (P = 0.035 and P = 0.045, respectively). There was also a significant difference in the stage of prolapse and pelvic floor muscle strength in both groups compared with baseline, although only pelvic floor. muscle strength differed significantly between the two groups (P = 0.041).

CONCLUSION

This new method of postural or positional inversion leads to a greater improvement in symptoms of pelvic organ prolapse.