Pelvic floor muscle training after childbirth to prevent pelvic organ dysfunction: a prospective, single-center, open, randomized study

Background. The pelvic floor dysfunction (PFD) refers to a multifactorial disease, including pelvic prolapse (PP), urinary incontinence (UI), fecal incontinence (FI) and sexual dysfunction (SD). The development of PFD with any manifestation leads to a decrease in the quality of life, disability, as well as social maladjustment of women of all age groups. Objective. Assessment of the effectiveness of pelvic floor muscle training (PFMT) after childbirth in reducing symptoms of pelvic organ dysfunction. Methods. Study design: prospective, single-center, open, randomized study. The study was approved by the Ethics Committee of Kemerovo State Medical University. Eighty women were randomly assigned to two groups12 weeks after childbirth. Randomization was carried out by the sealed code envelope method. Patients of group I (n=34) received daily trainings for 20 minutes using the EmbaGYN apparatus (United Kingdom) for 4 weeks; patients of group II (n=36) - using Magic Kegel Master (China). Before inclusion in the study, an anonymous survey of women was conducted using the PFDI-20 questionnaire (Pelvic Floor Distress Inventory Qestionnaire) and the FSFI questionnaire (Female sexual function index). The strength of the PFM was measured using pneumoperineometry with the iEASE XFT-0010. Statistical analysis of the research results was carried out using the Statistica Version 10. Results. After 4 weeks, a statistically significant decrease in complaints about the symptoms of PP, UI, FI in both groups was registered. The frequency of SD, however, significantly decreased only in group II: 25.0 vs 69.4% (р=0.001). After treatment, there was a significant decrease in the number of women with symptoms of urge UI from 35.3% to 8.8% (р=0.009), as well as with loss of urine associated with coughing, sneezing or laughing (from 41.2 to 11,8%; р=0.006) and the loss of a small amount of urine not related to exercise (from 23.5 to 5.9%; р=0.040) in the group I. Conclusion. Thus, training with the use of physical methods of rehabilitation for 4 weeks helps to reduce the frequency of symptoms of pelvic organ dysfunction. Furthermore, the use of EmbaGYN was more effective in reducing the symptoms of UI, and the Magic Kegel Master - in reducing the symptoms of SD.

pelvic floor dysfunction, pelvic prolapse, urinary incontinence, fecal incontinence, sexual dysfunction, pelvic floor muscle training, physical rehabilitation