Conservative management of pelvic organ prolapse in women.

BACKGROUND

Pelvic organ prolapse is common, and some degree of prolapse is seen in 50% of parous women. Women with prolapse can experience a variety of pelvic floor symptoms. Treatments include surgery, mechanical devices and conservative management. Conservative management approaches, such as giving lifestyle advice and delivering pelvic floor muscle training, are often used in cases of mild to moderate prolapse.

OBJECTIVES

To determine the effects of conservative management (physical interventions, such as pelvic floor muscle training and lifestyle interventions) for women with pelvic organ prolapse in comparison with no treatment or other treatment options (such as mechanical devices or surgery).

SEARCH STRATEGY

We searched the Cochrane Incontinence Group trials register (February 2004), MEDLINE (January 1966 to January 2003), PREMEDLINE (15 January 2003), EMBASE (January 1996 to January 2003), CINAHL (January 1982 to February 2003), PEDro (October 2003), the UK National Research Register (Issue 3, 2003), Controlled Clinical Trials (April 2003) and ZETOC (April 2003). We searched the reference lists of relevant articles.

SELECTION CRITERIA

Randomised and quasi-randomised trials in women with pelvic organ prolapse that included a physical or lifestyle intervention in at least one arm of the trial.

DATA COLLECTION AND ANALYSIS

No eligible completed, published or unpublished, randomised controlled trials were found; therefore no data collection or analysis were undertaken.

MAIN RESULTS

No published reports of randomised controlled trials relevant to the review objectives were found. Three ongoing randomised controlled trials of physiotherapy interventions which include some women with prolapse were identified.

REVIEWERS' CONCLUSIONS: Currently there is no rigorous evidence from randomised controlled trials regarding the use of conservative interventions in the management of pelvic organ prolapse.