Department of Gynecology and Obstetrics, Shuangqiao Hospital, Chaoyang District, Beijing, China.
Department of Reproductive Medicine, The First Affiliated Hospital of Xinxiang Medical College, No. 88, Health Road, Weihui, Xinxiang, Henan, China.
Int Urogynecol J. 2022 Jul;33(7):1789-1801. doi: 10.1007/s00192-022-05139-z. Epub 2022 Mar 21.
This study was aimed at evaluating the effect of pelvic floor muscle training (PFMT) as a conservative treatment for patients with pelvic organ prolapse (POP).
A comprehensive search to identify eligible randomized controlled trial (RCT) studies was conducted using electronic databases including PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase up to 10 June 2021. Results were presented as risk ratio (RR), the weighted mean difference (WMD), with 95% confidence interval (95% CI) using the random effects model. Outcome variables were pooled using Review Manager version 5.3.
Thirteen studies were included. Our results demonstrated that women who received PFMT intervention had a greater improvement than controls in prolapse symptom score (POP-SS; mean difference [MD] -1.66, 95% CI -2.36 to -0.97, p < 0.00001] and POP stages (risk ration [RR] 1.51, 95% CI 1.14-2.01, p = 0.004). The number of participants who felt better after PFMT was higher (RR 1.98, 95% CI 1.21-3.24, p = 0.006). Subgroup analysis showed that the symptoms of prolapse and the degree of prolapse were improved significantly in the short term, but there was no significant difference in the long-term effect. In addition, there was no significant difference in the impact of PFMT on the elderly and the quality of life. More RCTs are needed to evaluate the effect of PFMT on the elderly and whether the quality of life can be improved.
We found that PFMT can improve subjective symptoms and objective POP severity. More research is needed on the long-term effect.
本研究旨在评估盆底肌训练（PFMT）作为治疗盆腔器官脱垂（POP）患者的保守治疗方法的效果。
通过电子数据库（包括 PubMed、Cochrane 对照试验中心注册库（CENTRAL）和 Embase）进行全面检索，以确定合格的随机对照试验（RCT）研究，检索截至 2021 年 6 月 10 日。结果以风险比（RR）、加权均数差（WMD）表示，采用随机效应模型，95%置信区间（95%CI）。使用 Review Manager 版本 5.3 对结果变量进行合并。
纳入了 13 项研究。我们的结果表明，接受 PFMT 干预的女性在脱垂症状评分（POP-SS；MD-1.66，95%CI-2.36 至-0.97，p<0.00001）和 POP 分期（RR 1.51，95%CI 1.14-2.01，p=0.004）方面的改善优于对照组。接受 PFMT 后感觉更好的参与者比例更高（RR 1.98，95%CI 1.21-3.24，p=0.006）。亚组分析表明，PFMT 在短期内可显著改善脱垂症状和脱垂程度，但长期效果无显著差异。此外，PFMT 对老年人和生活质量的影响无显著差异。需要更多的 RCT 来评估 PFMT 对老年人的效果以及是否能提高生活质量。
我们发现 PFMT 可以改善主观症状和客观的 POP 严重程度。需要进一步研究其长期效果。
