Brown Claire A, Toong Ping Jing, Kearney Rohna, Hagen Suzanne, McPeake Joanne
Physiotherapy Department, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Addenbrookes Hospital, Box 185, Cambridge, CB2 0QQ, UK.
University of Cambridge, Cambridge, UK.
Int Urogynecol J. 2025 Mar;36(3):477-490. doi: 10.1007/s00192-024-05995-x. Epub 2024 Dec 12.
Treatment of pelvic organ prolapse (POP) is poorly understood in younger women as the majority of prolapse research is conducted in the older population. There is an urgent need to evaluate conservative POP treatments for management in younger women due to high surgical complications and reoperation rates.
Systematic review of the literature following PRISMA guidelines and registered in PROSPERO. Included studies were of conservative treatments in women younger than 51 years old.
From 416 retrieved studies, nine were included in the analysis. Two of three studies found pelvic floor muscle training (PFMT) significantly benefited patient reported outcome measures (PROM) compared to educational material. One of three studies found significant improvement in PROM using biofeedback in addition to PFMT versus PFMT alone. Electrical stimulation with PFMT versus PFMT alone (one study) showed significant additional benefit of the combined treatment. Biofeedback and electrical stimulation in combination with PFMT versus PFMT alone (one study) was found to provide significant additional benefits. One compared pessary use to no intervention but stopped early due to slow recruitment.
PFMT improves patient reported outcomes in younger women with POP. Electrical stimulation and biofeedback are useful adjuncts to PFMT. The gap in research investigating the effect of pessaries in younger women warrants further study.
由于大多数脱垂研究是在老年人群中进行的，年轻女性盆腔器官脱垂（POP）的治疗尚不为人所熟知。鉴于手术并发症和再次手术率较高，迫切需要评估针对年轻女性的盆腔器官脱垂保守治疗方法。
按照PRISMA指南对文献进行系统综述，并在PROSPERO中注册。纳入的研究为针对51岁以下女性的保守治疗。
在检索到的416项研究中，有9项纳入分析。三项研究中有两项发现，与教育材料相比，盆底肌肉训练（PFMT）能显著改善患者报告结局测量指标（PROM）。三项研究中有一项发现，除PFMT外使用生物反馈，相较于单独使用PFMT，PROM有显著改善。PFMT联合电刺激与单独使用PFMT（一项研究）相比，联合治疗显示出显著的额外益处。PFMT联合生物反馈和电刺激与单独使用PFMT（一项研究）相比，发现能提供显著的额外益处。一项研究将子宫托的使用与不干预进行比较，但由于招募缓慢而提前终止。
PFMT可改善年轻POP女性患者报告的结局。电刺激和生物反馈是PFMT的有用辅助手段。研究子宫托对年轻女性影响的研究空白值得进一步研究。
