Perioperative behavioral therapy and pelvic muscle strengthening do not enhance quality of life after pelvic surgery: Secondary report of a randomized controlled trial

for the Pelvic Floor Disorders Network

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background. There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective. The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design. This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting. This study was a multicenter trial. Participants. Participants were adult women with stage 2-4 POP and SUI. Intervention. Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements. Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse- Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results: The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations. The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions. Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.

Original languageEnglish (US)
Pages (from-to)1075-1083
Number of pages9
JournalPhysical Therapy
Volume97
Issue number11
StatePublished - Nov 1 2017

Fingerprint

Pelvic Organ Prolapse
Stress Urinary Incontinence
Ligaments
Randomized Controlled Trials
Quality of Life
Pelvic Floor
Muscles
Body Image
Prolapse
Suspensions
Reconstructive Surgical Procedures
Uterine Prolapse
Suburethral Slings
Therapeutics
Urinary Incontinence
Health Surveys
Multicenter Studies
Surveys and Questionnaires

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Perioperative behavioral therapy and pelvic muscle strengthening do not enhance quality of life after pelvic surgery : Secondary report of a randomized controlled trial. / for the Pelvic Floor Disorders Network.

In: Physical Therapy, Vol. 97, No. 11, 01.11.2017, p. 1075-1083.

Research output: Contribution to journalArticle

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title = "Perioperative behavioral therapy and pelvic muscle strengthening do not enhance quality of life after pelvic surgery: Secondary report of a randomized controlled trial",
abstract = "Background. There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective. The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design. This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting. This study was a multicenter trial. Participants. Participants were adult women with stage 2-4 POP and SUI. Intervention. Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements. Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse- Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results: The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74{\%}) of BPMT participants and 146 (78{\%}) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations. The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions. Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.",
author = "{for the Pelvic Floor Disorders Network} and Weidner, {Alison C.} and Barber, {Matthew D.} and Alayne Markland and Rahn, {David D.} and Yvonne Hsu and Mueller, {Elizabeth R.} and Sharon Jakus-Waldman and Dyer, {Keisha Y.} and Warren, {Lauren Klein} and Gantz, {Marie G.} and Susie Meikle and Dennis Wallace and Wilson, {Kevin A.} and Daryl Matthews and Terry, {Tamara L.} and Jutta Thornberry and Amanda Youmans-Weisbuch and Whitworth, {Ryan E.} and Hieronymus, {Michael P.} and Morton Brown and Nancy Janz and John Wei and Xiao Xu and Beverley Marchant and Donna DiFranco and Yang Casher and Kristina Slusser and Zhen Chen and Walters, {Mark D.} and Jelovsek, {J. Eric} and Paraiso, {Marie F.R.} and Ridgeway, {Beri M.} and Ly Pung and Cheryl Williams and Linda McElrath and Betsy O'Dougherty and Megan Edgehouse and Gouri Diwadkar and Anna Frick and Linda Brubaker and Mary Tulke and Kimberly Kenton and Kathleen Jesse and Nager, {Charles W.} and Albo, {Michael E.} and Cara Grimes and Brown, {Heidi W.} and Kirby, {Anna C.} and Marlene Corton and Clifford Wai",
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T1 - Perioperative behavioral therapy and pelvic muscle strengthening do not enhance quality of life after pelvic surgery

T2 - Secondary report of a randomized controlled trial

AU - for the Pelvic Floor Disorders Network

AU - Weidner, Alison C.

AU - Barber, Matthew D.

AU - Markland, Alayne

AU - Rahn, David D.

AU - Hsu, Yvonne

AU - Mueller, Elizabeth R.

AU - Jakus-Waldman, Sharon

AU - Dyer, Keisha Y.

AU - Warren, Lauren Klein

AU - Gantz, Marie G.

AU - Meikle, Susie

AU - Wallace, Dennis

AU - Wilson, Kevin A.

AU - Matthews, Daryl

AU - Terry, Tamara L.

AU - Thornberry, Jutta

AU - Youmans-Weisbuch, Amanda

AU - Whitworth, Ryan E.

AU - Hieronymus, Michael P.

AU - Brown, Morton

AU - Janz, Nancy

AU - Wei, John

AU - Xu, Xiao

AU - Marchant, Beverley

AU - DiFranco, Donna

AU - Casher, Yang

AU - Slusser, Kristina

AU - Chen, Zhen

AU - Walters, Mark D.

AU - Jelovsek, J. Eric

AU - Paraiso, Marie F.R.

AU - Ridgeway, Beri M.

AU - Pung, Ly

AU - Williams, Cheryl

AU - McElrath, Linda

AU - O'Dougherty, Betsy

AU - Edgehouse, Megan

AU - Diwadkar, Gouri

AU - Frick, Anna

AU - Brubaker, Linda

AU - Tulke, Mary

AU - Kenton, Kimberly

AU - Jesse, Kathleen

AU - Nager, Charles W.

AU - Albo, Michael E.

AU - Grimes, Cara

AU - Brown, Heidi W.

AU - Kirby, Anna C.

AU - Corton, Marlene

AU - Wai, Clifford

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Background. There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective. The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design. This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting. This study was a multicenter trial. Participants. Participants were adult women with stage 2-4 POP and SUI. Intervention. Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements. Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse- Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results: The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations. The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions. Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.

AB - Background. There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse. Objective. The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Design. This study is a secondary report of a 2 × 2 factorial randomized controlled trial. Setting. This study was a multicenter trial. Participants. Participants were adult women with stage 2-4 POP and SUI. Intervention. Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided. Measurements. Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse- Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores. Results: The 374 participants were randomized to BPMT (n = 186) and usual care (n = 188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures. Limitations. The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures. Conclusions. Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.

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