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

Alison C. Weidner*, Matthew D. Barber, Alayne Markland, David D. Rahn, Yvonne Hsu, Elizabeth R. Mueller, Sharon Jakus-Waldman, Keisha Y. Dyer, Lauren Klein Warren, Marie G. Gantz, Susie Meikle, Dennis Wallace, Kevin A. Wilson, Daryl Matthews, Tamara L. Terry, Jutta Thornberry, Amanda Youmans-Weisbuch, Ryan E. Whitworth, Michael P. Hieronymus, Morton BrownNancy Janz, John Wei, Xiao Xu, Beverley Marchant, Donna DiFranco, Yang Casher, Kristina Slusser, Zhen Chen, Mark D. Walters, J. Eric Jelovsek, Marie F.R. Paraiso, Beri M. Ridgeway, Ly Pung, Cheryl Williams, Linda McElrath, Betsy O'Dougherty, Megan Edgehouse, Gouri Diwadkar, Anna Frick, Linda Brubaker, Mary Tulke, Kimberly Kenton, Kathleen Jesse, Charles W. Nager, Michael E. Albo, Cara Grimes, Heidi W. Brown, Anna C. Kirby, Leah Merrin, Jo Ann Columbo, for the Pelvic Floor Disorders Network

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


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
Issue number11
StatePublished - Nov 1 2017

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Fingerprint Dive into the research topics of 'Perioperative behavioral therapy and pelvic muscle strengthening do not enhance quality of life after pelvic surgery: Secondary report of a randomized controlled trial'. Together they form a unique fingerprint.

Cite this