Skip to Main Content

RTI uses cookies to offer you the best experience online. By and clicking “accept” on this website, you opt in and you agree to the use of cookies. If you would like to know more about how RTI uses cookies and how to manage them please view our Privacy Policy here. You can “opt out” or change your mind by visiting: http://optout.aboutads.info/. Click “accept” to agree.

Accept
RTI International
  • About
    • Office Locations
    • Executive Leadership
    • Corporate Governance
    • Partner with Us
      • U.S. Government
      • Clients and Funding Agencies
      • Industry and Commercial Clients
      • Foundations and Associations
      • Bilateral Agencies and Multilateral Banks
      • Universities and Academic Research Institutions
      • Suppliers and Small Businesses
    • Commitment to Quality
      • RTI's Client Listening Program
    • Ethics and Human Research Protection
    • Living Our Mission
    • Open Science Initiative
    • Veteran Opportunities at RTI

    About

  • Practice Areas
    • Health
      • Public Health and Well-Being
      • Health Care Transformation
      • Behavioral Health
      • Health Behavior Change
      • Precision Medicine
      • RTI Health Solutions (RTI-HS)
      • RTI Center for Community Health Evaluation and Economics Research
      • Health Equity
      • RTI Health Advance
    • Transformative Research Unit for Equity​
      • Equity Capacity Building Hub
      • Social and Economic Justice Research Collaborative
      • Narrative Research and Community Engagement Lab
    • Education and Workforce Development
      • Early Childhood
      • K-12 Education
      • Postsecondary Education
      • Career and Adult Education and Workforce Development
      • Education Policy, Systems, and Governance
      • Education Research Methodologies
      • Education Technologies
    • International Development
      • Energy for Development
      • Environment
      • Global Food Security, Agriculture, and Nutrition
      • Global Health
      • International Education
      • Monitoring, Evaluation, Research, Learning, and Adapting (MERLA)
      • Youth and Economic Opportunity
      • Building Resilience Against COVID-19 in Developing Countries
      • Water, Sanitation, and Hygiene (WASH)
      • RTI Center for Governance
    • Climate Change
      • Clean Energy Technology and Renewables
      • Climate Finance
      • Climate Justice and Equity
      • Climate Planning, Preparedness and Resilience
      • Climate Policy
      • Climate Vulnerability, Adaptation, and Mitigation
      • Economic Impacts of Climate Change
    • Water
      • Food-Energy-Water Nexus
      • Water Quality
      • WASH (Water, Sanitation, Hygiene)
      • Water Resources Management
    • Energy Research
      • Carbon Capture and Utilization
      • Biomass Conversion
      • Natural Gas
      • Energy Efficiency
      • Industrial Water
      • Syngas Processing
    • Environmental Sciences
      • Air Quality
      • RTI Center for Water Resources
      • Urban Sustainability
      • Toxics
      • Building Resiliency in the FEW Nexus
      • Climate Change Sciences and Analysis
      • Environmental Policy
      • Environmental Justice
      • Sustainable Materials & Waste Management Solutions
    • Justice Research and Policy
      • RTI Center for Community Safety and Crime Prevention
      • RTI Center for Policing Research and Investigative Science
      • Child Well-Being and Family Strengthening
      • RTI Center for Forensic Sciences
      • Evidence-Based Strategies to Reduce Firearm Violence
    • Food Security and Agriculture
      • Market Systems Strengthening
      • Food Safety
      • Food and Nutrition
      • Global Food Security, Agriculture, and Nutrition
      • Climate-Smart Agriculture
      • Agricultural Innovation
      • Obesity Prevention
    • Innovation Ecosystems
      • Innovation Advising
      • Innovation for Economic Growth
      • Innovation for Emerging and Developing Economies
      • Innovation for Organizations
      • Research, Technology, and Innovation Policy
      • Technology Acceleration
    • Military Support
      • Military Behavioral Health
      • Military Health and Human Performance
      • Military Sexual Assault, Harassment, and Domestic Violence Prevention
      • Wearable Sensor Technologies
      • Military Health System Transformation
      • North Carolina Center for Optimizing Military Performance

    Practice Areas

  • Services + Capabilities
    • Surveys and Data Collection
      • Survey Design
      • Instrument Development
      • Survey Methodologies
      • Data Collection
      • Establishment Surveys
      • Health Registries
      • Data Analysis and Reporting
      • Research Operations Center
    • Statistics and Data Science
      • Survey Statistics
      • Environmental Statistics
      • Coordinating Centers for Multisite Studies
      • Analysis and Design of Complex Data
      • Biostatistics
      • RTI Center for Data Science
    • Evaluation, Assessment and Analysis
      • Evaluation Design and Execution
      • Advanced Qualitative, Quantitative, and Mixed Methods
      • Evaluation, Monitoring, and Assessment
      • Economic Analysis
      • Evaluating Communication Interventions and Campaigns
      • Evidence Synthesis for Policy and Practice
      • Risk Assessment and Prediction
    • Program Design and Implementation
      • Systems Strengthening and Scaling
      • Capacity Assessment and Building
      • Policy Reform Support
      • Curriculum and Teacher Professional Development
      • Interventions and Prevention Programs
      • Implementation Science
    • Digital Solutions for Social Impact
      • Human-Centered Design of Digital Solutions
      • Digital Product Development
      • Digital Communication Campaigns
      • Digital Data Analytics
    • Research Technologies
      • Survey Technologies
      • Data Management and Decision Support Systems
      • Geospatial Science, Technology, and Visualization
      • ICT for Limited-Resource Settings
      • Mobile Applications
      • Web Applications
      • Bioinformatics
      • Interactive Computing
    • Drug Discovery and Development
      • Medicinal Chemistry
      • Molecular Design and Cheminformatics
      • Behavioral Pharmacology
      • Drug Metabolism and Pharmacokinetics (DMPK)
      • In Vitro Pharmacology, Bioassay Development, and High-Throughput Screening (HTS)
      • Isotope Labeling
      • Regulatory Consulting and Support for Medical Products
    • Analytical Laboratory Sciences
      • Bioanalytical and Toxicology Research
      • Forensic Sciences
      • Physicochemical Characterizations
      • Metabolomics
      • Proficiency Testing and Reference Materials
      • Microbiology
      • Analytical Chemistry and Pharmaceutics
    • Engineering & Technology R&D
      • Biomedical Technologies
      • Decarbonization Sciences
      • Environmental Exposure & Protection
      • Materials & Environment
      • Sustainable Energy Solutions

    Services + Capabilities

  • Impact
    • Newsroom
    • Insights Blog
    • Events
    • Publications
    • RTI Press
      • About the RTI Press
      • Instructions for Authors
      • RTI Press Collections
    • Projects
    • Global Reach
      • Asia
      • Eastern Europe and Central Asia
      • RTI International India
      • Africa
      • Middle East and North Africa (MENA)
      • Latin America and the Caribbean (LAC)

    Impact

  • Experts
    • Our Experts
    • In-Depth With Our Experts
    • Related News
    • Experts In the Media
    • RTI Fellow Program

    Experts

  • Emerging Issues
    • COVID-19 Research
    • Artificial Intelligence
    • Global Health Security
    • Cannabis Research
    • Opioid Research
      • Interventions for Opioid Use Disorders
      • Preventing Opioid Misuse and Overdose
      • Treating Opioid Use Disorders
    • Policing Research and Investigative Science
    • Drone Research and Application
    • E-cigarette Research
    • Zika Virus Research
    • Integrated Governance

    Emerging Issues

  • COVID-19 Research + Response
  • Global Reach
  • Insights Blog
  • Newsroom
  • RTI Press
  • Publications
  • Partner With Us
  • Careers
  • Facebook IconTwitter IconInstagram IconYouTube IconLinkedin Icon
  • Home
  • Impact
  • Publications
  • Perioperative behavioral therapy & pelvic muscle strengthening does not improve quality of life after apical prolapse surgery

Perioperative behavioral therapy & pelvic muscle strengthening does not improve quality of life after apical prolapse surgery

A randomized controlled trial

Weidner, AC., Barber, MD., Markland, AD., Rahn, DD., Hsu, Y., Mueller, ER., Jakus-Waldman, S., Dyer, KY., Warren, L., Gantz, M., & Meikle, S. (2015). Perioperative behavioral therapy & pelvic muscle strengthening does not improve quality of life after apical prolapse surgery: A randomized controlled trial. International Urogynecology Journal, 26, S59-S61.

Copy citation

Abstract

Introduction: The value of perioperative behavioral therapy with pelvic floor muscle training (BPMT) for improving health-related quality of life (HRQOL) and sexual function is unknown in women undergoing transvaginal reconstructive surgery. While patients with better muscle conditioning have improved outcomes in a variety of surgeries (1), it is not standard practice for pelvic surgeries and robust clinical data supporting the practice is needed. (2)

Objective: To evaluate the effect of perioperative BPMT on HRQOL and sexual function over 24 months following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI). This report describes a planned secondary analysis of women undergoing surgery as part of the Operations and Pelvic Muscle Training in the Management of Apical Support Loss (OPTIMAL) trial. (3)

Methods: Adult women planning vaginal surgery for stage 2– 4 POP and SUI enrolled in a multi-site 2×2 factorial randomized controlled trial and underwent randomization to two interventions: 1) peri operative BPMT versus usual perioperative care and 2) sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS). Participants underwent transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) and received usual care or 5 perioperative BPMT visits: one preoperative (2–4 weeks before surgery) and 4 postoperative sessions (2, 4–6, 8, and 12 weeks after surgery) individualized with progressive pelvic floor muscle exercise and education on behavioral strategies for reducing urinary and colorectal symptoms. The Pelvic Floor Impact Questionnaire short form subscales (Urinary [UIQ], Prolapse [POPIQ], and Colorectal/anal [CRAIQ]), the SF-36, and the Patient Global Impression of Improvement (PGI-I) assessed outcomes related to HRQOL before and after randomization. The POP/UI sexual questionnaire short form (PISQ-12), a modified body image questionnaire, and selfreported post-operative treatment for dyspareunia at 6, 12, and 24 months addressed sexual function after randomization. Differences from baseline in QOL measures to 24 months were assessed between treatment groups using linear models.

Results: Of the 374 subjects who were randomized for the behavioral intervention (n=186) and usual care (n=188), the proportion of participants withdrawing after randomization were similar [34(18 %) BPMT, 24(13 %) usual care, p= 0.15]. Completed questionnaires at 24 months were available for 152(82%) of BPMTand 154(82 %) of usual care subjects. Self-reported adherence to exercise in the BPMT group was good at 12 (86 %) and 24 (81 %) months. Participants had significant improvements in UDI, POPDI and CRADI at 6 months post-operatively that were sustained at 24-months with no significant differences between groups (Figure). SF- 36, PGII, PISQ-12, body image, and post-operative treatment for dyspareunia were also similar for both groups.

Conclusions: Perioperative BPMT performed as an adjunct to two different types of vaginal surgery for POP and SUI does not improve quality of life or sexual function compared with usual care. While individualized treatments including physical and behavioral therapy can be offered to women reporting new or unresolved symptoms following surgery, our findings do not support routine perioperative BPMT for women undergoing vaginal surgery for stage 2–4 prolapse and SUI.

Share
  • Share on Facebook
  • Share on Twitter
  • Share on Linkedin
  • Email

Publications Info

To contact an RTI author, request a report, or for additional information about publications by our experts, send us your request.

  • +1 919 541 8787
  • publications@rti.org

Meet the Experts

View All Experts
Marie Gantz

Marie G. Gantz

Lauren Klein Warren

Lauren Klein Warren

Recent Publications

METHODS REPORT

Improving text classification with Boolean retrieval for rare categories

Article

Use of a web-based portal to return normal individual research results in Early Check

Article

Personal exposure to PM2.5 in different microenvironments and activities for retired adults in two megacities, China

Article

Estimating global artisanal fishing fleet responses in an era of rapid climate and economic change

RTI Logo
Partner With Us
  • US Government
  • Commercial
  • Foundations & Associations
  • Multilateral Donors
  • Universities
  • Suppliers
Site
  • Privacy Policy
  • Security Policy
  • Site Map
  • Terms of Use
  • Accessibility
  • Contact Us
Contact Us
Facebook Icon Twitter Icon Instagram Icon YouTube Icon Linkedin Icon
delivering the promise of science
for global good
RTI Health Solutions RTI Innovation Advisors RTI Health Advance

© 2023 RTI International. RTI International is a trade name of Research Triangle Institute. RTI and the RTI logo are U.S. registered trademarks of Research Triangle Institute.