Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women : Current Opinion in Obstetrics and Gynecology

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UROGYNECOLOGY: Edited by Kavita Mishra

Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women

Wallace, Shannon L.a; Miller, Lucia D.b; Mishra, Kavitaa

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Current Opinion in Obstetrics and Gynecology 31(6):p 485-493, December 2019. | DOI: 10.1097/GCO.0000000000000584


Purpose of review 

To describe the principles of pelvic floor physical therapy (PFPT), review the evidence for PFPT as a treatment for pelvic floor dysfunction, and summarize the current recommendations for PFPT as a first-line conservative treatment option for pelvic floor disorders.

Recent findings 

Pelvic floor dysfunction can cause voiding and defecation problems, pelvic organ prolapse (POP), sexual dysfunction, and pelvic pain. PFPT is a program of functional retraining to improve pelvic floor muscle strength, endurance, power, and relaxation in patients with pelvic floor dysfunction. Based on the available evidence, PFPT with or without supplemental modalities can improve or cure symptoms of urinary incontinence, POP, fecal incontinence, peripartum and postpartum pelvic floor dysfunction, and hypertonic pelvic floor disorders, including pelvic floor myofascial pain, dyspareunia, vaginismus, and vulvodynia. Currently, there is conflicting evidence regarding the effectiveness of perioperative PFPT before or after POP and urinary incontinence surgery.


PFPT has robust evidence-based support and clear benefit as a first-line treatment for most pelvic floor disorders. Standards of PFPT treatment protocols, however, vary widely and larger well designed trials are recommended to show long-term effectiveness.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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