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Outcomes of a Comprehensive Nonsurgical Approach to Pelvic Floor Rehabilitation for Urinary Symptoms, Defecatory Dysfunction, and Pelvic Pain

Starr, Julie A. MSN, FNP-BC; Drobnis, Erma Z. PhD; Lenger, Stacy BS; Parrot, Jessica MD; Barrier, Breton MD; Foster, Raymond MD

Female Pelvic Medicine & Reconstructive Surgery: September/October 2013 - Volume 19 - Issue 5 - p 260–265
doi: 10.1097/SPV.0b013e31829cbb9b
Review Articles

Objective The authors’ intent was to determine the clinical efficacy of comprehensive pelvic floor rehabilitation among women with symptoms of pelvic floor dysfunction (PFD).

Methods We performed a retrospective analysis of women referred to an academic female pelvic medicine and reconstructive surgery practice for PFD. Data were gathered from the records of 778 women referred for pelvic floor therapy for urinary, bowel, pelvic pain, and sexual symptoms over the course of 4 years.

Results Patients who completed at least 5 therapy sessions reported a mean symptom improvement of 80% in each of the 3 main categories analyzed, namely, urinary incontinence, defecatory dysfunction, and pelvic pain.

Conclusions Comprehensive, nonoperative management of PFD including pelvic floor muscle training, biofeedback, electrogalvanic stimulation, constipation management, behavioral modification, incontinence devices, and pharmacotherapy including vaginal estrogen is effective in the treatment of women with PFD.

Comprehensive pelvic floor rehabilitation is effective in the treatment of women with pelvic floor dysfunction.

From the Department of Obstetrics, Gynecology, and Women’s Health, University of Missouri School of Medicine, Columbia, MO.

Reprints: Julie A. Starr, MSN, FNP-BC, Continence and Advanced Pelvic Surgery, 500 N Keene St, Suite 306, Columbia, MO 65201. E-mail:

The authors have declared they have no conflicts of interest.

© 2013 by Lippincott Williams & Wilkins