A moderate quality randomised controlled trial published across two studies(5, 6) explored the effectiveness of a multicomponent intervention incorporating self-directed education and pelvic floor muscle training amongst patients waiting for pelvic organ prolapse surgery. This was compared to a control group receiving no intervention. The intervention was delivered a minimum of 3 months before the surgery date. Participants were directed to performed pelvic floor exercises, and received written education around technique, along with lifestyle advice. In addition, all postmenopausal women received local oestrogen therapy unless contraindicated, irrespective of group allocation.
The evidence of effectiveness of multicomponent interventions incorporating self-directed exercise components & education is lacking for the following outcomes:
Muscle strength:
Might be effective (one moderate quality study showing a significant effect for the intervention, compared to control)(6).
Urinary and colorectal anal distress:
Might not be effective (one moderate quality showing no effect for the intervention compared to control)(5).
Health-related QoL:
Might not be effective (one moderate quality study showing no effect for the intervention compared to control)(5).
The study was conducted in Norway(5, 6) and therefore, further consideration should be given to whether it would be generalisable to Wales.
The evidence for the outcomes listed above was derived from patients waiting for POP surgery and therefore may not be applicable to patients waiting for other elective surgeries.
It is suggested that further robust research and thorough evaluation of impact is needed.