Monday, 16 June 2014

The Best Evidence for Conservative Management of Prolapse

I strongly believe that it is important for women with prolapse to be as informed as possible about their condition and management options - particularly considering that many health professionals unfortunately do no have an in-depth knowledge of prolapse.

However, it can be a bit daunting for someone from a non-scientific background to access information that may rely heavily on statistics or technical language.

A good place to start for scientific information on any health condition is to see if there is a Cochrane review about it. A Cochrane review is a report published by experts in a medical field that summarises all of the current research on a particular topic. It means that rather than having to find and try to understand lots of specialist scientific papers, you can read the summary of one report and get a good idea about what the latest research is telling us about prolapse.
The Cochrane review about conservative management of prolapse can be found here: Conservative Management of Pelvic Organ Prolapse in Women. 'Conservative treatment' refers to non-surgical methods for managing prolapse including physiotherapy and pessary.
It is well worth reading the short summary of this review, but some of the key points include:
  • There has not been much research on this topic, which means that there is still a lot of questions that need to be answered
  • Pelvic floor muscle training (PFMT) seems to improve bladder and bowel function in many women with prolapse
  • PFMT seems to improve prolapse level by around 17% in many women with prolapse
  • PFMT, perhaps not surprisingly, seems to improve the general functioning of the pelvic floor
This review concludes that conservative treatment, particularly physiotherapy, can provide at least a small improvement in symptoms for many women suffering prolapse. Further research is needed to see which women are more likely to benefit, and which physiotherapy treatments provide the greatest benefit in each case.
Cochrane reviews are also a great resource for busy health professionals who want to keep up to date with the literature on a number of topics. These reviews are updated frequently, which means that you can check back every now and then to see what the latest consensus is, without having to read and synthesise every new piece of research that comes out.

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