• Marian Wiegersma, Chantal M C R Panman, Boudewijn J Kollen, Marjolein Y Berger, Yvonne Lisman-Van Leeuwen, and Janny H Dekker.
• *Dit onderzoek werd eerder gepubliceerd in British Medical Journal (2014;349:g7378) met als titel 'Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic pelvic organ prolapse: randomised controlled trial in primary care'. Afgedrukt met toestemming.
• Ned Tijdschr Geneeskd. 2015 Jan 1;159:A8855.

ObjectiveTo compare the effect of pelvic floor muscle training (PFMT) and watchful waiting on pelvic floor symptoms in women aged 55 years and over with symptomatic mild pelvic organ prolapse in primary care.DesignRandomised controlled trial in primary care.MethodWomen aged 55 years or over with symptomatic mild prolapse (leading edge above the hymen) were identified by screening. Women were randomised to PFMT or watchful waiting. Primary outcome was change in bladder, bowel and pelvic floor symptoms measured with the Pelvic Floor Distress Inventory-20 (PFDI-20), three months after the start of treatment. Secondary outcomes were changes in condition specific and general quality of life, sexual function, degree of prolapse, pelvic floor muscle function, and patients' perceived change of symptoms.ResultsOf the 278 women who were randomised to PFMT (n=145) or watchful waiting (n=142), 250 (87%) completed follow-up. Participants in the PFMT group improved by 9.1 (95% CI -15.4 to -2.8) points more on the PFDI-20 than did participants in the watchful waiting group (p = 0.005). Of women in the PFMT group, 57% (82/145) reported an improvement of overall symptoms from the start of the study compared with 13% (18/142) in the watchful waiting group (p < 0.0001). Other secondary outcomes showed no significant difference between the groups.ConclusionAlthough PFMT led to a significantly greater improvement in PFDI-20 score, the difference between groups was below the presumed level of clinical relevance (15 points). Nevertheless, 57% of the participants in the PFMT group reported an overall improvement of symptoms.

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