• Bruno Teixeira Bernardes, Ana Paula Magalhães Resende, Liliana Stüpp, Emerson Oliveira, Rodrigo Aquino Castro, Zsuzsanna Ilona Katalin Jármy di Bella, Manoel João Batista Castello Girão, and Marair Gracio Ferreira Sartori.
• Department of Gynecology and Obstetrics, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brazil. btbernardes@hotmail.com
• Sao Paulo Med J. 2012 Jan 1; 130 (1): 595-9.

Context And ObjectivePrevious studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA) of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse.Design And SettingProspective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo.MethodsFifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment.ResultsThe groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816).ConclusionsThe CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.

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