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Background and purpose Pelvic organ prolapse is a common female condition. It is estimated that 50 percent of parous women experience some degree of prolapse and that 10-20 percent seek medical care [Br. Med. J. 324 (2002) 1258]. The aim of the survey was to investigate current physiotherapy practice in the treatment of pelvic organ prolapse, specifically the use of pelvic floor muscle training, across the United Kingdom. An additional aim was to gauge the level of interest of individuals and centres in becoming involved in planned multi-centre research exploring the effectiveness of pelvic floor muscle training in the treatment of pelvic organ prolapse. Methods A questionnaire was mailed out to 484 physiotherapist members of the Association of Chartered Physiotherapists in Women's Health, and 54 non-member physiotherapists working in women's health, which asked about current practice in the treatment of pelvic organ prolapse. Results A total of 364 physiotherapists completed the questionnaire (a response rate of 71 percent , after excluding 27 cases) representing a range of clinical experience and practice. Of the respondents 92 percent (n=333) were assessing or treating women with pelvic organ prolapse. The questionnaire data showed that the various elements of pelvic floor muscle training and outcome measurement were being practised by physiotherapists working across the United Kingdom. However, access to pelvic floor muscle training may be inconsistent, as more than three-quarters of the study respondents reported that they did not have access to clinical guidelines (n=264, 79.3 percent) or referral guidelines (n=296, 88.9percent) for the management of pelvic organ prolapse. The majority of the sample expressed an interest in being involved in future research in this area of practice. There was interest at both an individual level (n=275, 82.5 percent) and as a centre (n=205, 86.1 percent ).Conclusions This survey has revealed that physiotherapy treatment for prolapse is being offered throughout the country despite the poor evidence base and lack of clinical and referral guidelines. There is a gap in the research evidence and therefore a need for randomised controlled trials looking at the effectiveness of pelvic floor muscle training, in the management of pelvic organ prolapse. Evidence-based guidelines should follow on from this. Standardised referral guidelines are also required to ensure equal access to assessment and physiotherapy treatment. |
