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STUDY QUESTION: Does pelvic floor muscle training lead to a greater change in bladder, bowel, and pelvic floor symptoms than watchful waiting in women aged 55 years or over with symptomatic mild pelvic organ prolapse recruited from primary care? SUMMARY ANSWER: Change in bladder, bowel, and pelvic floor symptoms differed significantly between pelvic floor muscle training and watchful waiting, but the clinical relevance of this difference remains unclear. WHAT IS KNOWN AND WHAT THIS PAPER ADDS: Pelvic floor muscle training seems to be effective in relieving symptoms of prolapse in women with an advanced stage pelvic organ prolapse. This is the first study to investigate the effects of pelvic floor muscle training in a primary care population of women with symptomatic mild pelvic organ prolapse. [ABSTRACT FROM AUTHOR]

Objective: To compare the effects of pelvic floor muscle training and watchful waiting on pelvic floor symptoms in a primary care population of women aged 55 years and over with symptomatic mild pelvic organ prolapse., Design: Randomised controlled trial., Setting: Dutch primary care., Participants: Women aged 55 years or over with symptomatic mild prolapse (leading edge above the hymen) were identified by screening. Exclusion criteria were current prolapse treatment or treatment in the previous year, malignancy of pelvic organs, current treatment for another gynaecological disorder, severe/terminal illness, impaired mobility, cognitive impairment, and insufficient command of the Dutch language., Interventions: Pelvic floor muscle training versus watchful waiting., Main Outcome Measures: The 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 in symptoms., Results: Of the 287 women who were randomised to pelvic floor muscle training (n=145) or watchful waiting (n=142), 250 (87%) completed follow-up. Participants in the intervention group improved by (on average) 9.1 (95% confidence interval 2.8 to 15.4) points more on the PFDI-20 than did participants in the watchful waiting group (P=0.005). Of women in the pelvic floor muscle training group, 57% (82/145) reported an improvement in overall symptoms from the start of the study compared with 13% (18/142) in the watchful waiting group (P<0.001). Other secondary outcomes showed no significant difference between the groups., Conclusions: Although pelvic floor muscle training led to a significantly greater improvement in PFDI-20 score, the difference between the groups was below the presumed level of clinical relevance (15 points). Nevertheless, 57% of the participants in the intervention group reported an improvement of overall symptoms. More studies are needed to identify factors related to success of pelvic floor muscle training and to investigate long term effects.Trial registration Dutch Trial Register (www.trialregister.nl) identifier: NTR2047., (© Wiegersma et al 2014.)