Joanie Mercier1, Mélanie Morin2, Dina Zaki3, Barbara Reichetzer4, Marie-Claude Lemieux5, Samir Khalifé6, Chantale Dumoulin7. 1. School of rehabilitation, Faculty of Medicine, Université de Montréal, Institut Universitaire de Gériatrie de Montréal Research Center, 4565 Chemin Queen-Mary, Montreal, Qc, H3W 1W5, Canada. Electronic address: joanie.mercier.1@umontreal.ca. 2. Centre hospitalier universitaire de Sherbrooke Research Centre, School of Rehabilitation, Faculty of Medicine, University of Sherbrooke, 12e Avenue N, Sherbrooke, QC, J1H 5N4, Canada. Electronic address: melanie.m.morin@usherbrooke.ca. 3. Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC, H2X 0C1, Canada. Electronic address: dina.s.zaki@gmail.com. 4. Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, 1000 rue Saint-Denis, Montreal, QC, H2X 0C1, Canada. Electronic address: barbara.reichetzer.1@umontreal.ca. 5. Department of Obstetrics and Gynecology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de l'Assomption, Montreal, QC, H1T 2M4, Canada. Electronic address: mclemieuxmd@videotron.ca. 6. Department of Obstetrics and Gynecology, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, 3755 Chemin de la Côte-Sainte-Catherine, Montreal, QC H3T 1E2, Canada. Electronic address: skhalife@videotron.ca. 7. School of rehabilitation, Faculty of Medicine, Université de Montréal, Institut Universitaire de Gériatrie de Montréal Research Center, 4565 Chemin Queen-Mary, Montreal, Qc, H3W 1W5, Canada. Electronic address: chantal.dumoulin@umontreal.ca.
Abstract
OBJECTIVES: Treatments for genitourinary syndrome of menopause (GSM) may not be suitable for all women, may not be completely effective, and may cause adverse effects. Therefore, there is a need to explore new treatment approaches. The objectives were to evaluate the feasibility of using a pelvic floor muscle training (PFMT) program in postmenopausal women with GSM, and to investigate its effect on symptoms, signs, activities of daily living (ADL), quality of life (QoL) and sexual function. STUDY DESIGN:Postmenopausal women with GSM participated in a single-arm feasibility study embedded in a randomized controlled trial (RCT) on PFMT for urinary incontinence. This substudy was composed of two pre-intervention evaluations, a 12-week PFMT program and a post-intervention evaluation. MAIN OUTCOME MEASURES: Feasibility was defined as study completion and participation in physiotherapy sessions and in-home exercises. The effects of the PFMT program were assessed by measuring GSM symptoms ('Most Bothersome Symptom' approach, ICIQ-UI SF), GSM signs (Vaginal Health assessment scale), GSM's impact on ADL (Atrophy Symptom questionnaire), QoL and sexual function (ICIQ-VS, ICIQ-FLUTSsex) and leakage episodes. RESULTS:Thirty-two women participated. The study completion rate was high (91%), as was participation in treatment sessions (96%) and in-home exercises (95%). Post-intervention, there were significant reductions in GSM symptoms and signs (p < 0.01) as well as in its impacts on ADL, QoL and sexual function (p < 0.05). CONCLUSIONS: A study including a PFMT program is feasible, and the outcomes indicate PFMT to be an effective treatment approach for postmenopausal women with GSM and urinary incontinence. This intervention should be assessed through a RCT.
RCT Entities:
OBJECTIVES: Treatments for genitourinary syndrome of menopause (GSM) may not be suitable for all women, may not be completely effective, and may cause adverse effects. Therefore, there is a need to explore new treatment approaches. The objectives were to evaluate the feasibility of using a pelvic floor muscle training (PFMT) program in postmenopausal women with GSM, and to investigate its effect on symptoms, signs, activities of daily living (ADL), quality of life (QoL) and sexual function. STUDY DESIGN: Postmenopausal women with GSM participated in a single-arm feasibility study embedded in a randomized controlled trial (RCT) on PFMT for urinary incontinence. This substudy was composed of two pre-intervention evaluations, a 12-week PFMT program and a post-intervention evaluation. MAIN OUTCOME MEASURES: Feasibility was defined as study completion and participation in physiotherapy sessions and in-home exercises. The effects of the PFMT program were assessed by measuring GSM symptoms ('Most Bothersome Symptom' approach, ICIQ-UI SF), GSM signs (Vaginal Health assessment scale), GSM's impact on ADL (Atrophy Symptom questionnaire), QoL and sexual function (ICIQ-VS, ICIQ-FLUTSsex) and leakage episodes. RESULTS: Thirty-two women participated. The study completion rate was high (91%), as was participation in treatment sessions (96%) and in-home exercises (95%). Post-intervention, there were significant reductions in GSM symptoms and signs (p < 0.01) as well as in its impacts on ADL, QoL and sexual function (p < 0.05). CONCLUSIONS: A study including a PFMT program is feasible, and the outcomes indicate PFMT to be an effective treatment approach for postmenopausal women with GSM and urinary incontinence. This intervention should be assessed through a RCT.
Authors: María Del Carmen Carcelén-Fraile; Agustín Aibar-Almazán; Antonio Martínez-Amat; David Cruz-Díaz; Esther Díaz-Mohedo; María Teresa Redecillas-Peiró; Fidel Hita-Contreras Journal: Int J Environ Res Public Health Date: 2020-04-14 Impact factor: 3.390