Multicentre Randomised Controlled Trial of Pelvic Floor Muscle Training to Prevent Pelvic Organ Prolapse in Women (PREVPROL)

Pelvic organ prolapse is the descent of the female genital organs (uterus, bladder and rectum) from their normal anatomical position into the vagina.  A third of women aged 45 or older have some degree of pelvic organ prolapse, and by the age of 80, more than 1 in 10 women will have undergone surgery for prolapse. The condition can badly affect a woman's daily life limiting physical and sexual functioning.  Depending on its severity, it can cause pressure-like discomfort, and also, at times, pain and incontinence.
 
Pelvic organ prolapse has many causes but the underlying cause is lack of support from the pelvic floor muscles and other structures. Pelvic floor exercises and physiotherapy are frequently recommended to prevent pelvic organ prolapse but we have no evidence that these approaches are effective in preventing prolapse surgery or incontinence. There have been few intervention studies aimed at the prevention of prolapse and none with long-term follow up.
 
Currently a pilot for the study proposed here is underway in Dunedin, New Zealand. This trial will be carried out in centres in Aberdeen and Birmingham in the UK, which, together with Dunedin, will recruit 400 women and will form the definitive multicentre trial. It will determine whether a structured programme of pelvic floor exercises will prevent the need for surgery and incontinence and improve the symptoms of pelvic organ prolapse. It is expected that the results of this major and important trial will have a significant impact and transform the quality of life of the many women with this debilitating condition.

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