Clinical and MRI changes of puborectalis and iliococcygeus after a short period of intensive pelvic floor muscles training with or without instrumentation. A randomized study

Abstract

PurposeThis study evaluates the impact of a 3-week period of intensive pelvic floor muscles training (PFMT), with or without instrumentation, on clinical and static magnetic resonance imaging (MRI) changes of puborectalis (PR) and iliococcygeus (IL) muscles.\n\nMethods24 healthy young 5 women were enrolled in the study and 17 achieved the 9 sessions of 30 minutes training exercises and conducted all assessments. Participants were randomly assigned in two training groups: voluntary contractions combined with hypopressive exercises (HYPO) or biofeedback exercises combined with transvaginal electrical stimulations (ELEC). Clinical and T2-weighted MRI assessments io were realized before and after training.\n\nResultsModified Oxford Grading System (MOGS) scores for left PR and perineal body significantly increased in the two groups (p=0.039, p=0.008), but MOGS score for right PR significantly increased only in HYPO (p=0.020). Muscle volumes of right and left IL significantly decreased (p=0.040, p=0.045) after training as well as signal i5 intensities of right and left PR (p=0.040, p=0.021) and thickness of right and left IL at mid-vagina location (p=0.012, p=0.011).\n\nConclusionsA short period of intensive PFMT induces clinical and morphological changes in PFMs at rest suggesting a decrease in IL volume and adipose content of PR. Given the difference in cost and accessibility between HYPO and ELEC approaches, PFMT should be based primarily on non-instrumented exercises.