Comprehensive management of pelvic floor dysfunction in women

Abstract

Objective: Advanced Practice Nurses (APRNs) in a urogynecology clinic are uniquely positioned to provide comprehensive, nonsurgical care for women with symptoms of pelvic floor dysfunction (PFD) including urinary, defecatory, and pelvic pain complaints. The aim of this study was to determine immediate and longterm effectiveness of comprehensive pelvic floor rehabilitative administered by an APRN. Methods: This study is a secondary analysis of a robust data set collected between February 2013 and February 2016. Data were analyzed on 406 subjects who completed up to five treatment sessions with an APRN, which included pelvic muscle biofeedback; vaginal electrogalvanic stimulation; behavior modification; and in some cases pessary fitting or pharmacologic intervention. Validated quality of life QOL instruments (e.g. PFDI-20 and PFIQ-7) and visual analog scale (VAS) were collected following initiation of treatment; and at six and twelve months. Results: Subjects experienced clinical and statistically significant improvement in QOL, which was durable at one year. VAS data revealed an 80% improvement in urinary, defecatory, and pain symptoms. Conclusion: Comprehensive nonsurgical management of women with symptoms of PFD by an NP is efficacious and results in improved QOL which is durable to one year.