Multidisciplinary team approach to pelvic floor disorders: A systematic review

Pelvic floor disorders (PFDs) severely and negatively impact on quality of life, affecting physical, psychological, and social well-being. Historically, PFDs have been managed within single-specialty frameworks, yet the complexity of these conditions often necessitates a comprehensive, multidisciplinary team (MDT) approach. This systematic review assesses the effectiveness of MDT strategies in improving outcomes for individuals with PFDs, aiming to identify the benefits and potential advantages of integrated, multi-specialty care for these complex conditions.

Following PRISMA guidelines, a systematic search of PubMed, EMBASE, and Cochrane CENTRAL was conducted through September 25, 2024. Inclusion criteria were studies of adult patients with PFDs in which MDT protocols were integrated for diagnosis, treatment, or rehabilitation. Eligible studies included comparisons between MDT and non-MDT care, as well as studies without a comparison group. Outcomes of interest were patient-reported outcomes, therapy adherence, complication rates, and recurrence rates. Three independent reviewers screened titles and abstracts for eligibility, with discrepancies resolved through discussion to reach a consensus. Data extraction was independently performed by two reviewers, and any discrepancies were adjudicated by a third reviewer.

In total, 24 studies conducted across various countries were included, comprising 21 retrospective cohort studies, 2 prospective cohort studies, and 1 randomized controlled trial (RCT), with sample sizes ranging from 36 to 3600 patients. The findings generally indicate favorable outcomes with an MDT approach, including enhanced surgical results, greater symptom relief, reduced recurrence and complication rates following surgical interventions, improved treatment adherence, and high patient satisfaction.

An MDT approach offers benefits for PFD management, improving patient-reported outcomes, treatment adherence, and quality of life. This review supports the broader adoption of MDT approaches for comprehensive PFD management. Further research is warranted to confirm long-term effectiveness and standardize MDT protocols.