Pelvic Floor Dysfunction Research: A Bibliometric Analysis with Retrospective Clinical Validation

Pelvic floor dysfunction (PFD), primarily manifesting as pelvic organ prolapse (POP) and urinary incontinence (UI), is a prevalent condition that severely impairs women's quality of life. While management strategies exist, outcomes are often suboptimal, highlighting the need for a deeper understanding of research trends and their clinical relevance.

This study employed a mixed-methods exploratory design. First, a comprehensive bibliometric analysis of 23,005 publications from the Web of Science Core Collection (2003-2023) was conducted to map the global PFD research landscape, identify key trends, and detect thematic shifts. Second, to contextualize these findings, a retrospective analysis of clinical outcomes from 350 women with moderate PFD who received standardized pelvic floor muscle training (PFMT) was performed. Pre- and post-treatment pelvic floor muscle function (via surface electromyography) and anatomical support (via perineal ultrasound) were compared.

Bibliometric analysis revealed a significant acceleration in publications after 2011, led by the United States, China, and the United Kingdom. Keyword analysis identified a clear thematic shift from a focus on surgical management (pre-2018) towards prevention, rehabilitation, and quality of life (post-2018), with PFMT emerging as a prominent research hotspot. The retrospective clinical analysis demonstrated that after one to two courses of PFMT, patients showed statistically significant improvements in muscle strength, endurance, and resting tone (all p < 0.01). These functional gains were corroborated by ultrasound evidence of pelvic organ elevation and a reduced levator hiatus area.

By synergistically integrating macro-level bibliometric trends with micro-level clinical evidence, this study provides a holistic overview of the evolving PFD research landscape. The alignment of a growing academic focus on conservative management with real-world clinical outcomes from a PFMT cohort suggests a paradigm shift towards function-oriented, patient-centered care and highlights its role as a cornerstone of PFD management.