Pelvic Floor Muscle Training Following Surgery for Pelvic Organ Prolapse: Recommendation from Scientific Literature

Background: POP surgery improves anatomical support and quality of life, but urinary, bowel, sexual, and pain issues are common after surgery. The role of rehabilitation in addressing these problems is recognized, though not yet clearly defined. Objective: This scoping review aims to map the clinical evidence on conservative rehabilitation interventions for urinary, bowel, and sexual dysfunction, and pelvic pain after POP surgery. Methods: In accordance with PRISMA-ScR guidelines, we included randomized controlled trials, cohort studies, observational studies, and systematic reviews relevant to post-surgical rehabilitation options frequently encountered in clinical settings, including pelvic floor muscle training (PFMT), physiotherapy, and multimodal programs. Meta-analysis was not conducted due to clinical and methodological heterogeneity across the studies. Results: PFMT demonstrates beneficial effects on symptom severity and pelvic muscle function in women with POP. Postoperative rehabilitation may improve urinary continence, sexual function, and pelvic pain, although the strength of current evidence remains limited. Many studies prioritize surgical revision over conservative management, and the effectiveness of rehabilitation for persistent or de novo symptoms is not well established. Conclusions: Conservative rehabilitation, especially PFMT, may aid recovery and improve function after POP surgery. More research is needed to define the optimal protocols and to determine how to incorporate them into post-surgical care.