Practice and Costs of Pelvic Floor Rehabilitation: Analysis of the French National Health Data System

Pelvic floor rehabilitation is the first-line treatment for patients with pelvic floor disorders such as urinary incontinence or genital prolapse. This rehabilitation can be carried out by a midwife, a physiotherapist, or autonomously using various therapeutic tools. We aimed to characterize the profiles of patients who have access to it, as well as their associated care pathways.

Using the French National Health Data System (SNDS), we identified female patients aged 18 to 65 who underwent pelvic floor rehabilitation in France in 2022. We defined two populations: postpartum (patients with a history of childbirth within the previous 6 months) and nonpostpartum (patients without such a history within the previous 6 months). We described their management.

We identified 638,982 patients (58.7% postpartum) who benefited from pelvic floor rehabilitation. The average age was 45.0 ± 11.3 years in the nonpostpartum group and 32.0 ± 4.7 years in the postpartum group. The average number of rehabilitation sessions ranged from 6.6 to 14.9 depending on the care pathway and was below recommended levels. The proportion of patients undergoing new pelvic floor rehabilitation within the following year was 4.5% in the postpartum group and 7.9% in the nonpostpartum group. The average recurrence interval was 168 ± 68 days. Pelvic floor rehabilitation generated 4.8 million consultations for a total of €114 million.

This study highlights a diversity of practices in pelvic floor rehabilitation. The collection of clinical data linked to the SNDS could improve the understanding of these care pathways.