Trial reportInternational urogynecology journal2023
Postpartum pelvic floor muscle training, levator ani avulsion and levator hiatus area: a randomized trial.
Trial report in International urogynecology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- The Risk Factors of Postpartum Urinary Retention for Women by Vaginal Birth: A Systematic Review and Meta-Analysis.International urogynecology journal · 2024Pooled it
- Effect of postpartum pessary use on pelvic floor function: a prospective multicenter study.Archives of gynecology and obstetrics · 2025Trial
- Levator hiatus area from 21 weeks' gestation to 8 years after first delivery according to vaginal parity: prospective cohort study with an 8-year recall extension.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2026Article
- Transperineal ultrasound versus digital palpation: Identifying key parameters for objective pelvic floor muscle contraction assessment.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Is There a Difference in Hiatal Area on Straining Between Type I and II Levator Avulsions?International urogynecology journal · 2026Observational
- Evaluation of the therapeutic effects of pelvic floor muscle training combined with electromagnetic stimulation on pelvic organ prolapse in elderly women using three-dimensional ultrasound parameters.International urology and nephrology · 2026Article
- Effects of Pelvic Floor Muscle Training in Pregnant and Postpartum Women: A Systematic Review.International urogynecology journal · 2026Review
- Hotspots and Trends in Research on Postpartum Pelvic Floor Dysfunction: A Visualization and Bibliometric Analysis Using CiteSpace.International urogynecology journal · 2026Review
- Pelvic Floor Adaptation to a Prenatal Exercise Program: Does It Affect Labor Outcomes or Levator Ani Muscle Injury? A Randomized Controlled Trial.Diagnostics (Basel, Switzerland) · 2025Article
- Women's experiences of life and healthcare after levator ani avulsion: a qualitative interview study.BMC women's health · 2025Article
- Unsupervised clustering analysis of treatment strategies for elite female athletes with severe stress urinary incontinence: focusing on competition return and SUI improvement.International urology and nephrology · 2025Article
- Review
- Analysis of Predictive Factors for Return to Sports in Female Athletes With Stress Urinary Incontinence.Cureus · 2023Article
- Long-Term Improvement in Urinary Incontinence in an Elite Female Athlete Through the Laser Treatment: A Case Report.Cureus · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisVaginal delivery may lead to tearing of the levator ani (LA) muscle from its bony insertions (complete LA avulsion) and increased levator hiatus (LH) area, both risk factors for pelvic floor dysfunctions. Early active rehabilitation is standard treatment after musculo-skeletal injury. We hypothesized that pelvic floor muscle training (PFMT) early postpartum would reduce the presence of LA avulsions and reduce LH area.
methodsWe carried out a planned secondary analysis from a randomized controlled study. Primiparous women (n=175) giving birth vaginally were included 6 weeks postpartum, stratified on complete LA avulsion, and thereafter randomized to PFMT or control. The training participants (n=87) attended a supervised PFMT class once a week and performed home-based PFMT daily for 16 weeks. The control participants (n=88) received no intervention. Presence of complete LA avulsion, LH area at rest, maximal contraction, and maximal Valsalva maneuver were assessed by transperineal ultrasound. Between-group comparisons were analyzed by analysis of covariance for continuous data, and relative risk (RR) for categorical data.
resultsSix months postpartum, the number of women who had complete LA avulsion was reduced from 27 to 14 within the PFMT group (44% reduction) and from 28 to 17 within the control group (39% reduction). The between-group difference was not significant, RR 0.85 (95% CI 0.53 to 1.37). Further, no significant between-group differences were found for LH area at rest, during contraction, or Valsalva.
conclusionsSupervised PFMT class combined with home exercise early postpartum did not reduce the presence of complete LA avulsion or LH area more than natural remission.
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