EFFECTIVENESS OF PELVIC FLOOR STRENGTHENING PROGRAMS IN THE EARLY WEEKS POSTPARTUM: A SYSTEMATIC REVIEW
Keywords:
pelvic floor; urinary incontinence; postpartum period; pelvic organ prolapse; rehabilitationAbstract
DOI: https://doi.org/10.46296/gt.v9i18edespsep.0450
Abstract
The objective of this studio is to synthesize the available evidence on the effectiveness of pelvic floor strengthening programs (Kegel exercises and/or biofeedback and/or electrical stimulation) started in the early postpartum period on urinary incontinence (UI) and pelvic organ prolapse (POP), compared with usual care; Methods: systematic review with searches in PubMed and Scopus (records exported in August 2026), following the PRISMA 2020 methodology; 197 records were identified, of which 143 were screened after removing duplicates, and 20 randomized controlled trials (RCTs) met the eligibility criteria; Results: most RCTs reported significant improvements in pelvic floor strength after structured training; the effect on UI was heterogeneous, with significant reductions versus usual care or general education in several trials, but no differences versus an active comparator in others; evidence on POP was scarce and mostly showed no significant between-group differences; Conclusion: early postpartum pelvic floor training consistently improves muscle strength, but its effect on urinary incontinence depends on the type of comparator and the intensity of the intervention; evidence on pelvic organ prolapse remains limited, and higher-quality RCTs with long-term follow-up are needed.
Keywords: pelvic floor; urinary incontinence; postpartum period; pelvic organ prolapse; rehabilitation.
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References
Adriana Peinado-Molina, R., Hernández-Martínez, A., Martínez-Vázquez, S., Rodríguez-Almagro, J., & Miguel Martínez-Galiano, J. (2023). RESEARCH Open Access Pelvic floor dysfunction: prevalence and associated factors. https://doi.org/10.1186/s12889-023-16901-3
Bø, K., Anglès-Acedo, S., Batra, A., Brækken, I. H., Chan, Y. L., Jorge, C. H., Kruger, J., Yadav, M., & Dumoulin, C. (2022). International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training. International Urogynecology Journal, 33(10), 2633–2667. https://doi.org/10.1007/s00192-022-05324-0
Chu, L., Jin, X., Wu, S., Tong, X., Li, H., & Chen, X. (2024). Effect of Pelvic Floor Muscle Training With Smartphone Reminders on Women in the Postpartum Period: A Randomized Controlled Trial. Urogynecology, 30(2), 138–146. https://doi.org/10.1097/SPV.0000000000001401
Danesh Shahraki, A., Hajhashemi, M., Movahedi, M., & Abbasi, F. (2025). Correlation between Delivery Type and Pelvic Floor Dysfunction: A Case-Control Study. Advanced Biomedical Research, 14(1). https://doi.org/10.4103/abr.abr_548_24
Ginnane, J. F., Aziz, S., Sultana, S., Allen, C. L., McDougall, A., Eddy, K. E., Scott, N., & Vogel, J. P. (2024). The cost-effectiveness of preventing, diagnosing, and treating postpartum haemorrhage: A systematic review of economic evaluations. PLoS Medicine, 21(9 September). https://doi.org/10.1371/journal.pmed.1004461
Monteiro, F., Antunes, P., Pereira, M., Canavarro, M. C., & Fonseca, A. (2022). Cost-utility of a web-based intervention to promote maternal mental health among postpartum women presenting low risk for postpartum depression. International Journal of Technology Assessment in Health Care, 38(1), e62. https://doi.org/10.1017/S0266462322000447
Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women - Woodley, SJ - 2020 | Cochrane Library. (s/f). Recuperado el 22 de agosto de 2026, de https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007471.pub4/full
Pérez Gómez, J. R., & Hernández Pérez, J. (2026). Efectos de la sutura continua vs discontinua en la reparación perineal posparto: revisión bibliográfica. Nure Investigación. https://doi.org/10.58722/nure.v23i142.2698
Reyes, C., José, E., De, E., Zegel, N., Medina, B., & Felipe, R. (2025). Estructuras metodológicas PICO y PRISMA 2020 en la elaboración de artículos de revisión sistemática: Lo que todo investigador debe conocer y dominar. Ciencia Latina Revista Científica Multidisciplinar, 9(1), 8525–8543. https://doi.org/10.37811/CL_RCM.V9I1.16491
Sacomori, C., Araya-Castro, P., Sperandio, F. F., Zomkowski, K., & Dantas, D. (2024). Pelvic Floor Physiotherapy and its Research Development in the Continuum of Gynecological, Prostate, and Colorectal Cancer Care. 411–440. https://doi.org/10.1007/16833_2024_205
Sigurdardottir, T., Steingrimsdottir, T., Geirsson, R. T., Halldorsson, T. I., Aspelund, T., & Bø, K. (2023). Postpartum pelvic organ prolapse and pelvic floor muscle training: secondary analysis of a randomized controlled trial of primiparous women. International Urogynecology Journal 2023 34:6, 34(6), 1319–1326. https://doi.org/10.1007/S00192-023-05502-8
Sitaraman, L., Lewicky-Gaupp, C., & Rao, S. S. C. (2025). Postpartum Anorectal and Pelvic Floor Disorders: Evaluation, Treatment, and Prevention. En Current Gastroenterology Reports (Vol. 27, Número 1). Springer. https://doi.org/10.1007/s11894-025-01000-7
Alahmri, L. M., & Embaby, H. (2024). Effect of home-based core exercises on postpartum stress urinary incontinence during COVID-19 pandemic in Jeddah city: A randomised control trial. Physiotherapy Quarterly. https://doi.org/10.5114/pq.2024.135420
Bø, K., Anglès-Acedo, S., Batra, A., Brækken, I. H., Chan, Y. L., Jorge, C. H., Kruger, J., Yadav, M., & Dumoulin, C. (2022). International urogynecology consultation chapter 3 committee 2; conservative treatment of patient with pelvic organ prolapse: Pelvic floor muscle training. International Urogynecology Journal. https://doi.org/10.1007/s00192-022-05324-0
Campbell, M., McKenzie, J. E., Sowden, A., Katikireddi, S. V., Brennan, S. E., Ellis, S., Hartmann-Boyce, J., Ryan, R., Shepperd, S., Thomas, J., Welch, V., & Thomson, H. (2020). Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. BMJ, 368, l6890. https://doi.org/10.1136/bmj.l6890
Chu, L., Jin, X., Wu, S., Tong, X., Li, H., & Chen, X. (2024). Effect of pelvic floor muscle training with smartphone reminders on women in the postpartum period: A randomized controlled trial. Urogynecology. https://doi.org/10.1097/SPV.0000000000001401
Dai, J., Jin, Z., Zhang, X., Lian, F., & Tu, J. (2024). Efficacy of warm acupuncture therapy combined with Kegel exercise on postpartum pelvic floor dysfunction in women. International Urogynecology Journal. https://doi.org/10.1007/s00192-023-05698-9
Fernandes, A. C. N. L., Jorge, C. H., Weatherall, M., Ribeiro, I. V., Wallace, S. A., & Hay-Smith, E. J. C. (2025). Pelvic floor muscle training with feedback or biofeedback for urinary incontinence in women. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD009252.pub2
He, X., Xie, Y., Xie, B., Zhao, M., Zhang, H., Zhao, X., & Zhao, H. (2025). Use of mobile fitness app to improve pelvic floor muscle training in puerperal women with gestational diabetes mellitus: A randomized controlled trial. Health Informatics Journal. https://doi.org/10.1177/14604582251316774
Jin, Z., Li, W., Tu, J., Yan, L., & Chen, Y. (2026). Effects of Kegel training combined with acupoint application in preventing postpartum pelvic floor dysfunction: A randomized controlled trial. African Journal of Reproductive Health. https://doi.org/10.29063/ajrh2026/v30i9s.3
Khorasani, F., Ghaderi, F., Bastani, P., Sarbakhsh, P., & Berghmans, B. (2020). The effects of home-based stabilization exercises focusing on the pelvic floor on postnatal stress urinary incontinence and low back pain: A randomized controlled trial. International Urogynecology Journal. https://doi.org/10.1007/s00192-020-04284-7
Lange, S., Lange, R., Tabibi, E., Hitschold, T., Müller, V. I., & Naumann, G. (2024). Comparison of vaginal pessaries to standard care or pelvic floor muscle training for treating postpartum urinary incontinence: A pragmatic randomized controlled trial. Geburtshilfe und Frauenheilkunde. https://doi.org/10.1055/a-2243-3784
Li, C., & Li, K. (2024). Effect of pelvic floor muscle exercise combined with infrared physiotherapy on postpartum urinary incontinence. Technology and Health Care. https://doi.org/10.3233/THC-240831
Li, Y., Bai, W., Zhang, J., & Zhang, R. (2024). Biofeedback electrical stimulation therapy in the rehabilitation of pelvic floor function after vaginal delivery: A clinical randomized controlled study. Chinese General Practice. https://doi.org/10.12114/j.issn.1007-9572.2023.0354
Movahedi, M., Torabipoor, M. S., Mohammadi, M. S., Shariat, M., Haghollahi, F., & Hajihashem, M. (2021). The effect of postpartum physiotherapy on sexual function and incontinence of primiparous women in Al-Zahra and Shahid Beheshti hospitals of Isfahan: A randomized clinical trial. Tehran University Medical Journal.
Nahid, R., Mahsa, B., Alimohammadi, N., & Samar, M. (2024). The effect of Kegel exercises and pelvic floor physiotherapy on the improvements of stress urinary incontinence and urge incontinence in women with normal vaginal delivery. Current Women's Health Reviews. https://doi.org/10.2174/1573404820666230517153716
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., ... Moher, D. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https://doi.org/10.1136/bmj.n71
Rao, L., Zhang, L., Yuan, J., & Lu, B. (2023). Effect of postpartum pelvic floor muscle training on improving pelvic floor function. Journal of Shanghai Jiao Tong University (Medical Science). https://doi.org/10.3969/j.issn.1674-8115.2023.03.006
Sacomori, C., Zomkowski, K., dos Passos Porto, I., Cardoso, F. L., & Sperandio, F. F. (2020). Adherence and effectiveness of a single instruction of pelvic floor exercises: A randomized clinical trial. International Urogynecology Journal. https://doi.org/10.1007/s00192-019-04032-6
Sigurdardottir, T., Steingrimsdottir, T., Geirsson, R. T., Halldorsson, T. I., Aspelund, T., & Bø, K. (2020). Can postpartum pelvic floor muscle training reduce urinary and anal incontinence?: An assessor-blinded randomized controlled trial. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2019.09.011
Sigurdardottir, T., Steingrimsdottir, T., Geirsson, R. T., Halldorsson, T. I., Aspelund, T., & Bø, K. (2023). Postpartum pelvic organ prolapse and pelvic floor muscle training: Secondary analysis of a randomized controlled trial of primiparous women. International Urogynecology Journal. https://doi.org/10.1007/s00192-023-05502-8
Sterne, J. A. C., Savović, J., Page, M. J., Elbers, R. G., Blencowe, N. S., Boutron, I., Cates, C. J., Cheng, H.-Y., Corbett, M. S., Eldridge, S. M., Emberson, J. R., Hernán, M. A., Hopewell, S., Hróbjartsson, A., Junqueira, D. R., Jüni, P., Kirkham, J. J., Lasserson, T., Li, T., ... Higgins, J. P. T. (2019). RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ, 366, l4898. https://doi.org/10.1136/bmj.l4898
Wang, J., & An, D. (2023). Effect of Internet combined with pelvic floor muscle training on postpartum urinary incontinence. International Urogynecology Journal. https://doi.org/10.1007/s00192-023-05561-x
Wang, X., Qiu, J., Li, D., Wang, Z., Yang, Y., Fan, G., Mao, X., Wang, J., Gao, S., Zhu, X., Xu, T., & Sun, Z. (2024). Pressure-mediated biofeedback with pelvic floor muscle training for urinary incontinence: A randomized clinical trial. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2024.42925
Wang, X., Xu, X., Luo, J., Chen, Z., & Feng, S. (2020). Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas: A randomized controlled trial. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2020.103527
Woodley, S. J., Lawrenson, P., Boyle, R., Cody, J. D., Mørkved, S., Kernohan, A., & Hay-Smith, E. J. C. (2020). Pelvic floor muscle training for preventing and treating urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007471.pub4
Wu, T.-F., Huang, L.-H., Lai, Y.-F., Chen, G.-D., & Ng, S.-C. (2021). Early postpartum biofeedback assisted pelvic floor muscle training in primiparous women with second degree perineal laceration: Effect on sexual function and lower urinary tract symptoms. Taiwanese Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.tjog.2020.11.011
Xiao, X., Zhang, C.-H., Yang, Y.-M., Yan, W.-W., Li, X.-J., & Shang, H.-L. (2025). Innovative application of mobile health management combined with the teach-back method in the rehabilitation of pelvic floor muscle in postpartum women with urinary incontinence. International Urogynecology Journal. https://doi.org/10.1007/s00192-025-06229-4
Zhang, R., Guo, Y., Zhang, J., Zhang, J., Zhuang, R., Liao, C., & Bo, H. (2025). Effectiveness of telehealth pelvic-abdominal mechanics training rehabilitation program for pelvic floor rehabilitation in puerperal women: A randomized controlled study. European Journal of Physical and Rehabilitation Medicine. https://doi.org/10.23736/S1973-9087.25.08971-3
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