Tratamento dos músculos do assoalho pélvico em casos de prolapso de órgãos pélvicos: um protocolo de revisão sistemática e meta-análise

Abstract

Introduction: Pelvic organ prolapse (POP) is a descent of vaginal structures, associated with symptoms such as a sensation of pelvic heaviness or pressure, vulvar volume, and urinary, sexual, and bowel dysfunctions. Risk factors such as age, multiparity, hormonal changes, and previous surgeries increase the likelihood of a person developing POP. Treatment can be conservative or surgical, with pelvic floor muscle training (PFMT) being effective in mild and moderate cases. However, the heterogeneity of protocols that exist in the literature still limits the standardization of recommendations. Objective: This systematic review and meta-analysis protocol aims to evaluate the effectiveness of PFMT in improving POP symptoms. Stages such as quality of life, satisfaction, psychological symptoms, and need for surgery will also be developed, comparing PFMT with control groups or other disciplines. Methodology: Systematic review and meta-analysis protocol registered in PROSPERO (CRD42024616277). Searches will be conducted in the PubMed/MEDLINE, SciELO, Web of Science, PEDro and Cochrane databases. Clinical trials with women over 18 years of age with POP, in which PFMT interventions are compared to other approaches, placebo or no intervention, will be included. Trials with POP in stage IV, pregnant women and postpartum women will be excluded. Expected Results: to identify studies with well-defined protocols, allowing the assessment of the impact of PFMT on prolapse severity and quality of life. The analysis may enable a meta-analysis to estimate the magnitude of the benefits. Despite the possible heterogeneity in measurement instruments and follow-up time, methodological consistency is expected in the studies. The results should provide support for clinical guidelines and point out important gaps, such as the scarcity of data on long-term follow-up and on poorly trained subgroups. Limitations related to publication view and variability in evaluation criteria will also be discussed in order to guide a careful interpretation of the findings.