The Effect of Physiotherapy Interventions Following Surgery for Pelvic Organ Prolapse: An Umbrella Review

Background In pelvic organ prolapse (POP), a common condition requiring surgical intervention, physiotherapy interventions including pelvic floor muscle training (PFMT) may improve recovery. Objectives The objective of this umbrella review was to provide a comprehensive synthesis of existing systematic reviews (SRs) of randomised controlled trials (RCTs) evaluating the effect of physiotherapy interventions following POP surgery compared to no physiotherapy intervention on POP symptoms, quality of life (QOL) and pelvic floor muscles (PFM) strength. Search Strategy A literature search was conducted in PubMed, Google Scholar, and the CRD database from inception to 1st January 2025, using search terms capturing SRs on pelvic organ prolapse, surgery, physiotherapy, and pelvic floor muscle training. Selection Criteria SRs of RCTs assessing physiotherapy interventions after POP surgery compared to a control group without physiotherapy were included. Data Collection and Analysis Corrected Covered Area (CCA) analysis addressed the degree of RCT overlap among the included systematic reviews. Methodological quality was assessed using AMSTAR 2 and ROBIS tools, and evidence was graded. Main Results A total of 8 SRs were included, with 11 unique RCTs. CCA was 28%, indicating a very high degree of overlap. AMSTAR‐2 assessment showed that all SRs were low or critically low, and ROBIS assessment showed that 3 out of 8 reviews had a low risk of bias. The graded evidence was mixed with variable methodological quality and heterogeneity. The effect of physiotherapy intervention (PFMT) on POP symptoms, QOL and PFM strength was mostly uncertain but one meta‐analysis with heterogeneity showed a statistically significant effect on QOL ( p = 0.03). Conclusion This umbrella review identified mixed‐grade evidence with a proportion of results in favour of PFMT on the outcomes POP symptoms, QOL and PFM strength. New high‐quality RCTs are needed to establish the role of PFMT.