{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:04:49Z","timestamp":1790949889904,"version":"4.1.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"11","funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 HD41249"],"award-info":[{"award-number":["U01 HD41249"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD41250"],"award-info":[{"award-number":["U10 HD41250"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD41261"],"award-info":[{"award-number":["U10 HD41261"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD41267"],"award-info":[{"award-number":["U10 HD41267"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD54136"],"award-info":[{"award-number":["U10 HD54136"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD54214"],"award-info":[{"award-number":["U10 HD54214"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD54215"],"award-info":[{"award-number":["U10 HD54215"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01 HD069031"],"award-info":[{"award-number":["U01 HD069031"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U10 HD54241"],"award-info":[{"award-number":["U10 HD54241"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>There is significant need for trials evaluating the long-term effectiveness of a rigorous program of perioperative behavioral therapy with pelvic floor muscle training (BPMT) in women undergoing transvaginal reconstructive surgery for prolapse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The purpose of this study was to evaluate the effect of perioperative BPMT on health-related quality of life (HRQOL) and sexual function following vaginal surgery for pelvic organ prolapse (POP) and stress urinary incontinence (SUI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This study is a secondary report of a 2 \u00d7 2 factorial randomized controlled trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>This study was a multicenter trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Participants were adult women with stage 2\u20134 POP and SUI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention<\/jats:title>\n                  <jats:p>Perioperative BPMT versus usual care and sacrospinous ligament fixation (SSLF) versus uterosacral ligament suspension (ULS) were provided.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Measurements<\/jats:title>\n                  <jats:p>Participants undergoing transvaginal surgery (SSLF or ULS for POP and a midurethral sling for SUI) received usual care or five perioperative BPMT visits. The primary outcome was change in body image and in Pelvic Floor Impact Questionnaire (PFIQ) short-form subscale, 36-item Short-Form Health Survey (SF-36), Pelvic Organ Prolapse-Urinary Incontinence Sexual Questionnaire short form (PISQ-12), Patient Global Impression of Improvement (PGII), and Brink scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The 374 participants were randomized to BPMT (n\u00a0=\u00a0186) and usual care (n\u00a0=\u00a0188). Outcomes were available for 137 (74%) of BPMT participants and 146 (78%) of the usual care participants at 24 months. There were no statistically significant differences between groups in PFIQ, SF-36, PGII, PISQ-12, or body image scale measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>The clinicians providing BPMT had variable expertise. Findings might not apply to vaginal prolapse procedures without slings or abdominal apical prolapse procedures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Perioperative BPMT performed as an adjunct to vaginal surgery for POP and SUI provided no additional improvement in QOL or sexual function compared with usual care.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzx077","type":"journal-article","created":{"date-parts":[[2017,7,26]],"date-time":"2017-07-26T03:11:09Z","timestamp":1501038669000},"page":"1075-1083","source":"Crossref","is-referenced-by-count":15,"title":["Perioperative Behavioral Therapy and Pelvic Muscle Strengthening Do Not Enhance Quality of Life After Pelvic Surgery: Secondary Report of a Randomized Controlled Trial"],"prefix":"10.1093","volume":"97","author":[{"given":"Alison C.","family":"Weidner","sequence":"first","affiliation":[{"name":"A.C. Weidner, MD, Department of Obstetrics and Gynecology, Duke University Medical Center, 5324 McFarland Dr, Suite 310, Durham, NC 27707 (USA)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Barber","sequence":"additional","affiliation":[{"name":"M.D. Barber, MD, MHS, Department of Obstetrics\/Gynecology and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alayne","family":"Markland","sequence":"additional","affiliation":[{"name":"A. Markland, MD, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Rahn","sequence":"additional","affiliation":[{"name":"D.D. Rahn, MD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Hsu","sequence":"additional","affiliation":[{"name":"Y. Hsu, MD, Department of Obstetrics and Gynecology, University of Utah Medical Center, Salt Lake City, Utah."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R.","family":"Mueller","sequence":"additional","affiliation":[{"name":"Elizabeth R. Mueller, MD, Department of Urology, Loyola University Medical Center Stritch School of Medicine, Chicago, Illinois."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Jakus-Waldman","sequence":"additional","affiliation":[{"name":"Sharon Jakus-Waldman, MD, MPH, Department of Obstetrics and Gynecology, Southern California Kaiser Permanente, Downey, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisha Y.","family":"Dyer","sequence":"additional","affiliation":[{"name":"K.Y. Dyer, MD, MPH, Department of Obstetrics and Gynecology, Kaiser Permanente San Diego Medical Center, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren Klein","family":"Warren","sequence":"additional","affiliation":[{"name":"Lauren Klein Warren, MS, Social, Statistical, and Environmental Sciences, RTI International, Research Triangle Park, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie G.","family":"Gantz","sequence":"additional","affiliation":[{"name":"Marie G. 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