Nepalese data

Studies about the effect and results of pelvic floor muscle training in Nepali women with POP are rare despite the fact that pelvic floor muscle training is almost routinely advised. Recently, in a randomised controlled trial, a one-time intervention of an informational flipchart on pelvic floor muscle training and lifestyle advice showed to be effective in improving QOL and symptoms for Nepali women with a POPstage I-III.6 But the same researches highlighted in a small study the low knowledge of the pelvic floor muscle, and the bad results of a brief verbal instruction with an illustrative leaflet in teaching Nepali women how to correctly contract their pelvic floor muscle.8 Moreover, in a small study in a gynaecological population in Kathmandu it was shown that pelvic floor muscle strength and thickness were not related to POP I-IV.7

 

There are a few studies on the effect of pessary treatment. 

A study among 74 women in Baglung district with POPsymptoms, identified 47 women who got pessary treatment. In 9 women complications were reported: pessary extrusion (n=4), discharge (n=2), pain leading to removal of the pessary (n=4).1

Recently, a 1-year prospective cohort study was conducted in Ramecchap district.2In total 142 women with symptomatic POP were seen; of them 134 got a pessary. At the 1-year follow-up 130 women were evaluated. From them, 72 were still using the pessary (55.4%). The primary reason for discontinuation was the pessary falling out (n=35), uncomfortable (n=14), vaginal discharge (n=4). Among the women retaining the pessary, 18 had vaginal erosions. The authors conclude that pessaries were found to be an acceptable and feasible option with minimal complications for treating POP in rural Nepal.