Efficacy of vaginal weights in pelvic floor dysfunction: A systematic review and meta-analysis

Deepthi Ganesan; Lavanya Prathap; Lee Zhi Ling; Yu ChyeWah; Prathap Suganthirababu; SankaraKumaran Pandian; Vinodhkumar Ramalingam

doi:10.53730/ijhs.v6nS3.5324

Authors

Deepthi Ganesan School of Physiotherapy, AIMST University, Malaysia
Lavanya Prathap Department of Anatomy, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
Lee Zhi Ling School of Physiotherapy, AIMST University, Malaysia
Yu ChyeWah Faculty of Allied Health Professions, AIMST University, Malaysia
Prathap Suganthirababu Saveetha College of Physiotherapy, Saveetha Institute of Medical and Technical Sciences, Chennai, India
SankaraKumaran Pandian School of Physiotherapy, AIMST University, Malaysia
Vinodhkumar Ramalingam
vinodh.ramalingam@newinti.edu.my
Department of Physiotherapy, Faculty of Health and Life Science, INTI International University, Malaysia

Keywords:

vaginal weights, vaginal cones, urinary incontinence, urge incontinence, vaginal prolapse, pelvic floor dysfunction

Abstract

Pelvic floor dysfunction (PFD) affects women's quality of life because the pelvic floor muscles are unable to contract and relax properly. Kegel exercise is the first line of treatment for PFD, while vaginal cones with weights have recently been used for pelvic floor strengthening. When compared to alternative treatments, various studies have evaluated the effectiveness of vaginal weights or cones in treating PFD. However, there are controversial conclusions reached when the effectiveness of vaginal weights is compared in various ways. The purpose of this study was determine the effectiveness of vaginal weights compared with other interventions in reducing the symptoms of PFD. Using various databases, an extensive literature search was conducted, and a randomised control trial examining the usefulness of vaginal weights in PFD was identified. PRISMA guidelines were used to synthesize the data. The risk of bias tools were used to assess the quality of the selected studies. Results suggest that vaginal cones are effective in treating PFD. However, when it was compared with other treatment modalities, no significant differences were found. Hence, the results are equivocal and cannot be generalized.

Downloads

Download data is not yet available.

References

Bø, K. (2015). Overview of physical therapy for pelvic floor dysfunction. In Evidence-Based Physical Therapy for the Pelvic Floor (pp. 1–8). https://doi.org/10.1016/b978-0-7020-4443-4.00001-7

Bo, K., Talseth, T., & Holme, I. (1999). Single blind, randomised controlled trial of pelvic floor exercises, electrical stimulation, vaginal cones, and no treatment in management of genuine stress incontinence in women. In BMJ (Vol. 318, Issue 7182, pp. 487–493). https://doi.org/10.1136/bmj.318.7182.487

Castro, R. A., Arruda, R. M., Zanetti, M. R. D., Santos, P. D., Sartori, M. G. F., &Girão, M. J. B. C. (2008). Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics , 63(4), 465–472.

Dieter, A. A., Wilkins, M. F., & Wu, J. M. (2015). Epidemiological trends and future care needs for pelvic floor disorders. In Current Opinion in Obstetrics & Gynecology (Vol. 27, Issue 5, pp. 380–384). https://doi.org/10.1097/gco.0000000000000200

Dur, R., Akkurt, İ., Coşkun, B., Dur, G., Çoşkun, B., Ünsal, M., &Sivaslıoğlu, A. A. (2019). The impact of vaginal cone therapy on stress urinary incontinence compared with transobturator tape. Turkish Journal of Obstetrics and Gynecology, 16(3), 169–173.

Eickmeyer, S. M. (2017). Anatomy and Physiology of the Pelvic Floor. Physical Medicine and Rehabilitation Clinics of North America, 28(3), 455–460.

Faubion, S. S., Shuster, L. T., &Bharucha, A. E. (2012). Recognition and management of nonrelaxing pelvic floor dysfunction. Mayo Clinic Proceedings. Mayo Clinic, 87(2), 187–193.

Gameiro, M. O., Moreira, E. H., Gameiro, F. O., Moreno, J. C., Padovani, C. R., & Amaro, J. L. (2010). Vaginal weight cone versus assisted pelvic floor muscle training in the treatment of female urinary incontinence. A prospective, single-blind, randomized trial. In International Urogynecology Journal (Vol. 21, Issue 4, pp. 395–399). https://doi.org/10.1007/s00192-009-1059-7

Golmakani, N., Khadem, N., Arabipoor, A., Kerigh, B. F., & Esmaily, H. (2014). Behavioral Intervention Program versus Vaginal Cones on Stress Urinary Incontinence and Related Quality of Life: A Randomized Clinical Trial. In Oman Medical Journal (Vol. 29, Issue 1, pp. 32–38). https://doi.org/10.5001/omj.2014.08

Higgins, J.P.T., Savović, J., Page, M.J., Elbers, R.G., Sterne, J.A.C. (2021). Chapter 8: Assessing risk of bias in a randomized trial. In: Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA (editors). Cochrane Handbook for Systematic Reviews of Interventions version 6.2 (updated February 2021). Cochrane, 2021. Available from www.training.cochrane.org/handbook.

Jundt, K., Peschers, U., & Kentenich, H. (2015). The Investigation and Treatment of Female Pelvic Floor Dysfunction. In Deutsches Aerzteblatt Online. https://doi.org/10.3238/arztebl.2015.0564

Kuo, L.-J., Lin, Y.-C., Lai, C.-H., Lin, Y.-K., Huang, Y.-S., Hu, C.-C., & Chen, S.-C. (2015). Improvement of fecal incontinence and quality of life by electrical stimulation and biofeedback for patients with low rectal cancer after intersphincteric resection. Archives of Physical Medicine and Rehabilitation, 96(8), 1442–1447.

Madill, S. J., & McLean, L. (2008). Quantification of abdominal and pelvic floor muscle synergies in response to voluntary pelvic floor muscle contractions. In Journal of Electromyography and Kinesiology (Vol. 18, Issue 6, pp. 955–964). https://doi.org/10.1016/j.jelekin.2007.05.001

Oblasser, C., Christie, J., & McCourt, C. (2015). Vaginal cones or balls to improve pelvic floor muscle performance and urinary continence in women post partum: A quantitative systematic review. In Midwifery (Vol. 31, Issue 11, pp. 1017–1025). https://doi.org/10.1016/j.midw.2015.08.011

Page, M.J., McKenzie, J.E., Bossuyt, P.M., Boutron, I., Hoffmann, T.C., Mulrow, C.D. et al. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372:n71. doi: 10.1136/bmj.n71

Santos, P. F. D., Oliveira, E., Zanetti, M. R. D., Arruda, R. M., Sartori, M. G. F., Girão, M. J. B. C., & Castro, R. A. (2009). [Electrical stimulation of the pelvic floor versus vaginal cone therapy for the treatment of stress urinary incontinence]. Revistabrasileira de ginecologia e obstetricia: revista da FederacaoBrasileira das Sociedades de Ginecologia e Obstetricia, 31(9), 447–452.

Schulz, K. F. (2001). Assessing allocation concealment and blindingin randomised controlled trials: why bother?” Evidence-Based Nursing, 4 (1), 4–6.

Sedgwick, P., & Marston, L. (2015). How to read a funnel plot in a meta-analysis. BMJ , 351, h4718.

Seo, J. T., Yoon, H., & Kim, Y. H. (2004). A Randomized Prospective Study Comparing New Vaginal Cone and FES-Biofeedback. In Yonsei Medical Journal, Vol. 45, Issue 5, p. 879. https://doi.org/10.3349/ymj.2004.45.5.879

Sterne, J.A., & Egger, M. (2001). Funnel plots for detecting bias in meta-analysis: Guidelines on choice of axis. Journal of Clinical Epidemiology, 54, 1046-1055.

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., Hernán, M.A., Hopewell, S., Hróbjartsson, A., Junqueira, D.R., Jüni, P., Kirkham, J.J., Lasserson, T., Li, T., McAleenan, A., Reeves. B.C., Shepperd, S., Shrier, I., Stewart, L.A., Tilling, K., White, I.R., Whiting, P.F., Higgins, J.P.T. (2019).RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ, 366, l4898.

Stüpp, L., Resende, A. P. M., Oliveira, E., Castro, R. A., Girão, M. J. B. C., & Sartori, M. G. F. (2011). Pelvic floor muscle training for treatment of pelvic organ prolapse: an assessor-blinded randomized controlled trial. International Urogynecology Journal, 22(10), 1233–1239.

Wallace, S. L., Miller, L. D., & Mishra, K. (2019). Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics & Gynecology, 31(6), 485–493.

Wiegersma, M., Panman, C. M. C. R., Kollen, B. J., Berger, M. Y., Lisman-Van Leeuwen, Y., & Dekker, J. H. (2014). Effect of pelvic floor muscle training compared with watchful waiting in older women with symptomatic mild pelvic organ prolapse: randomised controlled trial in primary care. BMJ , 349, g7378.

Williams, K. S., Assassa, R. P., Gillies, C. L., Abrams, K. R., Turner, D. A., Shaw, C., Haslam, J., Mayne, C., McGrother, C. W., & Leicestershire MRC Incontinence Study Team. (2006). A randomized controlled trial of the effectiveness of pelvic floor therapies for urodynamic stress and mixed incontinence. BJU International, 98(5), 1043–1050.