Pelvic Floor Exercises for Suboptimal Anorectal Manometry

Launched by KING'S COLLEGE HOSPITAL NHS TRUST · Jul 3, 2025

Keywords

ClinConnect Summary

This clinical trial is studying whether guided pelvic floor exercises can help women who have had an injury to the muscles around the anus during childbirth, known as an obstetric anal sphincter injury. These injuries can sometimes cause weakness in the muscles that control bowel movements. The study aims to see if doing special exercises with the help of a trained physiotherapist can improve muscle strength and function. If successful, this might give women more options for future deliveries, potentially allowing a safe vaginal birth instead of needing a planned Caesarean section.

Women who are eligible for this study are those who had this type of injury in their most recent delivery, are at least six weeks postpartum, and have not yet had guided pelvic floor exercises with a specialist. They should be able to understand and communicate in English (or have an interpreter) and be willing to attend clinic visits and complete questionnaires about their symptoms. Women who had the injury over a year ago, had another vaginal birth after the injury, are currently pregnant, or have conditions that make it hard to do pelvic floor exercises would not be eligible. Participants can expect to receive guidance on pelvic floor exercises and undergo tests to measure muscle strength before and after the exercise program to see if there is improvement.

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• 1. Female patients who have sustained an obstetric anal sphincter injury after their most recent delivery and:
• • 1. Are at least 6 weeks postpartum
• • 2. Has not received any form of guided pelvic floor exercises by a licensed women's health physiotherapist postpartum
• • 2. Either able to speak, read and write in English, or has a professional interpreter present at the time of appointment.
• • 3. Capable of understanding and signing the informed consent form after full discussion of the investigations and its risks and benefits.
• • 4. Able and willing to complete the St Mark's Score, ICIQ-UI SF and other trial related questionnaires, comply with scheduled clinic visits and manometry studies.
• Exclusion Criteria:
• • Inclusion Criteria
• 1. Female patients who have sustained an obstetric anal sphincter injury after their most recent delivery and:
• • 1. Are at least 6 weeks postpartum
• • 2. Has not received any form of guided pelvic floor exercises by a licensed women's health physiotherapist postpartum
• • 2. Either able to speak, read and write in English, or has a professional interpreter present at the time of appointment.
• • 3. Capable of understanding and signing the informed consent form after full discussion of the investigations and its risks and benefits.
• • 4. Able and willing to complete the St Mark's Score, ICIQ-UI SF and other trial related questionnaires, comply with scheduled clinic visits and manometry studies.
• • Exclusion Criteria
• • 1. Women who have sustained an obstetric anal sphincter injury more than a year ago
• • 2. Women who have had another vaginal delivery after sustaining an obstetric anal sphincter injury in a previous delivery.
• • 3. Existing anal pain precluding anorectal examination
• • 4. Existing neurological, musculoskeletal disorders which impedes ability to perform pelvic floor muscle exercises
• • 5. Age \<18 years old
• • 6. Currently pregnant
• • 7. Inability to comply with pelvic floor muscle exercises