Implementation and evidence-based pelvic floor muscle training intervention for women with pelvic organ prolapse


To maximise the delivery of effective PFMT for women with prolapse through the study of its implementation in three diverse settings using an evidence-based PFMT protocol. This will involve developing different service delivery models, incorporating a variety of staff skill mixes and number of sessions to increase capacity, with the format of delivery being determined locally.

To assess the impact of PFMT on longer-term treatment outcomes using linked healthcare data for the majority of the original POPPY trial participants (i.e. those based in Scotland).


Pelvic Organ Prolapse (POP) is estimated to affect 41%-50% of women aged over 40. The Pelvic Organ Prolapse Physiotherapy (POPPY) trial was a multi-centre randomised controlled trial of the effectiveness and cost-effectiveness of individualised pelvic floor muscle training (PFMT) compared to a lifestyle advice leaflet in newly-diagnosed women with stages I- III pelvic organ prolapsed (POP). Individualised PFMT was effective in reducing symptoms of prolapse, provided improvements in quality of life and showed clear potential to be cost-effective.

Despite this evidence, provision of PFMT for POP continues to vary across the UK, possibly because of the limited numbers of physiotherapists in some areas with specialist training in pelvic floor dysfunction/women’s health. Implementation of the robust evidence from the POPPY trial will be of benefit to large numbers of women but needs attention to different models of delivery to fit with differing care environments. Research is required to support the implementation of PFMT as a first line treatment for POP.

This project aims to study implementation and outcomes of different models of delivery, using different staff skill mixes such as Grade 5 Physiotherapists and continence/women’s health nurses to increase service provision of PFMT across contrasting NHS sites. Greater Glasgow & Clyde, Highlands and Leicestershire.

Principal Investigator: Professor Margaret Maxwell

NMAHP Research Unit Collaborators: Dr Karen Semple, Sarah Wane, Dr Edward Duncan, Dr Andrew Elders, Professor Suzanne Hagen, Eileen Calveley

External Collaborators: Abhyankar P, University of Stirling, Glazener C - University of Aberdeen, Gordon D - Bowel and Bladder Foundation,  Guerrero K - NHS Greater Glasgow and Clyde, Lough K - NHS Greater Glasgow and Clyde, Mason H - Glasgow Caledonian University, Stark D - University Hospitals of Leicester NHS Trust, Wilkinson J - University of Stirling.

Funder: NIHR

Project Website