Pelvic floor exercise program for weak anal sphincter after childbirth

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is an observational program enrolling women at least six weeks after an obstetric anal sphincter injury who have suboptimal anorectal manometry results. Participants complete baseline questionnaires and manometry, then attend a supervised course of pelvic floor muscle exercises with a women's health physiotherapist. Manometry and symptom questionnaires are repeated after the program to measure changes in incremental squeeze pressure and symptoms. The goal is to determine whether supervised exercises can improve sphincter function and broaden future delivery options.

Why it matters

Who can join: the full rules

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

Where it's running

• Kings College Hospital
  London, United Kingdom Recruiting

Study contacts

• Study coordinator: Kar Yee Lor, MBChB
• Email: kch-tr.anopress-research@nhs.net
• Phone: +442032993568

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Group-based follow-up for women after obstetric anal sphincter injury

  A group-based follow-up program is being tested to see if it can improve quality of life for women who had a tear at the anal sphincter after childbirth.

  Recruiting Herlev Hospital · Herlev, Capital Region · NCT07667660

• Physiotherapy and cold‑pack treatment for first-time mothers with perineal tears after vaginal delivery

  This will test whether pelvic floor muscle exercises plus cryotherapy started right after birth reduce perineal pain for first-time mothers who had a grade 2 or higher tear or an episiotomy.

  Recruiting University of Sao Paulo · Ribeirão Preto, São Paulo · NCT07170007

• Evaluating 3D Ultrasound for Anal Sphincter Assessment

  This study is testing new 3D ultrasound techniques to see how well they can check the condition of the anal sphincter in pregnant women and new mothers to better understand related injuries and symptoms.

  Recruiting IRCCS Azienda Ospedaliero-Universitaria di Bologna · Bologna, Bologna · NCT06773520

• Care pathways for women with obstetric anal sphincter injury-related incontinence

  This study looks at how women with incontinence from childbirth-related injuries are currently cared for to see if better support can be provided.

  Recruiting London North West Healthcare NHS Trust · London · NCT06143072

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.