RecruitingOBSERVATIONAL

Pelvic Floor Exercises for Suboptimal Anorectal Manometry

This study is for women who experienced a specific type of muscle tear in their bottom area during a previous childbirth, known as an obstetric anal sphincter injury. Currently, if this muscle isn't working well, doctors might suggest a C-section for future births. This research aims to find out if supervised pelvic floor exercises can help these muscles work better. If the exercises are successful, it could mean more women have the option of a vaginal birth again. We are looking for volunteers who haven't had guided pelvic floor exercises since their last delivery and meet other specific requirements.

At a glance

Status

Recruiting

Sponsor

King's College Hospital NHS Trust

Enrolment target

Start

15 Jun 2025

Estimated completion

15 Sep 2027

Obstetric Anal Sphincter Injury

What is this study about?

When a woman gives birth, sometimes the muscles around the opening of the bottom (called the anal sphincter) can get torn. This is known as an obstetric anal sphincter injury. If these muscles don't heal quite right, or don't work as strongly as they should, it can sometimes lead to problems like accidentally leaking a bit of poo or wind. Doctors check how well these muscles are working using tests.

At the moment, if tests show these muscles aren't working well, or if a woman is experiencing symptoms, guidelines suggest that a C-section might be a safer option for future pregnancies. This is to reduce the risk of further injury or worsening symptoms. Imagine if there was another way to help these muscles recover and get stronger, potentially giving women more choices for how they give birth in the future.

This study wants to explore exactly that. We want to see if a special programme of supervised exercises, focusing on the pelvic floor muscles, can make a real difference. The aim is to strengthen these muscles so they work better. If successful, this could mean that women who have had this type of injury might have the option of a vaginal birth again, rather than only considering a C-section. It's about empowering women with more choices for their birth plan.

Key takeaways

This study explores if pelvic floor exercises can help after a childbirth muscle injury.
It aims to offer more future birth options for women with this injury.
Participation involves supervised exercises, questionnaires, and simple tests.
You will receive expert guidance on strengthening your pelvic floor.
Your decision to join or leave the study will not affect your medical care.

Who may be eligible?

You might be able to join this study if you are a woman who had a specific type of muscle tear around your bottom during your most recent childbirth. This injury is called an obstetric anal sphincter injury. You must be at least six weeks past that delivery, and you shouldn't have had any supervised pelvic floor exercises from a women's health physiotherapist since then. You also need to be able to speak, read, and write in English, or have an interpreter to help you.

It's important that you can understand what the study involves, including any potential benefits or risks, and feel comfortable signing a consent form. You should also be willing to fill out some questionnaires and attend a few clinic appointments and tests.

However, you can't join if your injury happened more than a year ago, or if you've already had another vaginal delivery after that injury. If you have any ongoing bottom pain that makes examinations difficult, or if you have other health conditions that would stop you from doing the exercises, you also won't be able to take part. You must be at least 18 years old and not currently pregnant. Also, you need to be able to stick with the exercise programme.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am a woman who had a specific bottom muscle tear (obstetric anal sphincter injury) during my most recent delivery.
It has been at least 6 weeks since that delivery.
I have not had supervised pelvic floor exercises from a women's health physio since that delivery.
I am 18 years old or older and not currently pregnant.
I can speak and understand English, or an interpreter can help me.
I don't have ongoing bottom pain or other conditions that stop me from doing exercises.

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you will have a few appointments. First, you'll have a chance to ask any questions and decide if it's right for you. If you agree, you'll sign a consent form. You'll need to fill out some questionnaires about your symptoms and quality of life. You’ll also have some simple tests, including one to measure how well your anal sphincter muscles are working. This test is called anorectal manometry and involves a small tube being gently inserted to take measurements.

The main part of taking part involves supervised sessions with a women's health physiotherapist who will guide you through specific pelvic floor exercises. These exercises are gentle but designed to strengthen the muscles. You'll also need to do exercises at home. The study doesn't involve any new medications. You'll have follow-up appointments to see how you're progressing and to repeat some of the tests to see if the exercises have made a difference. The total duration of your involvement will depend on the study's schedule, but it will involve several clinic visits over a period.

Potential risks and benefits

Participating in this study might offer some potential benefits. You will receive expert, supervised pelvic floor muscle training, which could help strengthen your muscles and potentially improve any symptoms you might be experiencing. It could also provide you with more options for future childbirth. As for risks, the exercises are generally safe, but like any physical activity, there's a small chance of mild discomfort or muscle soreness. The tests, like the anorectal manometry, are usually well-tolerated but might cause brief, mild discomfort. You are completely free to withdraw from the study at any time, for any reason, without it affecting your medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Kings College Hospital
Verified postcode
London, United Kingdom· Recruiting

Common questions

What is an obstetric anal sphincter injury?

It's a type of tear in the muscles around your bottom that can happen during childbirth.

What are pelvic floor exercises?

These are gentle exercises to strengthen the muscles that support your bladder, bowel, and womb.

Will these exercises definitely mean I can have a vaginal birth?

This study aims to find out if they can help, but it doesn't guarantee a specific outcome. The goal is to give you more options.

How long will I need to do the exercises?

You will have a course of supervised exercises, and you'll also be asked to continue them at home regularly as part of the study.

What if I decide I don't want to continue with the study?

You can stop participating at any time you wish, and it won't affect your medical care.

How to find out more

Kar Yee Lor, MBChB

kch-tr.anopress-research@nhs.net +442032993568 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.