Pelvic Floor Exercises for Suboptimal Anorectal Manometry

NCT ID: NCT07062731

Last Updated: 2025-07-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-06-15

Study Completion Date

2027-09-15

Brief Summary

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Currently, guidelines from the Royal College of Obstetricians and Gynaecologists stipulate that all women who have sustained an obstetric anal sphincter injury in a previous pregnancy and who are symptomatic or have abnormal endoanal ultrasonography and/ or manometry should be counselled regarding the option of an elective Caesarean section. An abnormal endoanal ultrasonography is currently considered to be a defect of the external anal sphincter (EAS) of more than 30 degrees while an abnormal anorectal manometry would be an incremental squeeze pressure of less than 20mmHg.

This study aims to evaluate if a course of guided pelvic floor exercises could improve anal sphincter function on those with suboptimal or abnormal anal incremental squeeze pressures, and subsequently expand their options for future modes of delivery (vaginal delivery not contraindicated)

Detailed Description

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Conditions

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Obstetric Anal Sphincter Injury

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Obstetric anal sphincter injury (suboptimal/ abnormal)

Women who have sustained an obstetric anal sphincter injury and was found to have suboptimal (20-40mmHg) or abnormal (\<20mmHg) incremental squeeze pressure on anorectal manometry

Supervised pelvic floor muscle exercises

Intervention Type BEHAVIORAL

4 months of supervised physiotherapy by a women's health physiotherapists (3 sessions in total)

Interventions

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Supervised pelvic floor muscle exercises

4 months of supervised physiotherapy by a women's health physiotherapists (3 sessions in total)

Intervention Type BEHAVIORAL

Eligibility Criteria

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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.


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
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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King's College Hospital NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Kar Yee Lor

Dr. Kar Yee Lor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kings College Hospital

London, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Kar Yee Lor, MBChB

Role: CONTACT

+442032993568

Facility Contacts

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Lizzie Bingle

Role: primary

+44203 299 6635

Other Identifiers

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IRAS 353671

Identifier Type: -

Identifier Source: org_study_id

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