Abstract
Introduction/Background: One side effect of vaginal delivery is urinary incontinence and pelvic organ prolapse due to the weakness and difficulty activating the pelvic floor musculature. The purpose of this case study is to report on the outcomes associated with the addition of blood flow restriction (BFR) to conventional pelvic floor treatments in a patient with relapsing pelvic organ prolapse.
Case Description: A 39-year-old woman who was gravida 5 para 3 presented with cystocele, rectocele, and stress incontinence following the birth of her third child. Her primary goal was to return to running without a "falling out"-type feeling. Impairments were consistent with pelvic floor musculature weakness and difficulty with coordination of movement. Blood flow restriction was added as an adjunct to the current evidence-based strategies of pelvic floor exercises, biofeedback, electrical stimulation, and education.
Outcomes: The patient had improvements in biofeedback values, increased muscle strength of the pelvic floor via the Modified Oxford Scale, statistically significant scores on the Pelvic Floor Distress Inventory (PFDI-20), reduction of pelvic organ prolapse, and stress incontinence. There was a 75% improvement in her ability to run without symptoms.
Discussion: This case report demonstrates that BFR, along with traditional pelvic floor treatment, was associated with improvements in the patient's pelvic floor function. Blood flow restriction training may be a promising addition to pelvic floor rehabilitation for patients with pelvic floor musculature atrophy who do not fully respond to current best practice methods.
Informed Consent: Informed consent was obtained for this case report.