Urogynaecological physiotherapy as a support of surgical treatment in Poland - assessment of participation, awareness and satisfaction.

Abstract

Introduction: Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent conditions that significantly impair women's quality of life, yet awareness of conservative treatment options remains limited.

Aim: To assess women's knowledge and awareness regarding urogynaecological physiotherapy, as well as to evaluate quality of life and satisfaction after gynaecological and urogynaecological surgeries.

Material and methods: The study included 438 women undergoing surgery for pelvic floor dysfunction or other gynaecological conditions. Participants completed self-designed and validated questionnaires regarding physiotherapy knowledge, pre- and postoperative engagement, preventive behaviours and treatment satisfaction.

Results: Nearly half of the participants (48.1%) had never heard of pelvic floor physiotherapy, with POP patients being the least informed (53.6%). Only 24.3% received a physiotherapy referral before surgery, and 16.7% underwent preoperative therapy, most often limited to one or two sessions. After surgery, 30.5% were referred to physiotherapy, while 18.0% participated. Women who attended physiotherapy - especially pre- operatively - were significantly more likely to perform pelvic floor muscle training (PFMT) correctly (78.6% vs. 18.9%, p <0.001) and to engage in preventive behaviours (92.9% vs. 54.1%, p <0.001). Subjective outcomes were also better: patients with physiotherapy both before and after surgery most frequently rated their health as "much better" and expressed greater willingness to repeat surgery (p = 0.003).

Conclusion: Awareness of urogynaecological physiotherapy remains insufficient. Physiotherapy, particularly when integrated both pre- and postoperatively, enhances PFMT performance, preventive behaviours, subjective treatment outcomes and satisfaction with surgery. Expanding access to physiotherapy and improving patient education could optimise long-term management of UI and POP.