Research

This 2026 systematic review examines the diagnosis and management of pudendal neuralgia, highlighting that diagnosis is primarily clinical and that treatment generally progresses from conservative care to nerve blocks and, when needed, more invasive interventions. Pelvic floor physical therapy can be an important component of conservative care by addressing pelvic muscle tension, soft-tissue restrictions, movement patterns, and other musculoskeletal factors that may contribute to pelvic pain. (PubMed)

This review summarizes current knowledge about pudendal neuralgia, including its causes, diagnosis, and treatment options, and emphasizes that the available research remains limited and inconsistent. Because conservative treatment is considered first-line care, pelvic floor physical therapy may help address muscular and biomechanical contributors to symptoms while providing a non-invasive treatment option as part of a multidisciplinary approach. (PubMed)

This evidence-based guideline reviews the diagnosis and treatment of overactive bladder and incorporates evidence from 159 studies to guide clinicians through behavioral, non-invasive, medication, and procedural treatment options. Pelvic floor physical therapy can be an important conservative treatment for urgency and urge urinary incontinence by incorporating pelvic floor muscle training, bladder strategies, education, and individualized behavioral techniques to improve symptom control and quality of life. (AUA Journals)

The American Urological Association guideline recognizes that many patients with IC/BPS have pelvic floor muscle tenderness and recommends appropriately performed manual physical therapy for patients with pelvic floor tenderness. Importantly, the guideline cautions against routine pelvic floor strengthening exercises such as Kegels in these patients, emphasizing that treatment should instead focus on individualized techniques such as trigger-point treatment, muscle relaxation, and addressing connective-tissue restrictions. (AUA Journals)

This guideline provides a comprehensive approach to chronic constipation, beginning with dietary and lifestyle management and addressing pelvic floor dysfunction when present. For patients with pelvic floor dyssynergia, biofeedback is considered a first-line treatment, highlighting the role of pelvic floor physical therapy in retraining the coordination and relaxation of the muscles needed for effective bowel movements. (ASCRS U)

This prospective cohort study evaluated community-based pelvic floor rehabilitation as an initial treatment for adults with chronic constipation who had not improved with fiber or osmotic laxatives. After 12 weeks, participants experienced improvements in complete spontaneous bowel movements and symptoms such as straining, abdominal discomfort, bloating, and constipation severity, supporting pelvic floor physical therapy as a promising treatment option for appropriately selected patients. (CGH Journal)

These American College of Gastroenterology guidelines provide evidence-based recommendations for evaluating and treating several anorectal disorders, including fecal incontinence and defecatory dysfunction. Pelvic floor rehabilitation and biofeedback can be important components of conservative care because they can help patients improve pelvic floor and anal sphincter coordination, control, and awareness. (PubMed)

This ACOG Practice Bulletin emphasizes that fecal incontinence is common, underreported, and can significantly affect quality of life, with pregnancy, childbirth, and pelvic floor dysfunction among important risk factors. Pelvic floor physical therapy can provide conservative, individualized treatment to improve pelvic floor and sphincter function and is particularly relevant for patients whose symptoms are associated with pelvic floor dysfunction. (PubMed)

This clinical opinion from the American College of Obstetricians and Gynecologists describes persistent vulvar pain as a complex condition that can be difficult to diagnose and treat, often requiring individualized, multidisciplinary care. The authors specifically identify physical therapists as members of the treatment team, making pelvic floor physical therapy an important option for addressing musculoskeletal contributors to vulvar pain and helping patients work toward functional and quality-of-life goals. (PubMed)

This JAMA clinical review discusses dyspareunia, or pain with intercourse, emphasizing its significant effects on quality of life, sexual health, relationships, and self-image and the importance of identifying underlying causes. Pelvic floor physical therapy can be valuable when pelvic floor muscle tenderness, overactivity, weakness, or poor coordination contributes to painful intercourse, providing individualized treatment aimed at improving muscle function and reducing pain. (PubMed)

This clinical practice bulletin reviews the evaluation and management of urinary incontinence in women, including conservative treatment options for stress urinary incontinence. Pelvic floor muscle training is an important part of conservative care because it can improve the strength, endurance, and coordination needed to better support the urethra and manage increases in abdominal pressure during activities such as coughing, lifting, and exercise. (PubMed)

This Cochrane overview synthesized evidence from 29 systematic reviews involving thousands of women and found high-certainty evidence that pelvic floor muscle training can improve or cure symptoms of urinary incontinence and improve quality of life. The evidence also suggests that more intensive programs and greater professional support may improve outcomes, underscoring the value of individualized pelvic floor physical therapy rather than relying solely on unsupervised exercises. (Cochrane)

This Cochrane review included 46 trials involving more than 10,800 women and found that pelvic floor muscle training during pregnancy probably reduces the risk of urinary incontinence later in pregnancy and may provide benefits into the postpartum period, although evidence for treating established incontinence was less certain. Pelvic floor physical therapy is important during pregnancy because it can provide individualized instruction, help women correctly perform pelvic floor exercises, and address strength, coordination, relaxation, and functional demands as the body changes. (PubMed Central (PMC))

This 2026 systematic review and meta-analysis of 11 randomized controlled trials found that exercise significantly reduced pain and improved function in women with pregnancy-related pelvic girdle pain, with moderate-certainty evidence supporting exercise overall. Pelvic floor physical therapy can help tailor exercise to the individual’s symptoms and functional needs, incorporating abdominopelvic strengthening, movement retraining, and strategies to safely remain active throughout pregnancy. (PubMed)

This systematic review and meta-analysis included 65 studies and more than 21,000 participants and found that postpartum pelvic floor muscle training reduced the odds of urinary incontinence by 37% and pelvic organ prolapse by 56%, although evidence for some other outcomes was more limited. These findings support postpartum pelvic floor physical therapy as an important part of recovery, helping individuals safely rebuild pelvic floor and abdominal function while addressing incontinence, prolapse symptoms, and other postpartum concerns. (PubMed)

This 2026 systematic review included 26 trials and found that pelvic floor muscle training significantly improved pelvic floor muscle strength during both pregnancy and the postpartum period, with larger gains observed postpartum. The review also found that programs incorporating feedback tended to produce more reliable benefits, supporting the role of pelvic floor physical therapists in providing individualized instruction, correcting technique, and helping patients develop an effective and sustainable rehabilitation program. (PubMed)

This 2026 systematic review and meta-analysis evaluated five randomized controlled trials involving 236 men and found that pelvic floor muscle training alone was less effective for improving ejaculation latency than some medication or combined-treatment approaches. The findings still support pelvic floor rehabilitation as a potential component of care, particularly when combined with other strategies, and highlight the importance of individualized training rather than assuming that strengthening alone is the best approach. (PubMed)

This 2025 AUA guideline provides an evidence- and consensus-based framework for evaluating men with chronic pelvic pain, including chronic prostatitis/chronic pelvic pain syndrome and chronic scrotal content pain. The guideline recognizes pelvic floor and abdominopelvic muscle dysfunction as important contributors for some patients and supports specialized pelvic floor physical therapy, including individualized manual therapy and biofeedback, as part of multimodal treatment. (AUA Journals)

This guideline addresses urinary incontinence following prostate cancer treatment and emphasizes that while many men improve naturally after prostatectomy, some experience persistent leakage requiring treatment. Pelvic floor muscle exercises can help accelerate continence recovery and may be introduced before surgery, making pelvic floor physical therapy an important part of preparation and rehabilitation surrounding prostate treatment. (AUA Journals)

This Cochrane review analyzed 25 studies involving more than 3,000 men and found that the overall evidence for conservative interventions after prostate surgery remains uncertain, partly because studies used different treatment protocols and had methodological limitations. Despite these limitations, pelvic floor muscle training remains an important non-invasive component of rehabilitation, and individualized physical therapy can help patients learn proper pelvic floor activation and integrate those muscles into functional activities. (Cochrane)