High-quality pelvic health physiotherapy for vaginal mesh-associated complications: a modified e-Delphi consensus study

High-quality pelvic health physiotherapy for vaginal mesh-associated complications: a modified e-Delphi consensus study | Research Square Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article High-quality pelvic health physiotherapy for vaginal mesh-associated complications: a modified e-Delphi consensus study Virginia Rivers Bulkeley, Vicky MacBean, Elmar Kal This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8958474/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: Transvaginal mesh implants have been widely used to treat stress urinary incontinence and pelvic organ prolapse but have been associated with significant complications in some women. Specialist multidisciplinary Mesh Centres have been established to provide expert diagnosis and management. Pelvic health physiotherapy (PHPT) is recommended as part of this provision; however, to date no published interventional studies have directly evaluated PHPT in this population, and there is no consensus to guide high-quality PHPT service delivery. This study aimed to establish expert consensus on the components of high-quality PHPT for women with vaginal mesh-associated complications. Methods: A three-round modified e-Delphi study was conducted with specialist physiotherapists who were members of the Pelvic, Obstetric and Gynaecological Physiotherapy Mesh Centres Committee. Participants rated proposed quality indicators using a five-point Likert scale and provided free-text feedback. Response rates, agreement levels, and consensus stability were assessed. Consensus was predefined as > 75% agreement and stability as < 10% variation between the final two rounds. Results: Thirteen expert physiotherapists completed all three Delphi rounds. Forty quality indicators achieved stable consensus across five domains: (i) holistic care, (ii) integrated care, (iii) surgical care pathways, (iv) non-surgical care pathways, and (v) PHPT treatment modalities. Conclusion: This study establishes the first expert consensus defining high-quality PHPT services for women with vaginal mesh-associated complications. The resulting quality indicators provide a structured framework to inform commissioning, service design, and clinical practice. In the absence of direct interventional evidence, further research is required to evaluate their implementation and impact on patient-centred outcomes. Obstetrics & Gynecology Conservative management mesh complications pelvic floor disorders pelvic pain physical therapy surgical mesh Full Text Additional Declarations The authors declare potential competing interests as follows: Financial disclaimer/conflict of interest: VROB received a research grant from the Pelvic Obstetric and Gynaecological Physiotherapy network ( https://thepogp.co.uk ) to support this work (reference: POGPRG23A03). Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information

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