Real-time artificial intelligence-assisted assessment in a home-based pelvic floor muscle training device for pelvic organ prolapse and stress urinary incontinence: A single-center prospective study

OBJECTIVE: Pelvic floor muscle training (PFMT) is the first-line conservative treatment of pelvic organ prolapse (POP) and stress urinary incontinence (SUI), but its effectiveness is often limited by poor adherence and performance. We developed a third-generation home-based PFMT device incorporating real-time artificial intelligence (AI)-assisted assessment. This study aimed to evaluate the efficacy of this device in women with POP or SUI. MATERIALS AND METHODS: This prospective single-arm study was conducted at Taipei Veterans General Hospital. Women with stage I-II POP or SUI performed home-based PFMT using a noninvasive wireless pressure-sensing device with real-time AI-assisted assessment. Outcomes were assessed at baseline (M0), 1 (M1), and 2 (M2) months. Primary outcomes included the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and the 1-h pad test. Contraction patterns were analyzed and categorized as optimal or non-optimal. RESULTS: A total of 27 women (mean age 59.0 ± 14.3 years) were enrolled and completed the study. POPDI-6 decreased from 8.6 ± 2.6 to 5.2 ± 3.0 (p < 0.01), and UDI-6 from 6.4 ± 4.9 to 3.4 ± 3.4 (p < 0.05). The 1-h pad test decreased from 30.9 ± 41.9 g to 14.3 ± 23.5 g (p < 0.01); IIQ-7 reduction was also significant. Subjective and objective improvement rates were 89% and 54%, respectively. Physician-directed pattern optimization significantly improved contraction patterns, with 52.9% of patients converting from non-optimal to optimal patterns and increased the optimal contraction rate from 37.0% to 70.4% (p < 0.01). CONCLUSION: Real-time AI-assisted PFMT significantly improved symptom scores, objective urinary leakage, and contraction quality in women with POP or SUI. While limited by a small sample size, a short follow-up period, and a single-arm design, this approach effectively identifies and optimizes dysfunctional contraction patterns to enhance pelvic floor rehabilitation.