To characterise and compare pelvic floor muscle (PFM) function in women with urinary incontinence (UI) and pelvic organ prolapse (POP).

This observational, cross-sectional, descriptive study included women aged ≥18 years with a clinical diagnosis of UI or POP. Pelvic floor muscle assessment was performed with the participant in the supine position with hips and knees flexed. Digital vaginal palpation was conducted with insertion of the index finger approximately 4–6 cm into the vaginal canal. PFM function was assessed using the Modified Oxford Scale and included evaluation of endurance, repeatability, and number of fast contractions. POP was staged according to the Pelvic Organ Prolapse Quantification (POP-Q) system (stages I–IV). Prolapse reduction was performed during PFM assessment when necessary. Statistical analysis was conducted using Jamovi version 2.3.13, applying ANOVA and Kruskal–Wallis tests, with significance set at p < 0.05.

A total of 168 women underwent physical examination, including 102 with UI and 66 with POP. The groups were comparable in terms of age (mean 62 years) and body mass index (mean 28 kg/m²). The median PFM strength score was 2.88 in the UI group (Grade 2: weak contraction) and 1.8 in the POP group (Grade 1: flicker/trace contraction). This difference was statistically significant (p < 0.001), indicating superior PFM function in women with UI.

Although impaired PFM function is recognized as a contributing factor to UI, women with UI demonstrated better PFM performance compared to those with POP. These findings suggest that POP is more strongly associated with structural and supportive tissue failure, whereas UI is predominantly related to functional impairment of the pelvic floor musculature. This is consistent with the literature demonstrating an association between reduced PFM function and increasing POP stage, as well as evidence supporting the effectiveness of PFM training in improving continence and quality of life in women with UI.

Women with POP exhibit significantly poorer PFM function compared to women with UI. These findings reinforce the distinct pathophysiological mechanisms underlying these conditions and highlight the importance of standardized assessment to guide targeted and individualized therapeutic interventions.