PelvicEx evidence and source library

What this library is

The PelvicEx evidence library is a structured catalog that connects medical claims, training rules, safety routes, and educational guides to identifiable sources. As of 31 August 2026, the source catalog contains 75 records spanning textbooks, guidelines, consensus reports, systematic reviews, trials, public-health guidance, specialist resources, editorial standards, and dated official product listings.

It is not a database of every pelvic-floor paper ever published, and a record’s presence is not an endorsement of every conclusion in that source. The catalog exists to answer narrower questions:

Which source supports this claim or rule?
What population and outcome does it actually cover?
What limitation must travel with the citation?
Is the statement clinical evidence, terminology, public guidance, product fact, or a PelvicEx extrapolation?
When was a changing web source checked?

Each guide’s Sources section contains its citations and links.

What an evidence record contains

Each record uses a stable ID, such as COCHRANE-PFMT-UI-2018 or ICS-PFM-ASSESSMENT-2021. The ID is shorter than a full citation, so it can be attached consistently to program modules, rules, and articles.

A record normally includes:

type: guideline, systematic review, textbook chapter, trial, terminology report, public guidance, or another defined category;
citation: enough bibliographic information to identify the source;
official URL: a publisher, professional organization, government page, DOI, PubMed record, or legitimate product listing;
access date: especially for living guidelines, store pages, and web guidance;
supports: a compact list of the claims for which PelvicEx uses the source;
notes: population limits, uncertainty, conflicting evidence, and ways the source must not be overextended.

The supports field is not an automatic summary of the source. It is a claim-level ledger for PelvicEx. A source can support one sentence while being inappropriate for another.

The source hierarchy is question-specific

PelvicEx does not use a single ranking in which one source type always wins. The best source depends on the claim.

Definitions and terminology

International standardization reports are preferred for terms such as pelvic-floor muscle training, contraction, relaxation, assessment, urinary symptoms, and conservative management. Core examples include:

the IUGA/ICS conservative-management terminology report;
the ICS pelvic-floor assessment terminology report; and
the current International Continence Society glossary.

Terminology documents standardize language. They do not by themselves prove that an intervention works.

Treatment recommendations

Current clinical guidelines and high-quality systematic reviews are preferred for decisions about who may benefit, treatment order, supervision, contraindications, and uncertainty. PelvicEx uses official sources from organizations including:

A recommendation is still population- and jurisdiction-specific. A guideline for women with stress or mixed urinary incontinence does not become a universal Kegel prescription.

Durable foundations and clinical context

Current specialist textbooks and major reference works help explain anatomy, assessment, motor learning, training principles, and condition-specific care. The library uses the third edition of Evidence-Based Physical Therapy for the Pelvic Floor through its official Elsevier record, and Incontinence, 7th edition, available through the International Continence Society.

Books are valuable for connected explanations but can age. Current dose, safety, diagnostic, and treatment claims are re-checked against newer guidelines and reviews.

Accessible public guidance

Government and health-service pages help translate clinical boundaries into reader-friendly action. Examples include the US National Institute of Diabetes and Digestive and Kidney Diseases, NHS resources, Prostate Cancer UK, and Macmillan Cancer Support.

These pages are useful for public instructions and care routes. They should not be treated as substitutes for the underlying research or applied beyond their intended jurisdiction and population.

Primary studies

Trials and observational studies are used when they answer a specific question not resolved by a current synthesis—for example, a named functional contraction technique or an emerging sexual-health outcome. PelvicEx records design and population limits and avoids presenting one small positive study as settled practice.

Product and policy facts

App features, prices, platform requirements, and store privacy labels require current first-party product pages, not a medical textbook. These records carry a check date and support only product facts. Developer claims and store privacy declarations are not independent clinical or security audits.

Editorial and AI-governance pages use official standards such as the ICMJE recommendations and World Health Organization AI-for-health guidance, while clearly noting that PelvicEx is not a medical journal or a certified medical AI system.

How evidence IDs reach an article

An article begins with a claim outline. The editor identifies which statements require support and maps them to catalog IDs. The article frontmatter then lists the IDs used for the page’s evidence panel.

Reader-facing citations remain near substantive claim clusters. A compact panel alone would force readers to guess which source supports which sentence, so the final Sources section expands the key references into full links.

The same ID can also appear in a program, module, technique, or safety rule. This creates a chain:

source → bounded claim → content or rule → rendered guide or planned session

The chain should be inspectable in both directions. A rule without support or an ID that no longer resolves should fail catalog validation rather than silently ship.

“Supported” is not the same as “certain”

An evidence record may support language such as:

“PFMT can improve stress urinary-incontinence outcomes for some women”;
“post-prostate PFMT may hasten early continence recovery in selected settings”; or
“biofeedback is used in clinically diagnosed defecatory coordination disorders.”

It may not support:

“this exact app routine will cure your leakage”;
“everyone should complete the same repetitions”; or
“your symptom proves which muscle problem you have.”

The record’s notes preserve these distinctions. A citation is not a licence to use stronger language than the study or guideline.

Evidence, extrapolation, and product choice

PelvicEx uses three labels in its internal reasoning:

directly supported: a source matches the population, action, and claim closely;
bounded extrapolation: a conservative product choice draws on related evidence but is not itself established as optimal;
operational decision: a software or editorial choice, such as reason-code format, stable ad-slot height, or what an empty related-content area displays.

Exact starter blocks, progression thresholds, recovery scheduling, and multi-goal composition often include extrapolation because research does not supply every operational value. Those choices still need rationale, testing, and professional review; attaching a nearby reference must not disguise them as direct findings.

Read how PelvicEx designs programs for a concrete example.

Content risk and quality control

Evidence IDs do not determine how much scrutiny a page needs. The roadmap uses internal risk levels to prioritize:

lower-risk education and policy;
clinically meaningful evidence summaries and programme design; and
pain, red flags, postoperative, pregnancy, cancer, bowel, sexual-health, and other higher-risk topics.

Versioned internal records track source selection, interpretation, localization, and practical advice. Strong sources do not eliminate the need to check whether a claim matches its population, risk, and intended use.

English and Thai use the same evidence boundary

Localized pairs share a translation key and evidence IDs. Thai prose is adapted for clarity rather than translated mechanically, but it must not add a benefit, dose, diagnosis, or safety threshold absent from the English claim outline.

If a source is only in English, the Thai guide links the legitimate original and explains it in original Thai prose. PelvicEx does not publish an unofficial translated copy or imply that the source organization approved the adaptation.

Copyright and local research material

Some books may be consulted from legally available local research copies. Local file paths are internal locators, not public citations. They must never appear in rendered HTML, a sitemap, or a reader-facing link.

PelvicEx links to the official publisher or professional record and writes original prose from a fact outline. It does not reproduce book passages, figures, tables, screenshots, or distinctive diagrams. A local copy’s existence does not grant redistribution rights.

Maintenance and quality checks

The evidence catalog has a review date, but changing sources need their own access date. A record should be revisited when:

a living guideline updates;
a review is superseded;
a paper is corrected, withdrawn, or materially challenged;
a linked page moves or becomes inaccessible;
a product price, feature, privacy label, or business model changes;
a professional reviewer identifies a source-to-claim mismatch;
the English and Thai interpretations diverge.

Automated checks can confirm that IDs exist, links have valid syntax, frontmatter resolves, and no local paths appear in built HTML. They cannot decide whether a study was interpreted correctly. Human editorial and professional review remain necessary.

Evidence limits

Evidence remains uneven for app-delivered PFMT, optimal dose, long-term maintenance, diverse and underrepresented populations, male sexual-health outcomes, bowel self-management, and self-guided relaxation for pain or overactivity. Some source records are stronger for terminology or context than for treatment effect.

PelvicEx explains these evidence boundaries so readers can distinguish supported guidance from uncertain findings.

Core sources

Cardozo L, Rovner E, Wagg A, Wein A, Abrams P, editors. Incontinence. 7th edition. International Consultation on Incontinence and International Continence Society; 2023. Official ICS publication.
Bø K, Berghmans B, Mørkved S, Van Kampen M, editors. Evidence-Based Physical Therapy for the Pelvic Floor. 3rd edition. Elsevier; 2023. Official publisher record.
Bø K, Frawley HC, Haylen BT, et al. IUGA/ICS joint terminology report for conservative management of female pelvic-floor dysfunction. 2017. PubMed.
Frawley HC, Shelly B, Morin M, et al. ICS pelvic-floor muscle assessment terminology report. 2021. PubMed.
National Institute for Health and Care Excellence. Pelvic floor dysfunction: prevention and non-surgical management. NG210. Official NICE guidance.
Dumoulin C, Cacciari LP, Hay-Smith EJC. PFMT versus no treatment or inactive control for urinary incontinence in women. Cochrane Database of Systematic Reviews. 2018. Cochrane summary.
World Health Organization. Ethics and governance of artificial intelligence for health. 2021. Official WHO publication.