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International Urogynecology Journal
Published in: International Urogynecology Journal 11/2019

Open Access 01-11-2019 | Dyspareunia | Original Article

Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial

Authors: Fariba Ghaderi, Parvin Bastani, Sakineh Hajebrahimi, Mohammad Asghari Jafarabadi, Bary Berghmans

Published in: International Urogynecology Journal | Issue 11/2019

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Abstract

Introduction and hypothesis

Dyspareunia, the symptom of painful sexual intercourse, is a common sexual dysfunction in reproductive-aged women. Because of its multifactorial etiology, a multidisciplinary approach may be required to treat it. Musculoskeletal factors play an important role; thus, rehabilitating the pelvic floor and modifying the tone of the pelvic floor muscles (PFMs) may be an effective way to treat this dysfunction. The aim of this randomized controlled clinical study was to evaluate the effects of pelvic floor rehabilitation techniques on dyspareunia.

Methods

Of 84 women, assessed for eligibility, 64 women with dyspareunia were randomized into two groups: the experimental group (n = 32) received electrotherapy, manual therapy, and PFM exercises and the control group (n = 32) had no treatment while on the waiting list. Evaluations of PFM strength and endurance, sexual function, and pain were made directly before and after 3 months of treatment and at the 3-month follow-up.

Results

Between-group changes showed significant improvement in the experimental group in comparison with control group. Mean difference in the PFM strength (according to the 0-5 Oxford scale) between groups was 2.01 and the mean difference of endurance was 6.26 s. Also, the mean difference in the Female Sexual Function Index score (the score ranges from 2 to 95) was 51.05, and the mean difference in the VAS score was 7.32. All of the changes were statistically significant (p < 0.05).

Conclusions

According to the results, pelvic floor rehabilitation is an important part of a multidisciplinary treatment approach to dyspareunia.
Literature
1.
Rogers RG, Pauls RN, Thakar R, Morin M, Kuhn A, Petri E, et al. An international Urogynecological association (IUGA)/international continence society (ICS) joint report on the terminology for the assessment of sexual health of women with pelvic floor dysfunction. Int Urogynecol J. 2018;29(5):647–66. https://​doi.​org/​10.​1007/​s00192-018-3603-9.CrossRefPubMed
2.
Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281:537–44.CrossRef
3.
Sobhgol SS, Mohammad Alizadeh Charndabee S. Rate and related factors of dyspareunia in reproductive age women: a cross-sectional study. Int J Impot Res. 2007;19:88–94.CrossRef
4.
5.
Latthe P, Mignini L, Gray R. Factors predisposing women to chronic pelvic pain: systematic review. BMJ. 2006;332:749–55.CrossRef
6.
Goldfinger C, Pukall CF, Gentilcore-Saulnier E, McLean L, Chamberlain S. A prospective study of pelvic floor physical therapy: pain and psychosexual outcomes in provoked vestibulodynia. J Sex Med. 2009;6(7):1955–68.CrossRef
7.
Piassarolli VP, Hardy E, Andrade NF, Ferreira NO, Osis MJD. Pelvic floor muscle training in female sexual dysfunctions. Rev Bras Gynecol Obstet. 2010;32(5):234–40.
8.
Bø K, Berghmams B, Mørkved S, Van Kampen M. Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice. 2nd ed. Amsterdam: Elsevier; 2014.
9.
Rosenbaum TY, Owens A. Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review. J Sex Med. 2008;5:513–23.CrossRef
10.
11.
Montenegro MLLS, Vasconcelos ECLM, Candido dos Reis FJ, Nogueira AA. Physical therapy in the management of women with chronic pelvic pain. Int J Clin Pract. 2008;62(2):263–9.CrossRef
12.
Bergeron S, Binik YM, Khalife S, Pagidas K, Glazer HI, Meana M. A randomized comparison of group cognitive behavioural therapy , surface electromyographic biofeedback and vestibulectomy in the treatment of dyspareunia resulting from vulvar vestibulitis. Pain. 2001;91:297–306.CrossRef
13.
Rivalta M, Sighinolfi MC, Micali S, De Stefani S. Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor muscles exercises, and vaginal cones). J Sex Med. 2010;7:1200–8.CrossRef
14.
Bo K, Kvarstein B, Hagen R, Larsen S. Pelvic floor muscle exercises for the treatment of female stress urinary incontinence: II. Validity of vaginal pressure measurements of pelvic floor muscle strength and the necessity of supplementary methods for control of correct contraction. Neurourol Urodyn. 1990;9:479–87.CrossRef
15.
Fisher KA. Management of dyspareunia and associated levator ani muscle over activity. Phys Ther. 2007;87:935–41.CrossRef
16.
Ensor AW, Newton RA. The role of biofeedback and soft tissue mobilization in the treatment of dyspareunia: a systematic review. J Womens Health Phys Ther. 2014;38(2):74–80.CrossRef
17.
Morin M, Carroll MS, Bergeron S. Systematic review of the effectiveness of physical therapy modalities in women with provoked vestibulodynia. Sex Med Rev. 2017;5(3):295–322.CrossRef
18.
Asghari-Jafarabadi M, Sadeghi-Bazargani H. Randomization: techniques and software aided implementation in medical studies. J Clin Res Gov. 2015;4(2):1–6.
19.
Hartrick CT, Kovan JP, Shapiro S. The numeric rating scale for clinical pain measurement: a ratio measure? Pain Pract. 2003;3(4):310–6.CrossRef
20.
Fakhri A, Pakpour AH, Burri A, Morshedi H, Zeidi IM. The female sexual function index: translation and validation of an Iranian version. J Sex Med. 2012;9(2):514–23.CrossRef
21.
Murina F, Bernorio R, Palmiotto R. The use of Amielle vaginal trainers as adjuvant in the treatment of vestibulodynia: an observational multicentric study. Medscape J Med. 2008;10(1):23.PubMedPubMedCentral
22.
Danielsson I, Torstensson T, Brodda-Jansen G, Bohm-Starke N. EMG biofeedback versus topical lidocaine gel: a randomized study for the treatment of women with vulvar vestibulitis. Acta Obstet Gynecol Scand. 2006;85(11):1360–7.CrossRef
23.
Holland A. Physical therapy intervention for dyspareunia: a case report. J Sect Womens Health. 2003;27(1):18–20.
24.
Schvartzman R, Schvartzman L, Ferreira CF, Vettorazzi J, Bertotto A, Wender MCO. Physical therapy intervention for women with dyspareunia: a randomized clinical trial. J Sex Marital Ther. 2019;14:1–17.
25.
Shigeta M, Sekiguchi Y, Nakamura R. Effects of physical therapy on female dyspareunia in Japan. J Sex Med. 2016;13(6):S255.CrossRef
26.
Prendergast SA. Pelvic floor physical therapy for vulvodynia: a clinician’s guide. Obstet Gynecol Clin. 2017;44(3):509–22.CrossRef
27.
Denneny D, Frawley HC, Petersen K, McLoughin R, Brook S, Hassan S, et al. Trigger point manual therapy for the treatment of chronic noncancer pain in adults: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2019;100:562–77.CrossRef
28.
Felicíssimo MF, Carneiro MM, Saleme CS, Pinto RZ, da Fonseca AM, da Silva-Filho AL. Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial. Int Urogynecol J. 2010;21(7):835–40.CrossRef
29.
Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018;10:CD005654.PubMed
30.
Naess I, Bø K. Can maximal voluntary pelvic floor muscle contraction reduce vaginal resting pressure and resting EMG activity? Int Urogynecol J. 2018;29(11):1623–7.CrossRef
31.
Kaplan B, Rabinerson D, Pardo J, Krieser RU, Neri A. Transcutaneous electrical nerve stimulation (TENS) as a pain-relief device in obstetrics and gynaecology. Clin Exp Obstet Gynecol. 1997;24(3):123–6.PubMed
32.
Sobhgol SS, Priddis H, Smith CA, Dahlen HG. The effect of pelvic floor muscle exercise on female sexual function during pregnancy and postpartum: a systematic review. Sex Med Rev. 2019;7(1):13–28.CrossRef
33.
Metadata
Title
Pelvic floor rehabilitation in the treatment of women with dyspareunia: a randomized controlled clinical trial
Authors
Fariba Ghaderi
Parvin Bastani
Sakineh Hajebrahimi
Mohammad Asghari Jafarabadi
Bary Berghmans
Publication date
01-11-2019
Publisher
Springer International Publishing
Published in
International Urogynecology Journal / Issue 11/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-019-04019-3

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