Barbara Dionisi1, Roberto Senatori. 1. Outpatient Department of Pelvic Floor Rehabilitation and Vulvar Disease, Nursing Home Holy Family, Rome, Italy. b.dionisi@tiscali.it
Abstract
AIM: This article will evaluate the safety and efficacy of intravaginal transcutaneous electrical nerve stimulation (TENS) for the treatment of vulvar pain and dyspareunia during the postpartum period related to perineal trauma caused by episiotomy. METHODS: From January 2007 to January 2009, 45 women presenting with postpartum dyspareunia related to perineal trauma after a vaginal delivery were educated on the importance of the pelvic floor and its part in continuing dyspareunia. The treatment consisted of weekly applications of intravaginal TENS in an outpatient setting and daily home therapy with myofascial stretching and exercises of the pelvic floor musculature. The results were evaluated using the cotton swab test, the Marinoff Dyspareunia Scale and the Visual Analog Scale, and the anovulvar distance was assessed prior to and at the end of the treatment period. RESULTS: Of the women included in the study, 84.5% reported an improvement of dyspareunia after only five applications of TENS, with a total remission of symptoms (in 95% of patients) at the end of the protocol. At follow-up, eight months after the end of treatment, all patients were pain free. CONCLUSIONS: Therapy with intravaginal transcutaneous nerve stimulation and pelvic floor relaxation exercises is safe and effective in the improvement of vulvar pain and dyspareunia in women with postpartum perineal trauma due to episiorrhaphy, after spontaneous delivery.
AIM: This article will evaluate the safety and efficacy of intravaginal transcutaneous electrical nerve stimulation (TENS) for the treatment of vulvar pain and dyspareunia during the postpartum period related to perineal trauma caused by episiotomy. METHODS: From January 2007 to January 2009, 45 women presenting with postpartum dyspareunia related to perineal trauma after a vaginal delivery were educated on the importance of the pelvic floor and its part in continuing dyspareunia. The treatment consisted of weekly applications of intravaginal TENS in an outpatient setting and daily home therapy with myofascial stretching and exercises of the pelvic floor musculature. The results were evaluated using the cotton swab test, the Marinoff Dyspareunia Scale and the Visual Analog Scale, and the anovulvar distance was assessed prior to and at the end of the treatment period. RESULTS: Of the women included in the study, 84.5% reported an improvement of dyspareunia after only five applications of TENS, with a total remission of symptoms (in 95% of patients) at the end of the protocol. At follow-up, eight months after the end of treatment, all patients were pain free. CONCLUSIONS: Therapy with intravaginal transcutaneous nerve stimulation and pelvic floor relaxation exercises is safe and effective in the improvement of vulvar pain and dyspareunia in women with postpartum perineal trauma due to episiorrhaphy, after spontaneous delivery.