INTRODUCTION AND HYPOTHESIS: Our aim was to determine the effects of pelvic floor physical therapy (PT) and levator-directed trigger-point injections (LTPI) on sexual function and levator-related pelvic pain. STUDY DESIGN: A randomized trial among women with pelvic floor myalgia (PFM) was performed wherein participants received either PT or LTPI. Pain was assessed and 1 month posttreatment completion. Levator-based pain was assessed using a numeric rating scale (NRS) and the Patient Global Impression of Improvement (PGI-I) scale. Sexual function was assessed using the Female Sexual Function Index (FSFI). RESULTS:Twenty-nine women completed the study (17 had PT, 12 had LTPI). Both groups reported reduction in vaginal pain: mean NRS change from baseline of 4.47 [standard deviation (SD) 2.12) for PT and 4.67 (SD 1.72) for LTPI (p = 0.8)]. A >50 % improvement in NRS was documented among 59 % of women receiving PT and 58 % receiving LTPI (p = 1.0). Consistent with NRS scores, mean PGI-I score was 2.50 (SD 1.17) for PT and 2.17 (SD 1.01) for LTPI (p = 0.5). Mean change in FSFI favored PT [PT +8.87 (SD 5.60), LTPI +4.00 (SD 5.24), p = 0.04], reflecting improvement in the sexual pain domain favoring PT (p = 0.02). However, the time in weeks to effect improvement favored LTPI if controlling for the degree of change in NRS (p = 0.01) and FSFI (p = 0.01). CONCLUSIONS:Vaginal myalgia and sex-related pain improved with pelvic floor PT and LTPI. Time-to-effect improvement and significance of therapy are dependent on treatment type.
RCT Entities:
INTRODUCTION AND HYPOTHESIS: Our aim was to determine the effects of pelvic floor physical therapy (PT) and levator-directed trigger-point injections (LTPI) on sexual function and levator-related pelvic pain. STUDY DESIGN: A randomized trial among women with pelvic floor myalgia (PFM) was performed wherein participants received either PT or LTPI. Pain was assessed and 1 month posttreatment completion. Levator-based pain was assessed using a numeric rating scale (NRS) and the Patient Global Impression of Improvement (PGI-I) scale. Sexual function was assessed using the Female Sexual Function Index (FSFI). RESULTS: Twenty-nine women completed the study (17 had PT, 12 had LTPI). Both groups reported reduction in vaginal pain: mean NRS change from baseline of 4.47 [standard deviation (SD) 2.12) for PT and 4.67 (SD 1.72) for LTPI (p = 0.8)]. A >50 % improvement in NRS was documented among 59 % of women receiving PT and 58 % receiving LTPI (p = 1.0). Consistent with NRS scores, mean PGI-I score was 2.50 (SD 1.17) for PT and 2.17 (SD 1.01) for LTPI (p = 0.5). Mean change in FSFI favored PT [PT +8.87 (SD 5.60), LTPI +4.00 (SD 5.24), p = 0.04], reflecting improvement in the sexual pain domain favoring PT (p = 0.02). However, the time in weeks to effect improvement favored LTPI if controlling for the degree of change in NRS (p = 0.01) and FSFI (p = 0.01). CONCLUSIONS:Vaginal myalgia and sex-related pain improved with pelvic floor PT and LTPI. Time-to-effect improvement and significance of therapy are dependent on treatment type.
Authors: Catrina C Crisp; Christine M Vaccaro; M Victoria Estanol; Susan H Oakley; Steven D Kleeman; Angela N Fellner; Rachel N Pauls Journal: Int Urogynecol J Date: 2013-05-17 Impact factor: 2.894
Authors: Amos Adelowo; Michele R Hacker; Alex Shapiro; Anna Merport Modest; Eman Elkadry Journal: Female Pelvic Med Reconstr Surg Date: 2013 Sep-Oct Impact factor: 2.091
Authors: Mary P Fitzgerald; Rodney U Anderson; Jeannette Potts; Christopher K Payne; Kenneth M Peters; J Quentin Clemens; Rhonda Kotarinos; Laura Fraser; Annemarie Cosby; Carole Fortman; Cynthia Neville; Suzanne Badillo; Lisa Odabachian; Andrea Sanfield; Betsy O'Dougherty; Rick Halle-Podell; Liyi Cen; Shannon Chuai; J Richard Landis; Keith Mickelberg; Ted Barrell; John W Kusek; Leroy M Nyberg Journal: J Urol Date: 2013-01 Impact factor: 7.600