Dionisi Barbara, Senatori Roberto
Outpatient Department of Pelvic Floor Rehabilitation and Vulvar Disease, Nursing Home Holy Family, Rome, Italy.
J Obstet Gynaecol Res. 2011 Jul;37(7):750-3. doi: 10.1111/j.1447-0756.2010.01425.x. Epub 2011 Mar 13.
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.
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.
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.
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.
本文将评估经阴道经皮电刺激神经疗法（TENS）治疗产后因会阴侧切术导致会阴创伤引起的外阴疼痛和性交困难的安全性和有效性。
2007年1月至2009年1月，对45名经阴道分娩后出现与会阴创伤相关的产后性交困难的女性进行了盆底及其在持续性性交困难中作用的重要性教育。治疗包括在门诊每周进行一次经阴道TENS治疗，以及在家中每天进行肌筋膜拉伸和盆底肌肉组织锻炼。使用棉拭子试验、马里诺夫性交困难量表和视觉模拟量表评估结果，并在治疗期开始前和结束时评估肛门与外阴的距离。
在纳入研究的女性中，84.5%的女性仅接受5次TENS治疗后就报告性交困难有所改善，在方案结束时症状完全缓解（95%的患者）。在治疗结束八个月后的随访中，所有患者均无疼痛。
经阴道经皮神经刺激和盆底放松锻炼疗法对于改善自然分娩后因会阴缝合导致产后会阴创伤的女性的外阴疼痛和性交困难是安全有效的。
