Dos Bispo Ana Paula Santos, Ploger Christine, Loureiro Alessandra Fernandes, Sato Hélio, Kolpeman Alexander, Girão Manoel João Batista Castello, Schor Eduardo
Division of Chronic Pelvic Pain and Endometriosis, Department of Gynecology, Federal University of São Paulo, Rua Napoleão de Barros, 608, São Paulo, Brazil.
Pelvic Pain and Endometriosis Unit, Gynecology Department, Paulista School of Medicine, Federal University of Sao Paulo (EPM-UNIFESP), São Paulo, Brazil.
Arch Gynecol Obstet. 2016 Sep;294(3):519-23. doi: 10.1007/s00404-016-4025-x. Epub 2016 Feb 5.
To assess function and prevalence of spasms and trigger points of the pelvic floor muscles in women with deep endometriosis.
One hundred and four (104) patients were assessed. Group 1 (G1) was composed of 52 subjects diagnosed with deep endometriosis proven by magnetic resonance imaging (MRI); Group 2 (G2) was composed of 52 women with no signs of endometriosis. Subjects from both G1 and G2 were seen at the Division of Pelvic Pain and Endometriosis and at Center for Prevention of Sexually Transmitted Diseases, both at Federal University of São Paulo (UNIFESP), respectively. A full physical therapy evaluation was carried out, including medical history, presence of dyspareunia and physical examination, which included detailed evaluation of pelvic floor muscles and occurrence of muscle spasm, trigger point and muscle function.
The average age of the subjects in the study group was 36.4 and 30.9 years in the control group (p = 0.002). A greater prevalence of deep dyspareunia was found in the subjects in the endometriosis group when compared to the control group (p = 0.010). Women in G1 had higher prevalence of muscle spasms. In this group, 53.9 % had spasms-compared to only 17.3 % of women in G2 (p < 0.001). On the other hand, no significant difference between the groups (p = 0.153) was found while searching for the presence of trigger points.
Women with deep endometriosis have increased prevalence of pelvic floor muscle spasms when compared to the control group.
评估深部子宫内膜异位症女性盆底肌肉痉挛和触发点的功能及患病率。
对104例患者进行评估。第1组(G1)由52名经磁共振成像(MRI)证实患有深部子宫内膜异位症的受试者组成;第2组(G2)由52名无子宫内膜异位症迹象的女性组成。G1和G2组的受试者分别在圣保罗联邦大学(UNIFESP)的盆腔疼痛和子宫内膜异位症科以及性传播疾病预防中心就诊。进行了全面的物理治疗评估,包括病史、性交困难情况和体格检查,其中包括对盆底肌肉的详细评估以及肌肉痉挛、触发点和肌肉功能的发生情况。
研究组受试者的平均年龄为36.4岁,对照组为30.9岁(p = 0.002)。与对照组相比,子宫内膜异位症组受试者中深部性交困难的患病率更高(p = 0.010)。G1组女性肌肉痉挛的患病率更高。在该组中,53.9%的人有痉挛,而G2组中只有17.3%的女性有痉挛(p < 0.001)。另一方面,在寻找触发点时,两组之间未发现显著差异(p = 0.153)。
与对照组相比,深部子宫内膜异位症女性盆底肌肉痉挛的患病率增加。