Ghaderi Fariba, Bastani Parvin, Hajebrahimi Sakineh, Jafarabadi Mohammad Asghari, Berghmans Bary
Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Gynaecology, Woman's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Int Urogynecol J. 2019 Nov;30(11):1849-1855. doi: 10.1007/s00192-019-04019-3. Epub 2019 Jul 8.
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.
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.
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).
According to the results, pelvic floor rehabilitation is an important part of a multidisciplinary treatment approach to dyspareunia.
性交疼痛是育龄期女性常见的性功能障碍症状。由于其病因多因素,可能需要多学科方法来治疗。肌肉骨骼因素起重要作用;因此,盆底康复及调整盆底肌肉(PFMs)张力可能是治疗该功能障碍的有效方法。本随机对照临床研究的目的是评估盆底康复技术对性交疼痛的影响。
在84名接受资格评估的女性中,64名性交疼痛女性被随机分为两组:实验组(n = 32)接受电疗法、手法治疗和PFMs锻炼,对照组(n = 32)在等待名单上未接受治疗。在治疗3个月前后及3个月随访时直接评估PFMs强度和耐力、性功能及疼痛情况。
组间变化显示,与对照组相比,实验组有显著改善。两组间PFMs强度(根据0 - 5牛津量表)的平均差异为2.01,耐力平均差异为6.26秒。此外,女性性功能指数评分(评分范围为2至95)的平均差异为51.05,视觉模拟评分(VAS)的平均差异为7.32。所有变化均具有统计学意义(p < 0.05)。
根据结果,盆底康复是性交疼痛多学科治疗方法的重要组成部分。