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Physiotherapy for Pelvic Pain and Dyspareunia with Associated Muscular Spasm O’Connell JG, O’Sullivan S,O’Reilly B, Wiseman S, Khashan A. Introduction.

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Presentation on theme: "Physiotherapy for Pelvic Pain and Dyspareunia with Associated Muscular Spasm O’Connell JG, O’Sullivan S,O’Reilly B, Wiseman S, Khashan A. Introduction."— Presentation transcript:

1 Physiotherapy for Pelvic Pain and Dyspareunia with Associated Muscular Spasm O’Connell JG, O’Sullivan S,O’Reilly B, Wiseman S, Khashan A. Introduction Chronic Pelvic Pain is thought to make up 10% of all gynaecology referrals. Non-relaxing pelvic floor dysfunction is underappreciated as one of the main causes for chronic pelvic pain. This study aims to assess the effectiveness of manual therapy performed by a specialist physiotherapist for the treatment of chronic pelvic pain, dyspareunia and pelvic floor dysfunction in women who are found to have muscle spasm and tenderness on examination, in the absence of other pelvic pathology. Results: Of 31 women recruited,17 completed post treatment questionnaires. Two were lost to follow up. 12 remained in treatment. The mean age was 33.7 (SD=8). Patients were asked factors they associated with the onset of their pain with their responses in Figure 1 above. Statistically significant (P<.05) improvements were detected in 16 areas. These were found in intercourse pain and in sexual and bladder dysfunctions. We found statistically significant reduction in all cycle associated pain variables with no change in prolapse or bowel symptoms which required further physiotherapy treatment beyond the scope of this paper. Final results of the QFPFQ scores are summarised in table1. Contact: Wiseman.S, Physiotherapy Department, Cork University Maternity hospital, Cork, Rep.of Ireland. Tel. No: Conclusions: Manual therapy techniques in physiotherapy may be an effective treatment for sexual and bladder dysfunction in patients with NRPFD. Specialist physiotherapy for NRPFD associated pelvic pain and dyspareunia is an area which merits research and potentially a future randomised control trial. Fig 1: Factors associated with the onset of pain Table 1:Results from the QFPFQ Fig 2: Pre and Post Treatment Medians for the IPPSQ Methods We used questions from the validated International Pelvic Pain Society (IPPS) and Queensland Female Pelvic Floor (QFPF) questionnaires to assess pain, sexual dysfunction and quality of life issues. These were filled prior to treatment and after discharge or on completion of six sessions of therapy. The Wilcoxon signed-rank test was used to compare the scores reported by the participants before and after treatment. QFPFQ scores for 17 full protocol patients Pre- treatment Median Post – treatment MedianPossibleP- Value Bladder Dysfunction12( 2-20)4(1-14) Bowel Dysfunction7(4-11)6(1-10) Prolapse symptoms2(0-3)0(0-1)15`0.074 Sexual Dysfunction Total Queensland Female pelvic floor score 10(8-11) 27(19-41) 3(0-6) 11(9-23) References 1. Apte et al 2012,Chronic female pelvic pan –Part 1:Clinical Pathoanatomy and Examination of the pelvic region. Pain Practice,Vol 12, Issue 2, pp Reiter RC. A profile of women with chronic pelvic pain. Clinical obstetrics and gynecology. 1990;33(1): Epub 1990/03/ Bailliere's Clinical Obstetrics and Gynaecology, Vol. 14, No. 3, pp. 389±402, 2000


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