Effectiveness of vaginal analgesic electrostimulation versus sacral electroacupuncture in chronic pelvic pain of myofascial origin

Background: Chronic pelvic pain (CPP) of myofascial origin is a condition that is difficult to control and with great repercussion on the quality of life for women who suffer from it. This study objective was to compare the effectiveness of two treatments for the management of this pathology; vaginal analgesic electrostimulation (VES) versus sacral electroacupuncture (EAS).Methods: Quasi-experimental comparative study of two treatments in patients with myofascial CPP. The sample was made up of women who presented this condition during the period 2016 to 2019. The main objective was to assess the effectiveness of the treatments in comparison in terms of the decrease in the VAS score, the secondary ones were: To know the effectiveness of the VES for pain chronic pelvic myofascial (MFPP), the effectiveness of EA for the same condition, complications of therapies, main urological dysfunctions and other chronic pelvic pain associated with myofascial CPP.Results: Thirteen thousand patient files were reviewed, of which 47 were diagnosed with myofascial CCP, with 38 patients eligible for our study. The VES was more effective than the EAS in decreasing the VAS in the twelfth session from 1.36 versus 2.62 p .001. Both therapies were effective for the management of myofascial DCP as they decreased the VAS score to more than 60% of the initial VAS. Vulvodynia (34%), mixed urinary incontinence (32%), and voiding symptoms (26%) were other pelvic floor dysfunctions that presented concomitantly to the MFPP.Conclusions: In patients with myofascial CPP, vaginal VES is better than AD for the treatment of this condition.

Electrical stimulation combined with manual massage can relieve myofascial pelvic pain / 中华物理医学与康复杂志

Objective@#To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS).@*Methods@#A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group (n=30), an electrical stimulation group (n=31) and a combination group (n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment.@*Results@#The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%).@*Conclusion@#Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Multimodal treatment of myophasal chronic pelvic pain in women: institutional experience

Background: Chronic pelvic pain of myofascial origin is an underdiagnosed condition and with partial responses to the different treatment modalities. The objective of this study was to report the results of the multimodal management of Myofascial Chronic Pelvic Pain.Methods: Retrospective cohort of 33 patients with myofascial chronic pelvic pain, during the period 01 January 2016 to August 31, 2018, who were treated based on trigger point infiltration and analgesic vaginal electrostimulation. The analogous visual pain scale (VAS) was used at the beginning, sixth, twelfth and six months after the last electrostimulation session, in order to measure the effect of the treatment.Results: During the study period, 32 patients with chronic myofascial pelvic pain were found who received the multimodal scheme that is offered in our clinic. The average score of the EVA before starting the treatment was 8.5 points, at the sixth session of the treatment the average EVA was 3.6 points, at the twelfth session of 1.3 points and the average score of the EVA at six months after the last session of the multimodal treatment was 2.9 points. A significant difference was demonstrated in the average EVA score in the first with respect to the sixth, twelfth and six months (p = <0.000). There were no complications or adverse effects secondary to the multimodal treatment.Conclusions: Multimodal treatment was associated with progressive improvement in 80% of patients with miofascial chronic pelvic pain.