Comparison study between electrogalvanic stimulation and local injection therapy in levator ani syndrome

Park, Duk-Hoon; Yoon, Seo-Gue; Kim, Kuhn Uk; Hwang, Do Yeon; Kim, Hyun Shig; Lee, Jong Kyun; Kim, Kwang Yun

doi:10.1007/s00384-004-0662-9

Cited by 29 publications

(20 citation statements)

References 14 publications

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“…Tender points are di¡erent from trigger points as they are identi¢ed by local tenderness, located at multiple sites, and they do not cause referred pain or have palpable tissue changes [Tetttambel, 2005]. These women may have myofascial dysfunction or a vaginal manifestation of levator ani syndrome, a spastic cycle or local in£ammation of the levator ani muscle [Park et al, 2005]. Our hypothesis for this study was that there are components of both in£ammation and spasticity of the levator ani resulting in the vaginal trigger points and CPP.…”

Section: Introductionmentioning

confidence: 99%

Levator ani trigger point injections: An underutilized treatment for chronic pelvic pain

Langford

Nagy

Ghoniem

2007

Neurourology and Urodynamics

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Aims: We conducted this study to examine the role of trigger point injections in females with chronic pelvic pain (CPP) of at least 6 months duration and speci¢c levator ani trigger points. Methods: This prospective study included 18 consecutive female patients with CPP and speci¢c palpable levator ani trigger points. Pain was evaluated before and after trigger point injection on a Visual Analog Scale (VAS). Patient global satisfaction (PGS) and cure rates (PGC) were also measured by aVAS on a scale of 0^100%. The trigger points were identi¢ed manually by intravaginal palpation of the levator ani bilaterally. A mixture of 10 cc of 0.25% bupivacaine, 10 cc of 2% lidocaine and 1 cc (40 mg) of triamcinolone was used for injection of 5 cc per trigger point. A 5.5 00 Iowa trumpet pudendal needle guide was used for injection. All but one injection were performed in the o⁄ce setting without sedation. Pelvic £oor muscle exercises were taught for use after injection. Success was de¢ned as a decrease in pain as measured by a VAS of 50% or more, as well as PGS and PGC scores of 60% or greater. There was a mean follow up of 3 months after trigger point injection.Results: Thirteen of 18 women improved with the ¢rst trigger point injection resulting in a comprehensive success rate of 72%. Six (33%) of 18 women were completely pain free. Conclusion: In the management of CPP, a non-surgical o⁄ce-based therapy such as trigger point injections can be e¡ective in selected patients. Neurourol. Urodynam. 26: 59^62, 2007. ß 2006

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Section: Introductionmentioning

confidence: 99%

Levator ani trigger point injections: An underutilized treatment for chronic pelvic pain

Langford

Nagy

Ghoniem

2007

Neurourology and Urodynamics

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“…Some advances have been achieved in the diagnosis and treatment of CP[4,17,18]. However, the etiology and pathophysiology of CP is not well understood.…”

Section: Discussionmentioning

confidence: 99%

Role of three-dimensional endoanal ultrasound in assessing the anal sphincter morphology of female patients with chronic proctalgia

Xue

Ding

et al. 2017

WJG

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AIMTo assess the role of three-dimensional endoanal ultrasound (3D-EAUS) for morphological assessment of the anal sphincter of female patients with chronic proctalgia (CP).METHODSIn this unmatched case control study, 30 consecutive female patients with CP and 25 normal women (control group) were enrolled. 3D-EAUS was performed in all subjects. Thickness and length of internal anal sphincter (IAS), thickness of puborectalis muscle (PR), length of the external anal sphincter (EAS) plus PR, and puborectalis angle were measured and compared between the two groups.RESULTSPatients with CP had significantly shorter IAS length and greater PR thickness, as compared to those in normal individuals (26.28 ± 3.59 mm vs 28.87 ± 4.84 mm, P < 0.05 and 9.67 ± 1.57 mm vs 8.85 ± 0.97 mm, P < 0.05, respectively). No significant between-group differences were observed with respect to IAS thickness and the EAS plus PR length (P > 0.05). Puborectalis angle in the CP group was significantly decreased, both in resting (88.23° ± 1.81° vs 89.94° ± 2.07° in control group, P < 0.05) and straining (88.47° ± 3.32° vs 90.72° ± 1.87° in control group, P < 0.05) phases, which suggest the presence of paradoxical contraction of PR in patients with CP. In the CP group, no significant difference in puborectalis angle was observed between the resting and straining phases (88.23° ± 1.81° vs 88.47° ± 3.32° respectively, P > 0.05).CONCLUSIONThe association of greater PR thickness and paradoxical contraction of PR with CP suggest their potential value as markers of CP.

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“…Recently, a prospective, open label study compared electrogalvanic stimulation twice a week (n ¼ 22) vs. intrasphincteric injection of 40 mg triamcinolone (n ¼ 31). 57 In this study, subjects who received triamcinolone show more relief and improvement at 1, 3 and 6 months compared to electrogalvanic stimulation. However, at 12 months, eight subjects (26%) in the triamcinolone group and two subjects (9%) in the electrogalvanic stimulation group reported 'complete' symptomatic relief.…”

Section: Chronic Proctalgiamentioning

confidence: 94%

“…56,57 The rationale for this therapy is that at low frequency an oscillating current applied to the muscles of the anal canal induces fasciculation and fatigue, breaking the spastic cycle that may cause the patient's symptoms. Recently, a prospective, open label study compared electrogalvanic stimulation twice a week (n ¼ 22) vs. intrasphincteric injection of 40 mg triamcinolone (n ¼ 31).…”

Section: Chronic Proctalgiamentioning

confidence: 99%

Anorectal motor disorders

Troche

Rao

2007

Best Practice & Research Clinical Gastroenterology

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Comparison study between electrogalvanic stimulation and local injection therapy in levator ani syndrome

Cited by 29 publications

References 14 publications

Levator ani trigger point injections: An underutilized treatment for chronic pelvic pain

Levator ani trigger point injections: An underutilized treatment for chronic pelvic pain

Role of three-dimensional endoanal ultrasound in assessing the anal sphincter morphology of female patients with chronic proctalgia

Anorectal motor disorders

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