Extracorporeal shock wave therapy for treating dyspareunia: A prospective, randomized, double-blind, placebo-controlled study

Hurt, Karel; Zahálka, František; Halaška, Michael; Rakovičová, Ivana; Rakovic, Jakub; Cmelinsky, Vaclav

doi:10.1016/j.rehab.2021.101545

Cited by 4 publications

(10 citation statements)

References 20 publications

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“…Of the 19 articles, six applied multimodal physiotherapy treatments [ 17 – 22 ]; five studies utilized electrotherapy [ 23 – 27 ] (with two of them combined with drugs [ 24 , 25 ] and two with pelvic floor muscle training [ 26 , 27 ]); three studies used Thiele's massage [ 28 – 30 ] (with one of them including an educational session [ 30 ]); and two studies implemented an interdisciplinary intervention [ 31 , 32 ] or pelvic floor muscle training [ 33 , 34 ]. Lastly, one study exclusively applied extracorporeal shockwave therapy [ 35 ].…”

Section: Resultsmentioning

confidence: 99%

“…Radiofrequency at 448 kHz (bipolar capacitive in abdomen and perineum and intravaginal and lumbo-sacral resistive) 4 weeks (2 sessions each week) Franco et al (2021) [ 34 ] RCT 77 Experimental group: Pelvic floor muscle training (supervised and at home) Control group: no treatment 12 weeks (2 sessions each week) Ghaderi et al (2019) [ 17 ] RCT 64 Experimental group: intravaginal electrotherapy (transcutaneous nerve electrostimulation at 110 Hz, 80 ms pulses and maximum tolerated intensity). Manual therapy and pelvic floor muscle training Control group: no treatment 12 weeks (1 session each week) Hurt et al (2021) [ 35 ] RCT 62 Experimental group: Extracorporeal shock wave therapy Control group: Sham extracorporeal shock wave therapy 4 weeks (1 session each week) Kolberg et al (2015) [ 33 ] RCT 145 Experimental group: Pelvic floor muscle training Control group: home pelvic floor muscle training (3 series of 8–12 maximum contractions) 16 weeks (Experimental group: 1 session each week) Authors Design Sample size Intervention Time of intervention (Frequency of sessions) Mira et al (2015) [ 23 ] RCT 22 Transcutaneous nerve electrostimulation: Experimental group: at 8 Hz and 250 ms pulses Control group: self-applied at 85 Hz and 75 ms pulses 8 weeks (not described) Mira et al (2020) [ 24 ] RCT 42 Experimental group: Hormone pelvic floor muscle training and electrotherapy Control group: Hormone therapy 8 weeks ...…”

Section: Resultsmentioning

confidence: 99%

“…Simultaneous performance of another treatment for dyspareunia Reduction of pain intensity. Increased perineal strength and endurance and sexual function Hurt et al (2021) [ 35 ] To determine whether extracorporeal shock waves therapy is effective for treating dyspareunia in women Painful penile-vaginal penetration without pelvic organic reasons primarily connected to pain, a score of > 0 on the Marinoff Dyspareunia Scale and on a visual analog scale. Women aged between 20 and 75 years old.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the experimental designs of the analyzed studies, eight of them were randomized controlled trials [ 17 , 23 – 25 , 30 , 33 – 35 ], while the remaining studies were quasi-experimental. Among the quasi-experimental studies, eight had a single experimental group [ 19 , 21 , 22 , 26 – 28 , 31 , 32 ], and three had two experimental groups [ 18 , 20 , 29 ] (with only two of them having random assignment of participants [ 18 , 20 ]).…”

Section: Resultsmentioning

confidence: 99%

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Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

et al. 2023

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Background Dyspareunia is defined as the occurrence of pain during or after sexual intercourse, which directly affects physical, sexual, and mental health. This condition can lead to depression, anxiety, and low self-esteem in women who experience it. Objectives The aim of this research was to evaluate the effectiveness of physical therapy interventions for the treatment of female dyspareunia. Design A systematic review and meta-analysis was conducted. Method Search of publications was conducted in Scopus, Medline, Pubmed, Cinahl and Web of Science. Treatment effects were defined as standardized mean difference and their 95% confidence intervals. Statistical heterogeneity was assessed using Crohan's Q test and quantified using the I2 index. Results Of the 19 articles selected, six applied multimodal physiotherapy treatments; five, electrotherapy; three, Thiele's massage; two, interdisciplinary interventions or pelvic floor muscle training; and one, extracorporeal shockwave therapy. The meta-analysis showed significant results for the variables pain and quality of life with the interventions based on electrotherapy and electrotherapy combined with pelvic floor muscle training. These interventions did not show significant results for the improvement of sexual function. Conclusions Physiotherapy techniques are effective and procedures have been identified with reliable results in improving pain and quality of life in patients with dyspareunia. One of the most important aspects is the strengthening of the perineal musculature and the application of Transcutaneous Electrical Nerve Stimulation. Furthermore, manual trigger point release therapy and Thiele massage, optimize and guarantee the reduction of pain intensity. Prospero registration CRD42021236155.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

et al. 2023

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“…A retrospective study was performed to compare the treatment group with the controls. The study participants were women who took part in our previous study on dyspareunia conducted between 2017 and 2019, following a former feasibility study (previously published) [ 20 ].…”

Section: Participants and Methodsmentioning

confidence: 99%

Hypoxia as a potential cause of dyspareunia

Hurt

Zahálka²,

Zikán

et al. 2023

PLoS ONE

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Dyspareunia is genital pain before, during or after penile-vaginal sexual intercourse. The prevalence of dyspareunia ranges from 8 to 22%. Sexual intercourse concomitant with a pelvic organic lesion is likely to cause pain in most cases. However, in these cases, the pain depends not only on sexual intercourse. In its basic definition, dyspareunia in women is considered an idiopathic affection without a typical organic constitution. It is only present with penile-vaginal penetration. Long-term hypoxia in perineal muscles can cause muscle and perimuscular changes, leading to chronic pain not sufficiently responding to standard therapy. During the entrance examination to our previous study on dyspareunia, we noted significantly lower pulse oximetry levels in the perineal area of affected women. We aimed to compare pulse oximetry oxygen saturation (SpO2) of dyspareunia-affected women to healthy, pain-free women. A retrospective study was performed. The study participants were women who had participated in our previously published study on dyspareunia. This retrospective study was approved by the Ethical Committee. The study included 62 women: 31 dyspareunia-affected women in the treatment group and 31 healthy women in the control group. Method: During their examinations, women in the dyspareunia and control groups were measured for SpO2. The procedure was performed in the vulvo-perineal rear region, involving the commissure and the bulbospongiosus muscle. Median and mean SpO2 were compared between the treatment and control groups. Testing for sample size accuracy was performed retroactively. Results: There were 31 participants in each group. The SpO2 data were skewed and did not follow a Gaussian distribution. The Mann-Whitney U test was run to determine differences in perineum oximetry between the treatment group and controls. The median SpO2 was 91 in the treatment group and 92 in the control group. This difference was statistically significant, p = 0.002. Sample size accuracy was assured by post hoc calculation. Conclusions: Idiopathic dyspareunia is inherent in cohabitation muscle pain that standard therapy could not explain nor treat. We detected clinically meaningfully decreased levels of SpO2 in affected patients. We compared pelvic oximetry between dyspareunia-affected women in the treatment and control groups. This comparison showed significant hypoxia in the perineal muscle area (p = 0.002). Our results may help us understand the source of this pain and guide treatment accordingly.

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Effectiveness of nonpharmacological conservative therapies for chronic pelvic pain in women: a systematic review and meta-analysis

Starzec-Proserpio,

Frawley,

Bø

et al. 2025

American Journal of Obstetrics and Gynecology

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Extracorporeal shock wave therapy for treating dyspareunia: A prospective, randomized, double-blind, placebo-controlled study

Cited by 4 publications

References 20 publications

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

Effectiveness of physical therapy interventions in women with dyspareunia: a systematic review and meta-analysis

Hypoxia as a potential cause of dyspareunia

Effectiveness of nonpharmacological conservative therapies for chronic pelvic pain in women: a systematic review and meta-analysis

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