Low Dose, High Frequency Movement Based Dilator Therapy for Dyspareunia: Retrospective Analysis of 26 Cases

Abstract

Introduction: While two-thirds of women will experience dyspareunia and vaginal dilators are often used to treat dyspareunia, outside of a single case report, no study has investigated the potential of low-dose, high frequency movement-based dilator therapy for dyspareunia in premenopausal female patients. Aim: To determine the utility of low-dose, high frequency movement-based dilator use for dyspareunia in premenopausal female patients. Methods: Retrospective study of women presenting to outpatient hospital-based pelvic floor physical therapy office in a tertiary care center. All adult premenopausal female patients who were referred to pelvic floor physical therapy for dyspareunia and completed movement-based dilator therapy (MBDT) and met study criteria (n = 26) were included for analysis. Main Outcome Measure: Patient change in pain level status using Numeric Pain Rating Scale with intercourse was compared between initial evaluation and time of discharge from pelvic floor physical therapy. Results: Among the 26 women who met criteria for this study, the average pain score decreased from 8.3 (SD 2.2) before treatment to 1.3 (SD 2.0) after treatment and was statistically significant (P< .001). Complete resolution of dyspareunia was reported in 58% of patients. Patients completed between 2 and 6 total pelvic floor physical therapy visits (average 3.7, SD1.5), over 0−44 weeks (mean 9.6 weeks, SD 8.3). Conclusion: Low-dose, high frequency, movement-based dilator therapy significantly reduced or resolved the experience of pain with penetrative vaginal intercourse with dyspareunia. Future prospective studies with larger samples and the inclusion of sexual functional status should be considered to explore the full potential of this modality in treatment of premenopausal patients with dyspareunia. K Miles, S Miles. Low Dose, High Frequency Movement Based Dilator Treatment for Dyspareunia: Retrospective Analysis of 26 Cases. Sex Med 2021;9:100344.

Design and Material Characterization of an Inflatable Vaginal Dilator

“…Hard plastic, non-personalized dilator rods are currently given to patients to self-administer, and while diligent use of these devices is effective, patient acceptance is often poor, and compliance is a major issue (see Figure 2 ). Most vaginal dilators presently in use are smooth plastic rods [ 18 ], as shown in Figure 2 . The ill-fitting hard plastic rods being pushed at various angles into the vaginal vault are painful and this approach is disliked by many patients.…”