Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 3/2016

05.02.2016 | General Gynecology

Assessment of pelvic floor muscles in women with deep endometriosis

verfasst von: Ana Paula Santos dos Bispo, Christine Ploger, Alessandra Fernandes Loureiro, Hélio Sato, Alexander Kolpeman, Manoel João Batista Castello Girão, Eduardo Schor

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To assess function and prevalence of spasms and trigger points of the pelvic floor muscles in women with deep endometriosis.

Methods

One hundred and four (104) patients were assessed. Group 1 (G1) was composed of 52 subjects diagnosed with deep endometriosis proven by magnetic resonance imaging (MRI); Group 2 (G2) was composed of 52 women with no signs of endometriosis. Subjects from both G1 and G2 were seen at the Division of Pelvic Pain and Endometriosis and at Center for Prevention of Sexually Transmitted Diseases, both at Federal University of São Paulo (UNIFESP), respectively. A full physical therapy evaluation was carried out, including medical history, presence of dyspareunia and physical examination, which included detailed evaluation of pelvic floor muscles and occurrence of muscle spasm, trigger point and muscle function.

Results

The average age of the subjects in the study group was 36.4 and 30.9 years in the control group (p = 0.002). A greater prevalence of deep dyspareunia was found in the subjects in the endometriosis group when compared to the control group (p = 0.010). Women in G1 had higher prevalence of muscle spasms. In this group, 53.9 % had spasms—compared to only 17.3 % of women in G2 (p < 0.001). On the other hand, no significant difference between the groups (p = 0.153) was found while searching for the presence of trigger points.

Conclusion

Women with deep endometriosis have increased prevalence of pelvic floor muscle spasms when compared to the control group.
Literatur
1.
Zurück zum Zitat Haas D, Chvatal R, Reichert B, Renner S, Shebl O, Binder H, Wurm P, Oppelt P (2012) Endometriosis: a premenopausal disease? Age pattern in 42,079 patients with endometriosis. Arch Gynecol Obstet 286(3):667–670. doi:10.1007/s00404-012-2361-z CrossRefPubMed Haas D, Chvatal R, Reichert B, Renner S, Shebl O, Binder H, Wurm P, Oppelt P (2012) Endometriosis: a premenopausal disease? Age pattern in 42,079 patients with endometriosis. Arch Gynecol Obstet 286(3):667–670. doi:10.​1007/​s00404-012-2361-z CrossRefPubMed
2.
Zurück zum Zitat Del Frate C, Girometti R, Pittino M, Del Frate G, Bazzocchi M, Zuiani C (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. RadioGraphics 26:1705–1718CrossRefPubMed Del Frate C, Girometti R, Pittino M, Del Frate G, Bazzocchi M, Zuiani C (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. RadioGraphics 26:1705–1718CrossRefPubMed
3.
Zurück zum Zitat Arruda MS, Petta CA, Abrão MS, Benetti-Pinto CL (2003) Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod 18(4):756–759CrossRefPubMed Arruda MS, Petta CA, Abrão MS, Benetti-Pinto CL (2003) Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod 18(4):756–759CrossRefPubMed
4.
Zurück zum Zitat Matsuzaki S, Canis M, Poully JL, Rabischong B, Botchorishvili R, Mage G (2006) Relationship between delay of surgical diagnosis and severity of disease in patients with symptomatic deep infiltrating endometriosis. Fertil Steril 86(5):1314–1316CrossRefPubMed Matsuzaki S, Canis M, Poully JL, Rabischong B, Botchorishvili R, Mage G (2006) Relationship between delay of surgical diagnosis and severity of disease in patients with symptomatic deep infiltrating endometriosis. Fertil Steril 86(5):1314–1316CrossRefPubMed
5.
Zurück zum Zitat Hudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D, Tammaa A, Salzer H (2012) Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 27(12):3412–3416CrossRefPubMed Hudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D, Tammaa A, Salzer H (2012) Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 27(12):3412–3416CrossRefPubMed
6.
Zurück zum Zitat Marques A, Bahamondes L, Aldrighi JM, Petta CA (2004) Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire. J Reprod Med 49(2):115–120PubMed Marques A, Bahamondes L, Aldrighi JM, Petta CA (2004) Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire. J Reprod Med 49(2):115–120PubMed
7.
Zurück zum Zitat Baker PK (1993) Musculoskeletal origins of chronic pelvic pain—diagnosis e treatment. Obstet Ginecol Clin N Am 20(4):719–743 Baker PK (1993) Musculoskeletal origins of chronic pelvic pain—diagnosis e treatment. Obstet Ginecol Clin N Am 20(4):719–743
8.
Zurück zum Zitat FitzGerald MP, Kotarinos R (2003) Rehabilitation of the short pelvic floor. I: background and patient evaluation. Int Urogynecol J 14:261–268CrossRef FitzGerald MP, Kotarinos R (2003) Rehabilitation of the short pelvic floor. I: background and patient evaluation. Int Urogynecol J 14:261–268CrossRef
9.
Zurück zum Zitat Lukic A, Di Properzio M, De Carlo S, Nobili F, Schimberni M, Bianchi P, Prestigiacomo C, Moscarini M, Caserta D (2015) Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet. doi:10.1007/s00404-015-3832-9 PubMed Lukic A, Di Properzio M, De Carlo S, Nobili F, Schimberni M, Bianchi P, Prestigiacomo C, Moscarini M, Caserta D (2015) Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet. doi:10.​1007/​s00404-015-3832-9 PubMed
10.
Zurück zum Zitat Rolf IP (1999) A articulação que determina a assimetria. In: Rolfing: a Integração das Estruturas Humanas. Martina Fontes, São Paulo, p 127–136 Rolf IP (1999) A articulação que determina a assimetria. In: Rolfing: a Integração das Estruturas Humanas. Martina Fontes, São Paulo, p 127–136
11.
Zurück zum Zitat Doggweiler-Wiygul R, Wiygul JP (2002) Interstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients. J Urol 20:310–314 Doggweiler-Wiygul R, Wiygul JP (2002) Interstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients. J Urol 20:310–314
12.
13.
Zurück zum Zitat Yap EC (2007) Myofascial pain—an overview. Ann Acad Med Singap 36(1):43–48PubMed Yap EC (2007) Myofascial pain—an overview. Ann Acad Med Singap 36(1):43–48PubMed
14.
Zurück zum Zitat Guerineau M, Labat JJ, Sibert L, Delavierre D, Rigard J (2010) Traitement de la composante musculosquelettiqeu des douleurs pelvipérinéales chroniques. Progrès en urologie 20:1013–1110CrossRef Guerineau M, Labat JJ, Sibert L, Delavierre D, Rigard J (2010) Traitement de la composante musculosquelettiqeu des douleurs pelvipérinéales chroniques. Progrès en urologie 20:1013–1110CrossRef
15.
Zurück zum Zitat Weiss JM (2001) Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol 166:2226–2231CrossRefPubMed Weiss JM (2001) Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol 166:2226–2231CrossRefPubMed
16.
Zurück zum Zitat Bo K, Finckenhagen HB (2001) Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and squeeze pressure. J Urol 169(6):2428–2429 Bo K, Finckenhagen HB (2001) Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and squeeze pressure. J Urol 169(6):2428–2429
17.
Zurück zum Zitat Talasz H, Himmer-Perschak G, Marth E, Fischer-Colbrie J, Hoefner E, Lechleitner M (2008) Evaluation of pelvic floor muscle function in a randon group of adult women in Austria. Int Urogynecol J 19:131–135CrossRef Talasz H, Himmer-Perschak G, Marth E, Fischer-Colbrie J, Hoefner E, Lechleitner M (2008) Evaluation of pelvic floor muscle function in a randon group of adult women in Austria. Int Urogynecol J 19:131–135CrossRef
18.
Zurück zum Zitat Deguara CS, Pepas L, Davis C (2012) Does minimally invasive surgery for endometriosis improve pelvic symptoms and quality of life? Curr Opin Obstet Gynecol 24(4):241–244CrossRefPubMed Deguara CS, Pepas L, Davis C (2012) Does minimally invasive surgery for endometriosis improve pelvic symptoms and quality of life? Curr Opin Obstet Gynecol 24(4):241–244CrossRefPubMed
19.
Zurück zum Zitat Roman H, Vassilieff M, Gourcerol G, Savoye G, Leroi AM, Marpeau L, Michot F, Tuech JJ (2011) Surgical management of deep infiltrating endometriosis of the rectum: pleading for a symptomguided approach. Hum Reprod 26(2):274–281CrossRefPubMed Roman H, Vassilieff M, Gourcerol G, Savoye G, Leroi AM, Marpeau L, Michot F, Tuech JJ (2011) Surgical management of deep infiltrating endometriosis of the rectum: pleading for a symptomguided approach. Hum Reprod 26(2):274–281CrossRefPubMed
20.
Zurück zum Zitat Neville CE, Fitzgerald CM, Mallinson T, Badillo S, Hynes C, Tu F (2012) A preliminary report of musculoskeletal dysfunction in female chronic pelvic pain: a blinded study of examination findings. J Bodyw Mov Ther 16:50–56CrossRefPubMed Neville CE, Fitzgerald CM, Mallinson T, Badillo S, Hynes C, Tu F (2012) A preliminary report of musculoskeletal dysfunction in female chronic pelvic pain: a blinded study of examination findings. J Bodyw Mov Ther 16:50–56CrossRefPubMed
21.
Zurück zum Zitat Tu FF, Holt J, Gonzáles J, Fitzgerald CM (2008) Physical therapy evaluation of patients with chronic pelvic pain: a controlled study. Am J Obstet Gynecol 272(e1-272):e7 Tu FF, Holt J, Gonzáles J, Fitzgerald CM (2008) Physical therapy evaluation of patients with chronic pelvic pain: a controlled study. Am J Obstet Gynecol 272(e1-272):e7
22.
Zurück zum Zitat Montenegro MLLS, Lemes EC, Vasconcelos M, Silva JCRE, Nogueira AA, Reis FJC, Poli Neto OB (2010) Importance of pelvic floor muscle tenderness evaluation in women with chronic pelvic pain. Pain Med 11:224–228CrossRefPubMed Montenegro MLLS, Lemes EC, Vasconcelos M, Silva JCRE, Nogueira AA, Reis FJC, Poli Neto OB (2010) Importance of pelvic floor muscle tenderness evaluation in women with chronic pelvic pain. Pain Med 11:224–228CrossRefPubMed
23.
Zurück zum Zitat FitzGeral MC, Neville CE, Mallinson T, Badillo SA, Hynes CK, Tu FF (2011) Pelvic floor muscle examination in female chronic pelvic pain. J Reprod Med 56:117–122 FitzGeral MC, Neville CE, Mallinson T, Badillo SA, Hynes CK, Tu FF (2011) Pelvic floor muscle examination in female chronic pelvic pain. J Reprod Med 56:117–122
24.
Zurück zum Zitat Chapron C, Chopin N, Borghese B, Foulot H, Dousset B, Vacher-Lavenu MC, Vieira M, Hasan W, Bricou A (2006) Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod 21(7):1839–1845CrossRefPubMed Chapron C, Chopin N, Borghese B, Foulot H, Dousset B, Vacher-Lavenu MC, Vieira M, Hasan W, Bricou A (2006) Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod 21(7):1839–1845CrossRefPubMed
25.
Zurück zum Zitat Schliep KC, Mumford SL, Peterson CM, Chen Z, Johnstone EB, Sharp HT, Stanford JB, Hammoud AO, Sun L, Buck Louis GM (2015) Pain typology and incident endometriosis. Hum Reprod 30(10):2427–2438. doi:10.1093/humrep/dev147 CrossRefPubMed Schliep KC, Mumford SL, Peterson CM, Chen Z, Johnstone EB, Sharp HT, Stanford JB, Hammoud AO, Sun L, Buck Louis GM (2015) Pain typology and incident endometriosis. Hum Reprod 30(10):2427–2438. doi:10.​1093/​humrep/​dev147 CrossRefPubMed
26.
Zurück zum Zitat Travell J, Simons D (1983) The trigger point manual. William & Wilkins, Philadelphia, p 1 Travell J, Simons D (1983) The trigger point manual. William & Wilkins, Philadelphia, p 1
27.
Zurück zum Zitat Petersen CD, Giraldi A (2008) Should physiotherapy be part of a multidisciplinary treatment for women with chronic pelvic pain? Int J Clin Pract 62(2):174–175CrossRefPubMed Petersen CD, Giraldi A (2008) Should physiotherapy be part of a multidisciplinary treatment for women with chronic pelvic pain? Int J Clin Pract 62(2):174–175CrossRefPubMed
28.
Zurück zum Zitat Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Arne V, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisationsub committee of the International Continence Society. Am J Obstet Gynecol 187:116–126CrossRefPubMed Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Arne V, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisationsub committee of the International Continence Society. Am J Obstet Gynecol 187:116–126CrossRefPubMed
29.
Zurück zum Zitat Heim LJ (2001) Evaluation and differential diagnosis of dyspareunia. Am Fam Physician 63:1535–1544PubMed Heim LJ (2001) Evaluation and differential diagnosis of dyspareunia. Am Fam Physician 63:1535–1544PubMed
30.
Zurück zum Zitat Ferrero S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N (2005) Quality of sex life in women with endometriosis and deep dispareunia. Fertil Steril 83:573–579CrossRefPubMed Ferrero S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N (2005) Quality of sex life in women with endometriosis and deep dispareunia. Fertil Steril 83:573–579CrossRefPubMed
31.
Zurück zum Zitat Porpora MG, Koninickx PR, Piazze J, Natili M, Colagrande S, Cosmi EV (1999) Correlation between endometriosis and pelvic pain. J Am Assoc Gynecol Laparosc 6(4):429–434CrossRefPubMed Porpora MG, Koninickx PR, Piazze J, Natili M, Colagrande S, Cosmi EV (1999) Correlation between endometriosis and pelvic pain. J Am Assoc Gynecol Laparosc 6(4):429–434CrossRefPubMed
32.
Zurück zum Zitat Bellelis P, Dias JA Jr, Podgaec S, Gonzales M, Baracat EC, Abrão MS (2010) Epidemiological and clinical aspects of pelvic endometriosis—a case series. Rev Assoc Med Bras 56(4):467–471CrossRefPubMed Bellelis P, Dias JA Jr, Podgaec S, Gonzales M, Baracat EC, Abrão MS (2010) Epidemiological and clinical aspects of pelvic endometriosis—a case series. Rev Assoc Med Bras 56(4):467–471CrossRefPubMed
33.
Zurück zum Zitat Jia SZ, Leng JH, Sun PR, Lang JH (2013) Prevalence and associated factors of female sexual dysfunction in women with endometriosis. Obstet Gynecol 121(3):601–606CrossRefPubMed Jia SZ, Leng JH, Sun PR, Lang JH (2013) Prevalence and associated factors of female sexual dysfunction in women with endometriosis. Obstet Gynecol 121(3):601–606CrossRefPubMed
34.
Zurück zum Zitat Tripoli TM, Sato H, Sartori MG, de Araujo FF, Girão MJBC, Schor E (2011) Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med 8(2):497–503CrossRefPubMed Tripoli TM, Sato H, Sartori MG, de Araujo FF, Girão MJBC, Schor E (2011) Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med 8(2):497–503CrossRefPubMed
Metadaten
Titel
Assessment of pelvic floor muscles in women with deep endometriosis
verfasst von
Ana Paula Santos dos Bispo
Christine Ploger
Alessandra Fernandes Loureiro
Hélio Sato
Alexander Kolpeman
Manoel João Batista Castello Girão
Eduardo Schor
Publikationsdatum
05.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 3/2016
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4025-x

Weitere Artikel der Ausgabe 3/2016

Archives of Gynecology and Obstetrics 3/2016 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.