J Reprod Med. 2010 Jan-Feb;55(1-2):19-24.
Use of intravaginal electrical stimulation for the treatment of chronic pelvic pain: a randomized, double-blind, crossover clinical trial.
de Bernardes NO, Marques A, Ganunny C, Bahamondes L.
In this double-blind, crossover, randomized clinical trial, 26 women were randomly allocated to active intra vaginal electrical stimulation (IVES) or placebo. All women underwent 10 30-minute, twice-weekly sessions. The groups were then crossed over for a further 10 sessions. Pain was evaluated before and after each series. After the 2 sessions, 54.6% who initiated with placebo and 80% who initiated with active IVES had a pain score of less than 3. The authors conclude that intravaginal electrical stimulation was more effective than a placebo in alleviating pain in women with chronic pelvic pain
Gastroenterology. 2010 Apr;138(4):1321-9. Epub 2010 Jan 4.
Biofeedback is superior to electrogalvanic stimulation and massage for treatment of levator ani syndrome.
Chiarioni G, Nardo A, Vantini I, Romito A, Whitehead WE.
Study compares biofeedback to teach pelvic floor relaxation, electrogalvanic stimulation, and massage of levator muscles in the treatment of Levator ani syndrome (LAS). Biofeedback (87%) helped nearly twice as many patients as EGS (45%), whic in turn helped twice as many as massage (22%). Biofeedback is therefore the most effective of these treatments, and electrogalvanic stimulation is somewhat effective, whereas massage is effective for only a small proportion of women.
This study documents the voluntary reduction in medication use in patients with refractory chronic pelvic pain syndrome utilizing a protocol of pelvic floor myofascial trigger point release with an FDA approved internal trigger point wand and paradoxical relaxation therapy. Self-referred patients were enrolled in a 6-day training clinic from October, 2008 to May, 2011 and followed the protocol for 6 months. Medication usage and symptom scores on a 1-10 scale (10 = most severe) were collected at baseline, and 1 and 6 months. All changes in medication use were at the patient's discretion. Changes in medication use were assessed by McNemar's test in both complete case and modified intention to treat (mITT) analyses. 374 out of 396 patients met inclusion criteria; 79.7 % were male, median age of 43 years and median symptom duration of 5 years. In the complete case analysis, the percent of patients using medications at baseline was 63.6 %. After 6 months of treatment the percentage was 40.1 %, a 36.9 % reduction (p < 0.001). In the mITT analysis, there was a 22.7 % overall reduction from baseline (p < 0.001). Medication cessation at 6 months was significantly associated with a reduction in total symptoms (p = 0.03).