Hypothesis / aims of study
Physical therapy (PT) intervention, which include the use of biofeedback (BF) and the myofascial trigger point (MTP) release to promote pelvic floor muscles relaxation and pain relief, are conservative treatment for patients with Bladder Pain Syndrome (BPS). In addition, the use of transcutaneous electro neurostimulation (TENS) might be effective to decrease pain in active trigger points. Postural exercises (PE) can also lead to an improvement of pelvic mobility and stability. However, controlled studies are missing to analyze these effects on pain and urinary symptoms. Herein, our aim was to verify the effects of PT interventions on pain and urinary symptoms in women with BPS.
Study design, materials and methods
We conducted a parallel-randomized controlled trial on 24 female patients with the diagnosis of BPS according to NIH criteria. Specialized physiotherapists evaluated all women through story data, application of validated questionnaire of urinary symptoms (O´Leary), pain (VAS), sexual function (FSFI) and physical and electromyographic examination. After the assessment, patients were randomized 1:1:1, using a website (random.org), i.e., 2 groups of treatment, consisted by 10 weekly sessions of BF plus MTP release and either TENS (EG group) or PE (PG group), and the control group (CG group), in who treatment was delayed 3 months after the evaluation.
Interpretation of results
In our study, there was a prevalence of pain and urinary symptoms and EG group and PG group had a significant improvement when compared to CG group. PG showed better results of pain impact, decrease of painkillers intake and perineal pain after treatment and these results may be related to the technique itself, particularly because postural exercises included pelvic floor relaxation, breathing exercises and pelvic mobility and not only with pelvic floor muscles alone.