title: Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction.
abstract: OBJECTIVE
  To evaluate the effectiveness of transvaginal manual therapy of the pelvic floor musculature (Thiele massage) in symptomatic female patients with interstitial cystitis and high-tone dysfunction of the pelvic floor.
  
  
  METHODS
  A total of 21 women with documented interstitial cystitis and high-tone pelvic floor dysfunction underwent transvaginal massage using the Thiele technique twice a week for 5 weeks. Symptoms were evaluated before massage, at protocol conclusion, and at a mean of 4.5 months after therapy completion (long-term follow-up). The response to treatment was evaluated through the O'Leary-Sant Interstitial Cystitis Symptom and Problem Indexes, Likert Visual Analogue Scales for urgency and pain, and Short-Form 12-item (SF-12) Quality-of-Life Scale, and through changes in the physical examination findings using a 5-point modified Oxford Scale to document pelvic floor tenderness.
  
  
  RESULTS
  A statistically significant improvement was seen in the Symptom and Problem Indexes of the O'Leary-Sant Questionnaire (P = 0.015 and P = 0.039, respectively), Likert Visual Analogue Scales for urgency and pain (P = 0.001 and P = 0.005, respectively), the Physical and Mental Component Summary from the SF-12 Quality-of-Life Scale (P = 0.049 and P = 0.044, respectively), and the modified Oxford Scale (P <0.05) after protocol completion. At long-term follow-up, the O'Leary-Sant Interstitial Cystitis Symptom and Problem Indexes (P = 0.049 and P = 0.02, respectively), Likert Visual Analogue Scales for urgency and pain (P = 0.004 and P = 0.005, respectively), and modified Oxford Scale for three of four muscles in the pelvic floor (P <0.05) remained significantly improved.
  
  
  CONCLUSIONS
  Thiele massage appears to be very helpful in improving irritative bladder symptoms in patients with interstitial cystitis and high-tone pelvic floor dysfunction in addition to decreasing pelvic floor muscle tone.
authors.affiliation: University of Medicine and Dentistry New Jersey Robert Wood Johnson School of Medicine, Cooper Hospital, Camden, New Jersey 08043, USA.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Oyama
authors.forename: Amy
authors.initials: A
authors.lastname: Rejba
authors.forename: James C
authors.initials: JC
authors.lastname: Lukban
authors.forename: Erica
authors.initials: E
authors.lastname: Fletcher
authors.forename: Susan
authors.initials: S
authors.lastname: Kellogg-Spadt
authors.forename: Adam S
authors.initials: AS
authors.lastname: Holzberg
authors.forename: Kristene E
authors.initials: KE
authors.lastname: Whitmore
mesh_terms: D000328:Adult; D018856:Cystitis, Interstitial / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008405:Massage / Q000379:methods*; D010147:Pain Measurement; D017773:Pelvic Floor / Q000503:physiopathology*; D010808:Physical Examination; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D013035:Spasm / Q000628:therapy; D011795:Surveys and Questionnaires