A prospective study of pelvic floor physical therapy: pain and psychosexual outcomes in provoked vestibulodynia.
BACKGROUND
Research suggests that increased tension in the pelvic floor muscles of women with provoked vestibulodynia (PVD, the most common form of chronic vulvar pain) may play an important role in maintaining and exacerbating their pain. However, no prospective studies of pelvic floor physical therapy (PFPT) for PVD have been carried out.


OBJECTIVE
This study prospectively examined the effectiveness of a PFPT intervention in treating the pain and sexual and psychological components of PVD, and determined predictors of greater treatment success.


METHODS
Thirteen women with PVD completed eight sessions of PFPT. Participants were assessed at pre- and post-treatment via gynecological examinations, vestibular pain threshold testing, structured interviews, and standardized questionnaires. A 3-month follow-up interview assessed any further changes.


METHODS
Outcome measures included: vestibular pain thresholds, gynecological examination and intercourse pain ratings, sexual function and intercourse frequency, mental health, negative pain cognitions, and success rates.


RESULTS
Following treatment, participants had significantly higher vestibular pain thresholds and significantly lower pain ratings during the gynecological examination. Participants reported significant reductions in pain intensity during intercourse and were able to engage in significantly more pain-free activities. Although overall sexual function significantly improved, various components of sexual function and frequency of intercourse did not. Participants' mental health did not significantly improve; however, pain catastrophizing and pain-related anxiety significantly decreased. The treatment was considered to be successful for 10 of the 13 participants, and predictors of greater treatment success included greater reductions in helplessness and a longer period of time in treatment.


CONCLUSIONS
Results provide preliminary support for the effectiveness of PFPT in treating the pain of PVD, as well as some of the sexual and cognitive correlates of PVD. The results also indicate the need for large-scale, randomized studies of the effectiveness of PFPT in comparison and in conjunction with other treatment options.
Goldfinger
Corrie
C
Department of Psychology, Queen's University, 62 Arch Street, Kingston, Ontario, Canada. 5cg24@queensu.ca
Pukall
Caroline F
CF
Gentilcore-Saulnier
Evelyne
E
McLean
Linda
L
Chamberlain
Susan
S
D000223:Adaptation, Psychological; D000328:Adult; D000704:Analysis of Variance; D004414:Dyspareunia / Q000628:therapy*; D005260:Female; D006801:Humans; D008603:Mental Health; D010147:Pain Measurement; D017773:Pelvic Floor; D017699:Pelvic Pain / Q000628:therapy*; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D013223:Statistics as Topic; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D014844:Vulva; D014845:Vulvar Diseases / Q000628:therapy*