title: Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand.
abstract: Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.
authors.affiliation: Stanford University School of Medicine, 574 Junipero Serra Blvd, Stanford, CA, 94305, USA. rua@stanford.edu.
authors.forename: Rodney U
authors.identifier: 0000-0003-0766-3280
authors.initials: RU
authors.lastname: Anderson
authors.affiliation: National Center for Pelvic Pain Research, Sebastopol, CA, USA.
authors.forename: David
authors.initials: D
authors.lastname: Wise
authors.affiliation: National Center for Pelvic Pain Research, Sebastopol, CA, USA.
authors.forename: Tim
authors.initials: T
authors.lastname: Sawyer
authors.affiliation: OptiStatim, LLC, Longmeadow, MA, USA.
authors.forename: Brian H
authors.initials: BH
authors.lastname: Nathanson
authors.affiliation: , Sonoma, CA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Nevin Smith
mesh_terms: D000328:Adult; D059350:Chronic Pain; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000150:complications* / Q000628:therapy; D010147:Pain Measurement; D017773:Pelvic Floor; D017699:Pelvic Pain / Q000150:complications* / Q000628:therapy; D026741:Physical Therapy Modalities; D011472:Prostatitis; D012064:Relaxation Therapy / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D061028:Trigger Points / Q000502:physiology
keywords: Gender; Myofascial trigger points; Paradoxical relaxation; Pelvic pain; Urologic chronic pelvic pain syndromes