Comparison study between electrogalvanic stimulation and local injection therapy in levator ani syndrome

Area of Science:

• Pelvic floor dysfunction
• Pain management
• Gastroenterology

Background:

• Levator ani syndrome pathophysiology is debated, with spastic cycle and local inflammation (tendinitis) hypotheses proposed.
• This study aimed to compare two treatment modalities to evaluate these hypotheses.

Purpose of the Study:

• To compare electrogalvanic stimulation (EGS) and local injection (LI) treatments for levator ani syndrome.
• To determine the more appropriate pathophysiological hypothesis for levator ani syndrome.

Main Methods:

• A prospective study comparing EGS (n=22) with LI (n=31) using triamcinolone acetonide and lidocaine.
• Treatments were administered twice weekly for EGS and as a single injection for LI into the arcus tendon of the levator ani muscle.

Main Results:

• The LI group demonstrated greater relief, improvement, and fewer failures at 12 months compared to the EGS group.
• While overall pain scores at 1 week and 12 months were similar, the LI group showed superior outcomes at 1, 3, and 6 months.
• Tenderness was most commonly located in the left anterior arcus tendon of the levator ani muscle.

Conclusions:

• Local injections (LI) provided better short-term results than electrogalvanic stimulation (EGS) for levator ani syndrome.
• These findings suggest the tendinitis hypothesis is more reliable for explaining levator ani syndrome.
• However, insufficient patient satisfaction necessitates further investigation before definitively concluding the tendinitis hypothesis.