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Chronic pelvic floor dysfunction.

Dee Hartmann1, Julie Sarton2

  • 1Dee Hartmann Physical Therapy, 1417 West Grand Avenue, Chicago, IL 60642, USA.

Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 11, 2014
PubMed
Summary

Treating vulvar pain and pelvic floor dysfunction involves addressing multiple contributing factors. Physical therapy can successfully reduce chronic vulvar and sexual pain by normalizing associated muscular and visceral dysfunctions.

Keywords:
manual therapyorgan system dysfunctionpelvic floor muscle dysfunctionsexual dysfunctionvulvar painwomen's health physical therapy

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Area of Science:

  • Gynecology
  • Physical Therapy
  • Pain Management

Background:

  • Vestibulodynia is a chronic vulvar pain condition often linked to pelvic floor muscle hypertonicity.
  • Common comorbidities include painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder, contributing to widespread dysfunctions.
  • These associated disorders can cause muscular, visceral, bony, and fascial dysfunctions, complicating pain management.

Purpose of the Study:

  • To review pelvic anatomy and common findings related to vestibulodynia and pelvic floor dysfunction.
  • To explore the role of physical therapy in managing chronic vulvar pain and associated dysfunctions.
  • To highlight the importance of addressing comorbidities in treatment protocols.

Main Methods:

  • Review of relevant literature on pelvic anatomy, vestibulodynia, and pelvic floor dysfunction.
  • Discussion of common comorbidities and their impact on chronic pain.
  • Presentation of suggested physical therapy management strategies.

Main Results:

  • Pelvic floor muscle hypertonicity identified as a significant trigger for chronic vulvar pain.
  • Normalization of comorbidities appears crucial for reducing vulvar and sexual pain.
  • Physical therapists report success in restoring tissue normalcy and alleviating pain.

Conclusions:

  • Comprehensive treatment addressing multiple pain contributors is essential for women with vestibulodynia.
  • Physical therapy offers a promising approach to managing chronic vulvar pain and sexual dysfunction by targeting associated dysfunctions.
  • Further research is needed to establish specific treatment protocols, but current practices show positive outcomes.