{"paper_id":"baf4a21b-fe3f-4bd4-bb88-58f097ded5d1","body_text":"Abstract\nPurpose\nTo assess function and prevalence of spasms and trigger points of the pelvic floor muscles in women with deep endometriosis.\nMethods\nOne hundred and four (104) patients were assessed. Group 1 (G1) was composed of 52 subjects diagnosed with deep endometriosis proven by magnetic resonance imaging (MRI); Group 2 (G2) was composed of 52 women with no signs of endometriosis. Subjects from both G1 and G2 were seen at the Division of Pelvic Pain and Endometriosis and at Center for Prevention of Sexually Transmitted Diseases, both at Federal University of São Paulo (UNIFESP), respectively. A full physical therapy evaluation was carried out, including medical history, presence of dyspareunia and physical examination, which included detailed evaluation of pelvic floor muscles and occurrence of muscle spasm, trigger point and muscle function.\nResults\nThe average age of the subjects in the study group was 36.4 and 30.9 years in the control group (p = 0.002). A greater prevalence of deep dyspareunia was found in the subjects in the endometriosis group when compared to the control group (p = 0.010). Women in G1 had higher prevalence of muscle spasms. In this group, 53.9 % had spasms—compared to only 17.3 % of women in G2 (p < 0.001). On the other hand, no significant difference between the groups (p = 0.153) was found while searching for the presence of trigger points.\nConclusion\nWomen with deep endometriosis have increased prevalence of pelvic floor muscle spasms when compared to the control group.\nSimilar content being viewed by others\nReferences\nHaas D, Chvatal R, Reichert B, Renner S, Shebl O, Binder H, Wurm P, Oppelt P (2012) Endometriosis: a premenopausal disease? Age pattern in 42,079 patients with endometriosis. Arch Gynecol Obstet 286(3):667–670. doi:10.1007/s00404-012-2361-z\nDel Frate C, Girometti R, Pittino M, Del Frate G, Bazzocchi M, Zuiani C (2006) Deep retroperitoneal pelvic endometriosis: MR imaging appearance with laparoscopic correlation. RadioGraphics 26:1705–1718\nArruda MS, Petta CA, Abrão MS, Benetti-Pinto CL (2003) Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod 18(4):756–759\nMatsuzaki S, Canis M, Poully JL, Rabischong B, Botchorishvili R, Mage G (2006) Relationship between delay of surgical diagnosis and severity of disease in patients with symptomatic deep infiltrating endometriosis. Fertil Steril 86(5):1314–1316\nHudelist G, Fritzer N, Thomas A, Niehues C, Oppelt P, Haas D, Tammaa A, Salzer H (2012) Diagnostic delay for endometriosis in Austria and Germany: causes and possible consequences. Hum Reprod 27(12):3412–3416\nMarques A, Bahamondes L, Aldrighi JM, Petta CA (2004) Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire. J Reprod Med 49(2):115–120\nBaker PK (1993) Musculoskeletal origins of chronic pelvic pain—diagnosis e treatment. Obstet Ginecol Clin N Am 20(4):719–743\nFitzGerald MP, Kotarinos R (2003) Rehabilitation of the short pelvic floor. I: background and patient evaluation. Int Urogynecol J 14:261–268\nLukic A, Di Properzio M, De Carlo S, Nobili F, Schimberni M, Bianchi P, Prestigiacomo C, Moscarini M, Caserta D (2015) Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet. doi:10.1007/s00404-015-3832-9\nRolf IP (1999) A articulação que determina a assimetria. In: Rolfing: a Integração das Estruturas Humanas. Martina Fontes, São Paulo, p 127–136\nDoggweiler-Wiygul R, Wiygul JP (2002) Interstitial cystitis, pelvic pain, and the relationship to myofascial pain and dysfunction: a report on four patients. J Urol 20:310–314\nLavelle ED, Lavelle W, Smith HS (2007) Myofascial trigger points. Med Clin N Am 91:229–239\nYap EC (2007) Myofascial pain—an overview. Ann Acad Med Singap 36(1):43–48\nGuerineau M, Labat JJ, Sibert L, Delavierre D, Rigard J (2010) Traitement de la composante musculosquelettiqeu des douleurs pelvipérinéales chroniques. Progrès en urologie 20:1013–1110\nWeiss JM (2001) Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol 166:2226–2231\nBo K, Finckenhagen HB (2001) Vaginal palpation of pelvic floor muscle strength: inter-test reproducibility and comparison between palpation and squeeze pressure. J Urol 169(6):2428–2429\nTalasz H, Himmer-Perschak G, Marth E, Fischer-Colbrie J, Hoefner E, Lechleitner M (2008) Evaluation of pelvic floor muscle function in a randon group of adult women in Austria. Int Urogynecol J 19:131–135\nDeguara CS, Pepas L, Davis C (2012) Does minimally invasive surgery for endometriosis improve pelvic symptoms and quality of life? Curr Opin Obstet Gynecol 24(4):241–244\nRoman H, Vassilieff M, Gourcerol G, Savoye G, Leroi AM, Marpeau L, Michot F, Tuech JJ (2011) Surgical management of deep infiltrating endometriosis of the rectum: pleading for a symptomguided approach. Hum Reprod 26(2):274–281\nNeville CE, Fitzgerald CM, Mallinson T, Badillo S, Hynes C, Tu F (2012) A preliminary report of musculoskeletal dysfunction in female chronic pelvic pain: a blinded study of examination findings. J Bodyw Mov Ther 16:50–56\nTu FF, Holt J, Gonzáles J, Fitzgerald CM (2008) Physical therapy evaluation of patients with chronic pelvic pain: a controlled study. Am J Obstet Gynecol 272(e1-272):e7\nMontenegro MLLS, Lemes EC, Vasconcelos M, Silva JCRE, Nogueira AA, Reis FJC, Poli Neto OB (2010) Importance of pelvic floor muscle tenderness evaluation in women with chronic pelvic pain. Pain Med 11:224–228\nFitzGeral MC, Neville CE, Mallinson T, Badillo SA, Hynes CK, Tu FF (2011) Pelvic floor muscle examination in female chronic pelvic pain. J Reprod Med 56:117–122\nChapron C, Chopin N, Borghese B, Foulot H, Dousset B, Vacher-Lavenu MC, Vieira M, Hasan W, Bricou A (2006) Deeply infiltrating endometriosis: pathogenetic implications of the anatomical distribution. Hum Reprod 21(7):1839–1845\nSchliep KC, Mumford SL, Peterson CM, Chen Z, Johnstone EB, Sharp HT, Stanford JB, Hammoud AO, Sun L, Buck Louis GM (2015) Pain typology and incident endometriosis. Hum Reprod 30(10):2427–2438. doi:10.1093/humrep/dev147\nTravell J, Simons D (1983) The trigger point manual. William & Wilkins, Philadelphia, p 1\nPetersen CD, Giraldi A (2008) Should physiotherapy be part of a multidisciplinary treatment for women with chronic pelvic pain? Int J Clin Pract 62(2):174–175\nAbrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U, van Kerrebroeck P, Arne V, Wein A (2002) The standardisation of terminology of lower urinary tract function: report from the standardisationsub committee of the International Continence Society. Am J Obstet Gynecol 187:116–126\nHeim LJ (2001) Evaluation and differential diagnosis of dyspareunia. Am Fam Physician 63:1535–1544\nFerrero S, Esposito F, Abbamonte LH, Anserini P, Remorgida V, Ragni N (2005) Quality of sex life in women with endometriosis and deep dispareunia. Fertil Steril 83:573–579\nPorpora MG, Koninickx PR, Piazze J, Natili M, Colagrande S, Cosmi EV (1999) Correlation between endometriosis and pelvic pain. J Am Assoc Gynecol Laparosc 6(4):429–434\nBellelis P, Dias JA Jr, Podgaec S, Gonzales M, Baracat EC, Abrão MS (2010) Epidemiological and clinical aspects of pelvic endometriosis—a case series. Rev Assoc Med Bras 56(4):467–471\nJia SZ, Leng JH, Sun PR, Lang JH (2013) Prevalence and associated factors of female sexual dysfunction in women with endometriosis. Obstet Gynecol 121(3):601–606\nTripoli TM, Sato H, Sartori MG, de Araujo FF, Girão MJBC, Schor E (2011) Evaluation of quality of life and sexual satisfaction in women suffering from chronic pelvic pain with or without endometriosis. J Sex Med 8(2):497–503\nAcknowledgments\nThe authors would like to thank CAPES for their financial support.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nEthics declarations\nConflict of interest\nWe declare that we have no conflict of interest.\nRights and permissions\nAbout this article\nCite this article\ndos Bispo, A.P.S., Ploger, C., Loureiro, A.F. et al. Assessment of pelvic floor muscles in women with deep endometriosis. Arch Gynecol Obstet 294, 519–523 (2016). https://doi.org/10.1007/s00404-016-4025-x\nReceived:\nAccepted:\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-016-4025-x","source_license":"CC0","license_restricted":false}