Pelvic floor hypertension: possible factors for pelvic floor tenderness in endometriosis patients—a pilot study

Jumana Muallem, Renata Voltolini Velho, Johanna Netzl, Jalid Sehouli, Sylvia Mechsner
Archives of gynecology and obstetrics · 2023 · vol. 308(6) , pp. 1803–1809 · doi:10.1007/s00404-023-07192-5 · PMID:37672087 · W4386466823
article OA: hybrid CC0 ⤵ 1 in-corpus citation
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This pilot study localized myofascial trigger points in the pelvic floor muscles of endometriosis patients and found targeted electrostimulation reduced muscle tone.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This prospective pilot study investigated pelvic floor muscle (PFM) electromyography patterns in 15 women with histologically confirmed endometriosis and chronic acyclical pelvic pain, using the Multiple Array Probe Leiden (MAPLe) system, followed by targeted intravaginal electrostimulation to localized hypertensive muscles. Key findings were that myofascial trigger points could be localized in 80% of participants (most commonly the puborectalis), and that PFM resting tone was significantly elevated at baseline; after stimulation, overall average resting tone remained similar on the reported analysis, while the resting tone of hypertensive muscles specifically showed a significant reduction. The authors note limitations including the small sample size and that the effect on general resting tone was not clearly statistically significant after the intervention. This paper is centrally about endometriosis—specifically assessing pelvic floor muscle hypertonicity/tenderness and testing targeted vaginal electrostimulation as a complementary intervention for endometriosis-related chronic pelvic pain.

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Abstract

PURPOSE: Chronic pelvic pain (CPP) is one of the main problems of endometriosis, leading to a significant impairment of quality of life. Understanding the pain mechanisms and the pelvic floor muscles (PFM) changes in these patients is essential to integrate additional therapeutic strategies. We hypothesize that endometriosis patients have changes in PFM and that targeted vaginal electrostimulation can be a treatment option for CPP in this disease. METHODS: Fifteen patients with endometriosis and chronic acyclical pelvic pain were included. PFM electromyography with the Multiple Array Probe Leiden (MAPLe) was performed. Mapping of PFM was utilized and targeted electrostimulation of the hypertensive muscles was conducted. Control electromyography was performed afterward to evaluate the electrostimulation therapeutic effect. RESULTS: In 12/15 (80%) patients, the myofascial trigger point could be localized by digital examination. The most frequently affected muscle was the puborectalis (10/15-66.7%). Most of the patients showed serious changes in the average resting tone (aRT) of PFM. aRT was significantly increased in all patients and decreased after stimulation, whereby the difference prior to and after stimulation was not significant (p = 0.064). The detailed separated analysis of the hypertensive muscles showed a significant (p = 0.026) reduction in their resting tone (hRT), after targeted stimulation. CONCLUSION: Vaginal electrostimulation is a promising and feasible complementary treatment option for CPP in endometriosis patients. Targeted treatment of pelvic floor dysfunction should be included in clinical trials.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Pelvic Floor Disorders Pelvic Floor Disorders Pelvic Floor Disorders Pelvic Floor Disorders Pelvic Floor Disorders Pelvic Floor Disorders Pelvic Floor Disorders Pelvic Floor Disorders

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (27)

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