The Effect of Polydioxanone Thread and Platelet Rich Plasma in Treating Myofascial Pelvic Pain

Introduction: Myofascial pelvic pain is a major component of chronic pelvic pain. Effective treatments are available to reduce pain, including myofascial tender point release. The study investigated the safety, feasibility and early outcomes of releasing myofascial tender point by polydioxanone thread and platelet rich plasma treatment in myofascial pelvic pain patients. Methods Twenty myofascial pelvic pain patients underwent polydioxanone thread and platelet rich plasma treatment. After autologous platelet rich plasma was injected into the pelvic muscles through vaginal access, a multi-braided polydioxanone thread was inserted into the middle and deep layers of the pelvic muscles. Pre- and post-procedural satisfaction surveys and Female Sexual Function Index scores (FSFI) were obtained. Vaginal manometry measured mobility and pressure of pelvic floor muscles. The patients were followed-up at 3 and 6 months after the procedure. Results At 3-months after the procedure, 65% of the patients answered positively on the improvement of symptoms and tenderness, 35% answered no difference, and none answered worsening. At this period, FSFI did not show a significant change in any of the six categories. After six months, however, there was a statistically significant improvement in all the indices except for sexual desire (p < 0.05). Conclusions Pelvic floor muscle targeted polydioxanone thread insertion and platelet rich plasma injection is safe and feasible, and may minimize pelvic pain without side effects such as infection or bleeding. It may potentially improve urinary control and sexual function by releasing myofascial tenderness.