Pelvic floor physical therapy and mindfulness: approaches for chronic pelvic pain in women—a systematic review and meta-analysis

Purpose Chronic pelvic pain (CPP) in women is a complex syndrome and symptoms are associated with sexual dysfunction, musculoskeletal and myofascial disorders, and comorbid psychiatric disorders. Its widespread prevalence results in substantial expense due to therapy and lost productivity, and it is perhaps one of the most urgent and neglected medical needs. This systematic review and meta-analysis aimed to estimate the role of mindfulness and pelvic floor physical therapy (PFPT) in the treatment or management of women with CPP.

This systematic review (CRD42020204987) searched for relevant publications between January 2000 and November 2020 on MEDLINE/PubMed, Web of Science, One File GALE, and Technology Research databases using the following search terms: chronic pelvic pain, pelvic floor physical therapy/physiotherapy, mindfulness, and their variants. Risk of bias and quality of evidence were evaluated.

Seven clinical trials (n = 279) were included in the review, and five in the meta-analysis (n = 225). For the pain outcome and its catastrophizing, there was a statistical difference for the Pain Catastrophizing Scale after treatment and during follow-up with mindfulness and PFPT (MD = − 3.82 [− 6.97, − 0.68], p = 0.01, and MD = − 4.49 [− 7.61, − 1.37], p = 0.00, respectively). Sexual function, assessed by the female sexual function index, differed significantly during follow-up between PFPT and mindfulness (MD = − 0.72 [− 1.38, − 0.05], p = 0.03).

The small number of studies applying both PFPT and mindfulness to CPP suggests that a multidisciplinary approach is required to treat women with CPP, and further studies involving these therapeutic techniques throughout the CPP cycle are needed. Similar content being viewed by others Availability of data and materials All relevant data are within the paper.

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MC: data collection. Corresponding author Ethics declarations Conflict of interest The authors have no conflicts of interest to disclose. Code availability Not applicable. Ethics approval Not applicable. Consent to participate Not applicable. Consent for publication Not applicable. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Below is the link to the electronic supplementary material. Rights and permissions About this article Cite this article Bittelbrunn, C.C., de Fraga, R., Martins, C. et al. Pelvic floor physical therapy and mindfulness: approaches for chronic pelvic pain in women—a systematic review and meta-analysis. Arch Gynecol Obstet 307, 663–672 (2023). https://doi.org/10.1007/s00404-022-06514-3 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-022-06514-3