The Consideration of Endometriosis in Women with Persistent Gastrointestinal Symptoms and a Novel Neuromusculoskeletal Treatment Approach

The paper discusses a neuromusculoskeletal outpatient protocol intended as an adjunct to hormonal and surgical management for endometriosis-related chronic pelvic pain with a gastrointestinal/colorectal focus. It builds on a retrospective chart review of 16 women with biopsy-confirmed endometriosis treated with weekly (6 weeks) external ultrasound-guided pelvic-floor myofascial trigger-point injections and peripheral nerve hydrodissection along the pudendal and posterior femoral nerves, reporting mean reductions in pain (VAS 6.0 to 2.9) and pelvic function impairment (FPPS 14.4 to 9.1). The authors also outline proposed mechanisms linking endometriosis to bowel symptoms, including pudendal nerve involvement, nonrelaxing pelvic floor dysfunction with trigger points, cross-sensitization, and peripheral/central sensitization, while acknowledging key caveats typical of a small retrospective chart review without a control group. This paper is centrally about endometriosis—specifically an adjunct neuromusculoskeletal treatment targeting pelvic-floor trigger points and peripheral nerve hydrodissection to address gastrointestinal and chronic pelvic pain symptoms in women with endometriosis.

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