The role of reflexology in the comprehensive rehabilitation of patients with endometriosis-associated pelvic pain

A. G. Gramatikova, V. F. Bezhenar, Е. Р. Баранцевич, В А Линде, Sviatoslav Yu. Kruglov, Daria S. Kochergina-Strukova, Ilarion A. Barnash
In: Russian Military Medical Academy Reports · 2026 · vol. 45(2) , pp. 187–196 · doi:10.17816/rmmar691739 · W7172311172
article OA: closed CC0
Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-08-10 ⓘ

This study evaluated reflexology combined with dydrogesterone in endometriosis patients and found it effectively reduced pelvic pain and improved quality of life postoperatively compared to dydrogesterone with nimesulide.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by gpt-5.6-luna, 2026-08-12 · read from full text ⓘ

This study evaluated reflexology as a postoperative rehabilitation component for chronic pelvic pain in patients with deep infiltrating endometriosis. Thirty-six patients with persistent dysmenorrhea, intermenstrual pain, dyspareunia, and reduced quality of life were randomized to 12 days of reflexology plus dydrogesterone (n=20) or dydrogesterone plus nimesulide (n=16), with pain and quality of life assessed before surgery, 45 days afterward, and 30 days after treatment. Both groups improved initially, but pain partially recurred in the comparison group, while the reflexology group maintained improvement and showed significantly greater gains in quality-of-life measures; no adverse events were reported, and the abstract states no specific limitation. This paper is centrally about endometriosis — evaluating reflexology for sustained postoperative relief of endometriosis-associated pelvic pain after surgery for deep infiltrating disease.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Background: The most severe form of endometriosis is deep infiltrating endometriosis. Pain is one of its leading clinical features. The main treatment for deep infiltrating endometriosis is surgery, followed by hormone-modulating therapy postoperatively. However, this does not always provide sustained relief of chronic pain. AIM: To evaluate the efficacy of reflexology in postoperative rehabilitation of patients with chronic pain associated with deep infiltrating endometriosis. METHODS: We examined and treated 36 patients with deep infiltrating endometriosis whose main preoperative symptoms were chronic pain (dysmenorrhea, intermenstrual pain, and dyspareunia) and reduced quality of life, which persisted to varying degrees by day 45 after surgery. Pain was assessed using the Visual Analogue Scale and the McGill Pain Questionnaire. Quality of life was assessed using the N.E. Vodopyanova Scale. Patients were tested before surgery and on day 45 postoperatively. For the reflexology evaluation, participants were randomized using a random number generator (even numbers: main group; odd numbers: comparison group). The main group (n = 20) received a 12-day course of reflexology with dydrogesterone. The comparison group (n = 16) received dydrogesterone plus nimesulide. RESULTS: All patients in the main group tolerated reflexology well; no complications or adverse events occurred. At the end of treatment, both groups showed marked improvement. To assess durability, all parameters were measured 30 days later. Chronic pain partially recurred in the comparison group, whereas the main group maintained sustained improvement. Quality of life (N.E. Vodopyanova Scale) improved significantly only in the main group. The quality of life index improved in both groups, but significantly more in the main group. CONCLUSION: Reflexology using the proposed protocol is an effective component of comprehensive rehabilitation for patients with endometriosis-associated pelvic pain after surgery for deep infiltrating endometriosis.
Full text 8,217 characters · extracted from oa-doi-fallback · 5 sections · click to expand

Abstract

Background: The most severe form of endometriosis is deep infiltrating endometriosis. Pain is one of its leading clinical features. The main treatment for deep infiltrating endometriosis is surgery, followed by hormone-modulating therapy postoperatively. However, this does not always provide sustained relief of chronic pain. AIM: To evaluate the efficacy of reflexology in postoperative rehabilitation of patients with chronic pain associated with deep infiltrating endometriosis.

Methods

We examined and treated 36 patients with deep infiltrating endometriosis whose main preoperative symptoms were chronic pain (dysmenorrhea, intermenstrual pain, and dyspareunia) and reduced quality of life, which persisted to varying degrees by day 45 after surgery. Pain was assessed using the Visual Analogue Scale and the McGill Pain Questionnaire. Quality of life was assessed using the N.E. Vodopyanova Scale. Patients were tested before surgery and on day 45 postoperatively. For the reflexology evaluation, participants were randomized using a random number generator (even numbers: main group; odd numbers: comparison group). The main group (n = 20) received a 12-day course of reflexology with dydrogesterone. The comparison group (n = 16) received dydrogesterone plus nimesulide.

Results

All patients in the main group tolerated reflexology well; no complications or adverse events occurred. At the end of treatment, both groups showed marked improvement. To assess durability, all parameters were measured 30 days later. Chronic pain partially recurred in the comparison group, whereas the main group maintained sustained improvement. Quality of life (N.E. Vodopyanova Scale) improved significantly only in the main group. The quality of life index improved in both groups, but significantly more in the main group.

Conclusion

Reflexology using the proposed protocol is an effective component of comprehensive rehabilitation for patients with endometriosis-associated pelvic pain after surgery for deep infiltrating endometriosis. Full Text About the authors Ana G. Gramatikova Pavlov First Saint Petersburg State Medical University Email: [email protected] ORCID iD: 0000-0001-7463-1831 SPIN-code: 5543-0410 MD, Obstetrician-Gynecologist Russian Federation, Saint PetersburgVitaly F. Bezhenar Pavlov First Saint Petersburg State Medical University Email: [email protected] ORCID iD: 0000-0002-7807-4929 SPIN-code: 8626-7555 MD, Dr. Sci. (Medicine), Professor Russian Federation, Saint PetersburgEvgenii R. Barantsevich Pavlov First Saint Petersburg State Medical University Email: [email protected] ORCID iD: 0000-0003-3804-3877 SPIN-code: 9715-2844 MD, Dr. Sci. (Medicine), Professor Russian Federation, Saint PetersburgViktor A. Linde City Mariinsky Hospital Email: [email protected] ORCID iD: 0000-0002-6032-1936 SPIN-code: 3315-8385 MD, Dr. Sci. (Medicine), Professor Russian Federation, Saint PetersburgSviatoslav Yu. Kruglov City Hospital of St. John of Kronstadt Email: [email protected] ORCID iD: 0000-0001-7399-3398 SPIN-code: 8732-6970 MD, Cand. Sci. (Medicine) Russian Federation, Saint PetersburgDaria S. Kochergina-Strukova Pavlov First Saint Petersburg State Medical University Author for correspondence. Email: [email protected] ORCID iD: 0009-0008-1597-0946 SPIN-code: 1614-6717 PhD Student Russian Federation, Saint PetersburgIlarion A. Barnash Pavlov First Saint Petersburg State Medical University Email: [email protected] ORCID iD: 0009-0006-9177-7166 SPIN-code: 6582-9848 PhD Student Russian Federation, Saint Petersburg

References

- Adamyan LV, Andreeva EN, Absatarova YuS, et al. Endometriosis. Endometriosis. Clinical guidelines. Moscow; 2024. 62 p. (In Russ.) doi: 10.18565/aig.2025.231 EDN: WHTGVG - Petrova EA, Cherepovskaya VA, Pakhomova FV, et al. Emotional and personality traits of pain perception in women with pain syndrome in endometriosiss. The Record of the I. P. Pavlov St. Petersburg State Medical University. 2019;26(2):62–68. doi: 10.24884/1607-4181-2019-26-2-62-68 EDN: AIPRBX - Lövkvist L, Boström P, Edlund M, Olovsson M. Age-related differences in quality of life in Swedish women with endometriosis. J Womens Health (Larchmt). 2016;25(6):646–653. doi: 10.1089/jwh.2015.5403 - Chuprynin VD, Yazykova OI, Buralkina NA, et al. Quality of life in women with infiltrative endometriosis. Obstetrics and Gynecology. 2016;(5):49–54. doi: 10.18565/aig.2016.5.49-54 EDN: WFVWTZ - Raos M, Mathiasen M, Seyer-Hansen M. Impact of surgery on fertility among patients with deep infiltrating endometriosis. Eur J Obstet Gynecol Reprod Biol. 2023;280:174–178. doi: 10.1016/j.ejogrb.2022.12.004 - Bezhenar VF, Kruglov SYu, Arakelyan BV, et al. Nerve-sparing surgery for deep infiltrating endometriosis. Doktor.Ru. 2019;(7(162)):40–45. doi: 10.31550/1727-2378-2019-162-7-40-45 EDN: KENIWD - Ianieri M, Mautone D, Ceccaroni M. Recurrence in deep infiltrating endometriosis: a systematic review of the literature. J Minim Invasive Gynecol. 2018;25(5):786–793. doi: 10.1016/j.jmig.2017.12.025 - Adamyan LV, Andreeva EN. Endometriosis and its global impact on a woman’s body. Russian Journal of Human Reproduction. 2022;28(1):54–64. doi: 10.17116/repro20222801154 EDN: ELOTDZ - Barbara G, Buggio L, Facchin F, Vercellini P. Medical treatment for endometriosis: tolerability, quality of life and adherence. Front Glob Womens Health. 2021;2:729601. doi: 10.3389/fgwh.2021.729601 - Bezhenar VF, Barantsevich ER, Linde VA, et al. To the issue on the use of acupuncture in chronic pelvic pain syndrome (literature review). Effektivnaya farmakoterapiya. 2020;16(28):18–23. doi: 10.33978/2307-3586-2020-16-28-18-23 EDN: NGFNZQ - Jarrell JF, Vilos GA, Allaire C, et al. No. 164-consensus guidelines for the management of chronic pelvic pain. J Obstet Gynaecol Can. 2018;40(11):e747–e787. doi: 10.1016/j.jogc.2018.08.015 - Armour M, Smith CA, Schabrun S, et al. Manual acupuncture plus usual care versus usual care alone in the treatment of endometriosis-related chronic pelvic pain: study protocol for a randomised controlled feasibility study. J Altern Complement Med. 2021;27(10):841–849. doi: 10.1089/acm.2021.0004 - Chong OT, Critchley HO, Horne AW, et al. Chronic pelvic pain in women: an embedded qualitative study to evaluate the perceived benefits of the meridian balance method electro-acupuncture treatment, health consultation and National Health Service standard care. Br J Pain. 2019;13(4):244–255. doi: 10.1177/2049463718814870 - Yaremenko AI, Isaeva ER, Kolegova TE, et al. Satisfaction with quality of life in patients with minimum cicatricial damage of the face and neck. Clinical Psychology and Special Education. 2018;7(1):75–90. doi: 10.17759/cpse.2018070106 EDN: OXXOOL - Buralkina NA, Katkova AS, Kiseleva IA. Dysmenorrhea: pathogenetic validation of pharmacotherapy. Medical Council. 2018;(7):23–26. doi: 10.21518/2079-701X-2018-7-23-26 EDN: YWRKQY - Kuznetsova IV, Evsyukova LV. Nonsteroidal anti-inflammatory drugs for management of pelvic pain in women. Medical Council. 2019;(7):27–32. doi: 10.21518/2079-701X-2019-7-27-32 EDN: UJHGTR - Kachan AT, Bogdanov NN, Varnakov PKh, et al. Anatomical and topographic location of corporal acupuncture points and indications for their use. Voronezh: Izd-vo Voronezhskogo un-ta; 1990. 144 p. (In Russ.) - Cheng Y, Yuan Y, Jin Y, et al. Acupuncture for chronic pelvic inflammatory disease: a systematic review protocol. Medicine (Baltimore). 2018;97(13):e0225. doi: 10.1097/MD.0000000000010225

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

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 (17)

Source provenance

openalex
last seen: 2026-09-21T06:00:58.944781+00:00
License: CC0 · commercial use OK