8355 Transvaginal Photobiomodulation for Treatment of Pelvic Pain Associated with Endometriosis: A Report from Clinical Settings

Abstract

<h3>Study Objective</h3> To determine if transvaginal photobiomodulation (TV-PBM) decreases pain in women with endometriosis associated chronic pelvic pain (CPP). <h3>Design</h3> IRB approved before-after prospective cohort. <h3>Setting</h3> 24 US gynecology practices. <h3>Patients or Participants</h3> Women with endometriosis and pelvic pain lasting longer than 6 months. <h3>Interventions</h3> 8 TV-PBM treatments administered 1-2 times a week for 8 weeks <h3>Measurements and Main Results</h3> From 2019-21, 502 women with CPP received TV-PBM; 9.6% (n = 48) had endometriosis, all completed treatment and were included in this analysis. Pain was measured using the numeric rating scale (NRS) categorized as 0-1 no pain, 2-4 mild, 5-7 moderate, and 8-10 severe pain. The primary outcome was change in overall pelvic pain from baseline compared to after 8 treatments. Minimal Clinically Important Difference (MCID) was defined as pain reduction of ≥2 NRS points. After therapy, 14.6% (n=7) reported no change, 6.3% (n=3) worsened, 79.2% (n=38) improved by ≥1 point, and 58.3% (n=28) improved by ≥2 points. Among those who improved, average pain levels decreased as follows: overall pain MCID = -2.7, dyspareunia MCID = -3.0, pain with bowel movements MCID = -2.1, dysuria MCID = -3.3, pain with sitting MCID = -1.6, pain with standing MCID = -1.6, and pain with exercise MCID = -2.4. Compared to baseline, the percentage of women reporting moderate/severe pain decreased from 85.5% (n=41) to 43.8% (n=21). <h3>Conclusion</h3> In this study TV-PBM significantly reduced severity of pelvic pain in nearly 60% of women with endometriosis. All pain parameters improved; the largest decreases were noted in overall pelvic pain, dyspareunia, and dysuria. Additional controlled studies are needed to confirm these findings, however, in this preliminary analysis, the efficacy of TV-PBM, as it is currently being used in clinic practice, is promising.