Abstract
Chronic pelvic pain (CPP) is a highly disabling disorder in women usually associated with hypertonic dysfunction of the pelvic floor musculature (PFM). The literature on the subject is not conclusive about the diagnostic potential of surface electromyography (sEMG), which could be due to poor signal characterization. In this study, we characterized the PFM activity of three groups of 24 subjects each: CPP patients with deep dyspareunia associated with a myofascial syndrome (CPP group), healthy women over 35 and/or parous (>35/P group, i.e., CPP counterparts) and under 35 and nulliparous (<35&NP). sEMG signals of the right and left PFM were recorded during contractions and relaxations. The signals were characterized by their root mean square (RMS), median frequency (MDF), Dimitrov index (DI), sample entropy (SampEn), and cross-correlation (CC). The PFM activity showed a higher power (>RMS), a predominance of low-frequency components (<MDF, >DI), greater complexity (>SampEn) and lower synchronization on the same side (<CC) in CPP patients, with more significant differences in the >35/P group. The same trend in differences was found between healthy women (<35&NP vs. >35/P) associated with aging and parity. These results show that sEMG can reveal alterations in PFM electrophysiology and provide clinicians with objective information for CPP diagnosis.
Highlights
Chronic pelvic pain (CPP) is a complex clinical condition characterized by persistent or recurrent pelvic pain for longer than six months with no proven infection or obvious pathology [1]
root mean square (RMS) values computed during the pelvic floor musculature (PFM) contraction are depicted on the upper panels and those obtained during PFM relaxation are shown on the lower
PFM activity was assessed in women with CPP associated with deep dyspareunia and healthy women with different demographic and obstetric characteristics from surface electromyography (sEMG) recordings
Summary
Chronic pelvic pain (CPP) is a complex clinical condition characterized by persistent or recurrent pelvic pain for longer than six months with no proven infection or obvious pathology [1]. One of the most common syptoms associated with its appearance is dyspareunia, defined as recurrent or persistent genital pain during sexual intercourse [2]. 7.5% of sexually active women in Britain suffer from dyspareunia [5], while the prevalence in the United States ranges from 17% to 19% [6]. As for its social impact, CPP associated with dyspareunia or other disorders can be highly disabling and have a serious impact on women’s lives. It can significantly alter social activities, psychical health, professional life, finances, and sexual relationships [11]
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