Czy terapia Recover skutecznie zmniejsza ból u kobiet z wulwodynią?

Abstract

Introduction: Vulvodynia (Vd) is a form of chronic vulvar pain and other discomfort that persists for more than three months in the absence of any evident vulvovaginal pathology. Provoked Vd is one of the reasons of dyspareunia. Vd is classified as a functional pain syndrome that is mediated by pelvic floor muscles dysfunction (PFMD overactive state) and psychological predisposition. Treatment standards do not exist, although multidisciplinary therapy seems to be the most effective. Material and methods: Retrospective study was performed within 121 women with Vd who undergo Recover therapy. Nineteen therapeutic sessions were included, with manual pelvic therapy, initial general physiotherapy and psychological consultations performed during minimum 5 days. Vd patients with PFMD overactive state were qualified by a gynecologist to the therapy, who also summarizes the treatment. Pain rate and characteristics of vulvar discomfort were assessed before and 2 and 6 months after therapy, recorded in NRS. Results: Vulvar pain and discomfort subjective reduction by 65% was confirmed after therapy, even more, 2/3 of women reported a minimum 50% relief in pain, the improvements were maintained over the time. The best treatment results in dyspareunia women caused by provoked Vd were obtained. The outcome was not dependent on the duration of Vd. Conclusions: In the center when women with vulvar diseases and Vd are treated, interdisciplinary Vd therapeutic program was developed. Recover therapy can lead to clinically meaningful improvement in Vd pain, according to chronic pain therapy assessment criteria. Randomized clinical trial with control group is indicated, when other key parameters of IMMPACT consensus, for Recover therapy assessment, would be taken under consideration.