Pelvic floor rehabilitation in the treatment of dyspareunia in women

A Findings from recent studies suggest that the pelvic floor musculature may play a role in the pathophysiology of dyspareunia, particularly provoked vestibutodynia. Objective. - The main purpose of this paper is to present the different components of pelvic floor rehabilitation (education, biofeedback, manual and insertion techniques, in addition to electrotherapeutic modalities) and to discuss their effectiveness in the treatment of dyspareunia in women. Method. -The manuscript was based on a literature search performed in Pubmed. Results. - The present state of knowledge concerning the use of pelvic floor rehabilitation in the treatment of dyspareunia is based on three randomized outcome studies demonstrating the effectiveness of biofeedback and transcutaneus electrical stimulation. Evidence regarding the effectiveness of other modalities stems from studies with either observational or retrospective designs. Discussion. - Findings suggest that pelvic floor rehabilitation is a promising treatment for vestibutodynia. However, randomized controlled-trials are required in order to document the efficacy of the combined modalities included in pelvic floor rehabilitation and to examine its usefulness as a treatment for other types of sexual pain, such as vaginismus. (C) 2009 Elsevier Masson SAS. All rights reserved.