Effect of transcutaneous electrical nerve stimulation on the postpartum dyspareunia treatment. 2011

Barbara Dionisi, and Roberto Senatori
Outpatient Department of Pelvic Floor Rehabilitation and Vulvar Disease, Nursing Home Holy Family, Rome, Italy. b.dionisi@tiscali.it

OBJECTIVE This article will evaluate the safety and efficacy of intravaginal transcutaneous electrical nerve stimulation (TENS) for the treatment of vulvar pain and dyspareunia during the postpartum period related to perineal trauma caused by episiotomy. METHODS From January 2007 to January 2009, 45 women presenting with postpartum dyspareunia related to perineal trauma after a vaginal delivery were educated on the importance of the pelvic floor and its part in continuing dyspareunia. The treatment consisted of weekly applications of intravaginal TENS in an outpatient setting and daily home therapy with myofascial stretching and exercises of the pelvic floor musculature. The results were evaluated using the cotton swab test, the Marinoff Dyspareunia Scale and the Visual Analog Scale, and the anovulvar distance was assessed prior to and at the end of the treatment period. RESULTS Of the women included in the study, 84.5% reported an improvement of dyspareunia after only five applications of TENS, with a total remission of symptoms (in 95% of patients) at the end of the protocol. At follow-up, eight months after the end of treatment, all patients were pain free. CONCLUSIONS Therapy with intravaginal transcutaneous nerve stimulation and pelvic floor relaxation exercises is safe and effective in the improvement of vulvar pain and dyspareunia in women with postpartum perineal trauma due to episiorrhaphy, after spontaneous delivery.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D004414 Dyspareunia Recurrent genital pain occurring during, before, or after SEXUAL INTERCOURSE in either the male or the female.
D004561 Transcutaneous Electric Nerve Stimulation The use of specifically placed small electrodes to deliver electrical impulses across the SKIN to relieve PAIN. It is used less frequently to produce ANESTHESIA. Analgesic Cutaneous Electrostimulation,Electric Stimulation, Transcutaneous,Electroanalgesia,Percutaneous Electric Nerve Stimulation,TENS,Transdermal Electrostimulation,Electrical Stimulation, Transcutaneous,Percutaneous Electrical Nerve Stimulation,Percutaneous Electrical Neuromodulation,Percutaneous Neuromodulation Therapy,Transcutaneous Electrical Nerve Stimulation,Transcutaneous Nerve Stimulation,Cutaneous Electrostimulation, Analgesic,Electrical Neuromodulation, Percutaneous,Electrical Neuromodulations, Percutaneous,Electroanalgesias,Electrostimulation, Analgesic Cutaneous,Electrostimulation, Transdermal,Nerve Stimulation, Transcutaneous,Neuromodulation Therapy, Percutaneous,Neuromodulation, Percutaneous Electrical,Neuromodulations, Percutaneous Electrical,Percutaneous Electrical Neuromodulations,Percutaneous Neuromodulation Therapies,Stimulation, Transcutaneous Electric,Stimulation, Transcutaneous Nerve,Therapy, Percutaneous Neuromodulation,Transcutaneous Electric Stimulation,Transcutaneous Electrical Stimulation
D004841 Episiotomy An incision of the posterior vaginal wall and a portion of the pudenda which enlarges the vaginal introitus to facilitate delivery and prevent lacerations. Episiotomies
D005081 Exercise Therapy A regimen or plan of physical activities designed and prescribed for specific therapeutic goals. Its purpose is to restore normal musculoskeletal function or to reduce pain caused by diseases or injuries. Rehabilitation Exercise,Remedial Exercise,Therapy, Exercise,Exercise Therapies,Exercise, Rehabilitation,Exercise, Remedial,Exercises, Rehabilitation,Exercises, Remedial,Rehabilitation Exercises,Remedial Exercises,Therapies, Exercise
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D015331 Cohort Studies Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics. Birth Cohort Studies,Birth Cohort Study,Closed Cohort Studies,Cohort Analysis,Concurrent Studies,Historical Cohort Studies,Incidence Studies,Analysis, Cohort,Cohort Studies, Closed,Cohort Studies, Historical,Studies, Closed Cohort,Studies, Concurrent,Studies, Historical Cohort,Analyses, Cohort,Closed Cohort Study,Cohort Analyses,Cohort Studies, Birth,Cohort Study,Cohort Study, Birth,Cohort Study, Closed,Cohort Study, Historical,Concurrent Study,Historical Cohort Study,Incidence Study,Studies, Birth Cohort,Studies, Cohort,Studies, Incidence,Study, Birth Cohort,Study, Closed Cohort,Study, Cohort,Study, Concurrent,Study, Historical Cohort,Study, Incidence

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