None listed
Conditions
Brief summary
Patients with persistent pelvic pain (PPP), including those with endometriosis associated pelvic pain, often have pelvic floor muscle tenderness and tension. These problems may be related to their pelvic pain continuing, despite medical or surgical treatments for endometriosis. Prior to a patient’s first laparoscopy for the investigation of PPP, we will investigate if they experience tenderness and tension in their pelvic floor muscles and whether this is associated with their pelvic pain. We will also investigate whether the pelvic floor muscle tenderness and tension, and pelvic pain, change following the laparoscopy, in the short term (3 months) and the medium term (1 year). This study will also test how well gynaecologists and physiotherapists are able to detect pelvic floor muscle tenderness and tension to ensure patients with pelvic floor muscle problems receive appropriate treatment.
Interventions
This study will identify the prevalence and severity of pelvic floor muscle tenderness, increased pelvic floor muscle tone and pelvic pain symptoms in women with endometriosis-associated pelvic pain, before and after surgical treatment of endometriosis.
Women will be assessed by a pelvic floor physiotherapist at 3 time-points: before surgery, 3 months after surgery and 12 months after surgery. Duration of each assessment:
- T1 (pre-operative): 1 hour
- T2 (3 months post-operative): 45 minutes
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This study will identify the prevalence and severity of pelvic floor muscle tenderness, increased pelvic floor muscle tone and pelvic pain symptoms in women with endometriosis-associated pelvic pain, before and after surgical treatment of endometriosis. Women will be assessed by a pelvic floor physiotherapist at 3 time-points: before surgery, 3 months after surgery and 12 months after surgery. Duration of each assessment: - T1 (pre-operative): 1 hour - T2 (3 months post-operative): 45 minutes - T3 (12 months post-operative): 45 minutes. Assessment sites include public hospitals and private physiotherapy practices. Assessments will follow a standardised protocol and include: 1. intra-vaginal digital palpation to assess pelvic floor muscle resting tone, tenderness, strength of contraction, ability to relax. 2. intra-vaginal algometry to assess pressure pain thresholds of the levator ani and obturator internus muscles. 3. intra-vaginal pressure manometry to assess resting pressure and squeeze pressure of the pelvic floor muscles. No physiotherapy treatment will be provided as part of the study, however women will be free to seek physiotherapy treatment outside of the study, between the 3- and 12-month study assessment time-points.
Sponsors
NHMRC-MRFF
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
• Women with pelvic pain for at least 6 months duration • Scheduled for laparoscopy for investigation of pelvic pain, with or without sonographic evidence of endometriosis • No prior history of surgically treated endometriosis • Agreement to not receive physiotherapy treatment for PFM dysfunction or persistent pelvic pain between baseline assessment and 3 months post-operatively.
Exclusion criteria
• Women who cannot have vaginal examination: o have never had vaginal intercourse o are unable to tolerate vaginal examination o are un-suitable for vaginal examination • Pregnant, lactating, or peri-/post-menopausal women • Inability to understand and fully comprehend consent information, including non-English speaking • Known pathology other than endometriosis or adenomyosis as likely cause of pain • History of or planned hysterectomy
Outcome results
None listed