ESWT for the treatment of dyspareunia and vulvodynia

ESWT for the treatment of dyspareunia and vulvodynia

We would like to present two very interesting randomised controlled studies that investigated the effect of ESWT in the treatment of indications in the field of sexual medicine.

The first study1 evaluated the effect of ESWT in the treatment of dyspareunia – a painful cramping of the pelvic floor muscles during or after penetrative sex.

61 women took part in the study. Perineal treatment with ESWT (and placebo treatment) took place every week for 4 weeks. Measuring instruments included the Marinoff Dyspareunia Scale and a visual analogue scale (VAS) for pain intensity. Follow-up examinations were performed 1, 4 and 12 weeks after the final ESWT session.

Results: There were differences in the Marinoff Dyspareunia Scale and the VAS for the ESWT group, but not for the placebo group. The differences pre- and post-treatment were all p < 0.001 within the groups and p < 0.001 between the groups. Pain reduction was always > 30%. The strength of the effect was great: Marinoff 0.825 and VAS 0.883. The authors concluded that ESWT significantly reduced subjective pain perception.

The second study2 evaluated the effect of ESWT in the treatment of vulvodynia – a chronic pain syndrome affecting the vulvar area and for which there is as yet no universally effective therapy strategy.

62 women took part in the study. Patients in the ESWT group received perineal ESWT for a period of 4 weeks. Subjective pain was evaluated by each patient before and after treatment using the VAS and cotton swab test (CST, Goetsch scale 0-4). Follow-ups were performed 1, 4 and 12 weeks after the final ESWT session.

Results: There were significant changes in the ESWT group. In all three follow-ups, reductions were observed in VAS (p < 0.01) and CST (p < 0.01), with pain reduction always > 30%. There were no statistically significant changes in the placebo group. Prior to the treatment, there were no differences between the ESWT and placebo groups but statistically significant differences were recorded at all three follow-ups (VAS p < 0.01; CST p < 0.01). The authors concluded that ESWT appears to be an effective treatment.

References:
1. Hurt K, Zahalka F, Halaska M, et al. Extracorporeal shock wave therapy for treating dyspareunia: A prospective, randomized, double-blind, placebo-controlled study. Ann Phys Rehabil Med. 2021 Nov;64(6):101545. doi: 10.1016/j.rehab.2021.101545, https://www.sciencedirect.com/science/article/pii/S1877065721000634
2. Hurt K, Zahalka F, Halaska M, et al. Extracorporeal shock wave therapy for treatment of vulvodynia: a prospective, randomized, double-blind, placebo-controlled study. Eur J Phys Rehabil Med. 2020 Apr;56(2):169-174. doi: 10.23736/S1973-9087.20.05903-1, https://pubmed.ncbi.nlm.nih.gov/31939265/

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