Assessment of pelvic floor muscles in women with deep endometriosis

Arch Gynecol Obstet. 2016 Sep;294(3):519-23. doi: 10.1007/s00404-016-4025-x. Epub 2016 Feb 5.


Purpose: To assess function and prevalence of spasms and trigger points of the pelvic floor muscles in women with deep endometriosis.

Methods: One hundred and four (104) patients were assessed. Group 1 (G1) was composed of 52 subjects diagnosed with deep endometriosis proven by magnetic resonance imaging (MRI); Group 2 (G2) was composed of 52 women with no signs of endometriosis. Subjects from both G1 and G2 were seen at the Division of Pelvic Pain and Endometriosis and at Center for Prevention of Sexually Transmitted Diseases, both at Federal University of São Paulo (UNIFESP), respectively. A full physical therapy evaluation was carried out, including medical history, presence of dyspareunia and physical examination, which included detailed evaluation of pelvic floor muscles and occurrence of muscle spasm, trigger point and muscle function.

Results: The average age of the subjects in the study group was 36.4 and 30.9 years in the control group (p = 0.002). A greater prevalence of deep dyspareunia was found in the subjects in the endometriosis group when compared to the control group (p = 0.010). Women in G1 had higher prevalence of muscle spasms. In this group, 53.9 % had spasms-compared to only 17.3 % of women in G2 (p < 0.001). On the other hand, no significant difference between the groups (p = 0.153) was found while searching for the presence of trigger points.

Conclusion: Women with deep endometriosis have increased prevalence of pelvic floor muscle spasms when compared to the control group.

Keywords: Deep dyspareunia; Deep endometriosis; Muscle spasm; Pelvic floor muscles; Physical therapy; Trigger point.

MeSH terms

  • Adult
  • Case-Control Studies
  • Dyspareunia / etiology
  • Endometriosis / complications*
  • Female
  • Humans
  • Pelvic Floor*
  • Spasm / etiology*