To analyze the effects of an intervention combining PPT with non-ablative radiofrequency in postpartum pelviperineal pain.
A pre-post randomized parallel-group pilot test was conducted. Postpartum women with an eutocic or instrumental delivery and experiencing pelviperineal pain (equal to or greater than 4 cm on the Visual Analog Scale, VAS) were recruited.
Two assessments pre- and post-intervention were carried out by a women’s health expert physiotherapist, blinded to intervention group. The physiotherapy interventions for both groups were performed by a different physiotherapist.
The first assessment included baseline characteristics of the participants. The primary variable assessed was pain (VAS) and female SF (FSFI questionnaire). Additionally, a validated questionnaire was used to measure perceived PFM self-efficacy (Broome Scale).
Participants were randomly assigned to two intervention groups: the PPT control group; and the PPT plus radiofrequency intervention group.
Twelve 45-minute sessions were conducted, with a frequency of 2 sessions/week for 6 weeks. Both groups received therapeutic patient education, specific PFM training and treatment for myofascial pain syndrome. The experimental group received extra and intravaginal radiofrequency for 30 minutes/session to improve vulvovaginal tissue.
For statistical analysis, a descriptive analysis was performed using means and standard deviations; and means and medians based on normality assessed by Shapiro-Wilk test. Categorical variables were expressed as numbers and percentages. Inferential statistics included the independent samples t-test and the Mann-Whitney U test to estimate differences between groups, as well as the paired samples t-test and the Wilcoxon test to calculate within-group differences before and after the intervention.
A total of 23 women took part in the study between March 2023-September 2024, with only one dropout.
All participants presented pelviperineal pain that affected their SF, as 65% of them didn’t resume sexual activity after childbirth.
After the intervention, improvements were observed in pain, sexual health, and PFM self-efficacy in both treatment groups. However, no significant differences were found between groups in the overall results. Regarding within-group differences, improvements were observed for all variables in both groups. All changes were significant at the total scores in the intervention group, and pain and SF were significant in the radiofrequency group.
The study provides preliminary evidence supporting the effectiveness of radiofrequency plus PPT in treating postpartum pelviperineal pain. However, the superiority of the combined treatment over PPT is still unclear.. Further research with larger sample sizes is required to confirm these findings.
The results suggest that a multimodal approach of PPT and radiofrequency may be an effective strategy by improving pelvic health outcomes of postpartum women with pelvic pain.
Pelvic Health
Postpartum
