Abstrakt

Introduction: Treatment of dyspareunia without organic pathology is complex and remains elusive. It is difficult to provide pre-coital premedication in women because of the genesis of this dysfunction. Extracorporeal shock wave therapy (ESWT) is widely used for the treatment of musculoskeletal diseases, tendon disorders, plantar fasciitis and muscle spasticity after spinal lesions. We decided to assess the effects of ESWT in women with dyspareunia.  

Methods: A prospective study was conducted between 2017 and 2019. The feasibility study included 20 women who reported suffering from dyspareunia for at least 3 months in the past year. The patients received perineally applied ESWT weekly (4000 pulses each for four consecutive weeks). ESWT was generated by a standard electromagnetic shock wave unit with a focused shock wave handpiece. Eight areas covered the whole vulva and perineum and the treatment area was changed after every 500 pulses.

The grade of dyspareunia was estimated using the Marinoff scale (0-3) and subjective intensity of the pain was rated on VAS an 11-point visual analog scale (0-10) before and after treatment.  Follow-ups were done after 4 and 12 weeks after the final ESWT session. Ethical approval and written consent were obtained.

Results:  The study was completed by 19 women. Significant differences were found for before treatment and the 4- and 12-week follow-ups (p < 0.05) for both the Marinoff scale and the VAS. At all assessments, pain reduction was always > 30%. 

Conclusions: ESWT significantly reduced subjective pain in our group of patients treated for dyspareunia. We are inspired by the results of the study and therefore recommend continued application of this modern technique. The method is easily repeatable, inexpensive and completely free of side effects. Incidentally, ESWT is only one of a few therapies to treat this dysfunction.