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Physiotherapy

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Bladder Pain Syndrome

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Abstract

The pelvic floor musculature (PFM) has long been considered a contributing factor for lower urinary tract symptoms. Research has demonstrated that the majority of bladder pain syndrome/interstitial cystitis (BPS/IC) patients have overactive pelvic floor muscles (OPFM), a condition in which PFM does not relax. The BPS International Consultation on Incontinence recommends physiotherapy as first line to treat this condition. Research, including one prospective trial, supports manual physical therapy for treatment of OPFM.

The Etiology of OPFM is variable and can occur secondary to other visceral pain and myofascial pain disorders. The clinician needs to obtain a detailed history and physical exam and also needs to refer and collaborate with the physiotherapist. Physiotherapists should evaluate the patient’s biomechanics, connective tissue, and internal PFM and be able to implement treatments for each of these specific deficits.

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References

  1. Bo K, Talseth T, Holme I. Single blind, randomized controlled trial of pelvic floor excercises, electrical stimulation, vaginal cones, and no treatment in the management of genuine stress incontinence in women. BMJ. 1999;318:487–93.

    Article  PubMed  CAS  Google Scholar 

  2. Burns PA, Pranikoff K, Nochaski T, et al. Treatement of stress urinary incontinence with pelvic floor exercises and biofeedback. J Am Geriatr Soc. 1990;38:341–4.

    PubMed  CAS  Google Scholar 

  3. Abrams P, Anderson KE, Birder L, et al. Fourth International Consulation on Incontinence recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29:213–40.

    Article  PubMed  CAS  Google Scholar 

  4. Hanno P, Lin A, Nordling J, et al. Bladder pain syndome International Consulation on Incontinence. Neurourol Urodyn. 2010;29:191–8.

    Article  PubMed  Google Scholar 

  5. Messelink B, Benson T, Berghmans B, et al. Standardization of the terminology of the pelvic floor muscle function and dysfunction: report form the pelvic floor clinical assessment group of the International Continence Society. Neurourol Urodyn. 2005;24:374–80.

    Article  PubMed  Google Scholar 

  6. Whitmore K, Kellogg-Spadt S, Fletcher E. Comprehensive assessment of pelvic floor dysfunction. Issues in Incont. 1998;Fall: 1–2, 10.

    Google Scholar 

  7. Fitzgerald MP, Kotarinos R, Fitzgerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. I: background and patient evaluation. Int Urogynecol J. 2003;14:261–8.

    Article  CAS  Google Scholar 

  8. Butrick CW. Pelvic floor hypetonic disorders: identification and management. Obstet Gynecol Clin North Am. 2009;36:707–22.

    Article  PubMed  Google Scholar 

  9. Peters KM, Carrico DJ, Kalinowski SE, et al. Prevalence of pelvic floor dysfunction in patients with interstitial cystitis. Urology. 2007;70:16–8.

    Article  PubMed  Google Scholar 

  10. Butrick CW, Sanford D, Hou Q, et al. Chronic pelvic pain syndromes: clinical urodynamic and urothelial observations. Int Urogynecol J Pelvic Floor Dysfucnt. 2009;20:1047–53.

    Article  Google Scholar 

  11. Cameron A, Gajewski J. Bladder outlet obstruction in painful bladder syndrome/interstitial cystitis. Neurourol Urodyn. 2009;28:944–8.

    Article  PubMed  Google Scholar 

  12. Hetrick DC, Ciol MA, Rothman I, et al. Musculoskeletal dysfunction in men with chronic pelvic pain syndrome type III: a case–control study. J Urol. 2003;170:828–31.

    Article  PubMed  Google Scholar 

  13. Chaitow, Leon ND. Chronic pelvic pain: pelvic floor problems, sacroiliac dysfunction and the trigger point connection. 6th Interdisciplinary World Congress on Low Back and Pelvic Pain Barcelona November 2007; 42–52.

    Google Scholar 

  14. Tu FF, Hold J, Gonzales J, Fitzgerald CM. Physical Therapy evaluation of patients with chronic pelvic pain: a controlled study. Am J Obstet Gynecol. 2008;198:272e1–7.

    Article  Google Scholar 

  15. Anderson RU, Sawyer T, Wise D, et al. Painful Myofascial trigger points and pain sites in men with chronic prostatis/chronic pelvic pain syndrome. J Urol. 2009;182:2753–8.

    Article  PubMed  Google Scholar 

  16. Butrick CW. Pathophysiology of the pelvic floor hypertonic disorders. Obstet Gynecol Clin North Am. 2009;36:699–705.

    Article  PubMed  Google Scholar 

  17. Simons DG, Travell JG, Simons LS. Myofascial pain and dysfunction: the trigger point manual, vol. 1. Baltimore: Lippincot Williams and Wilkins; 1999.

    Google Scholar 

  18. Gerwin RD. Classification, epidemiology, and natural history of myofascial pain syndrome. Curr Pain Headache Rep. 2001;5:412–20.

    Article  PubMed  CAS  Google Scholar 

  19. Baker PK. Musculoskeletal origins of chronic pelvic pain. Obstet Gynecol Clin North Am. 1993;20:719–41.

    PubMed  CAS  Google Scholar 

  20. Thiele GH. Coccygodynia: cause and treatment. Dis Colon Rectum. 1963;6:422–36.

    Article  PubMed  CAS  Google Scholar 

  21. Weiss J. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol. 2001;166:2226–31.

    Article  PubMed  CAS  Google Scholar 

  22. Oyama IA, Rejba A, Lukban JC, et al. Modified thiele massage as therapeutic intervention for female patients with interstitial cystitic and high-tone pelvic floor dysfunction. Urology. 2004;64:862–5.

    Article  PubMed  Google Scholar 

  23. Fitzgerald MP, Anderson RU, Potts J, et al. Randomized multicenter feasibility trial of myofascial physical therapy for the treatment of urologic chronic pelvic pain syndromes. J Urol. 2009;182:570–80.

    Article  PubMed  Google Scholar 

  24. Fitzgerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. II: treatment of the patient with the short pelvic floor. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:269.

    Article  PubMed  CAS  Google Scholar 

  25. Laslett M. Evidenced-based diagnosis and treatment of the painful sacroiliac joint. J Man Manip Ther. 2008;16:142–52.

    PubMed  Google Scholar 

  26. Wesselmann U, Lai J. Mechanisms of referral visceral pain: uterine inflammation in the adult virgin rat results in plasma extravasation in the skin. Pain. 1997;73:309–17.

    Article  PubMed  CAS  Google Scholar 

  27. Prendergast SA, Weiss JM. Screening for musculoskeletal causes of pelvic pain. Clin Obstet Gynecol. 2003;46:4.

    Article  Google Scholar 

  28. Barral J-P. Urogenital manipulation. Seattle: Eastland Press; 2003.

    Google Scholar 

  29. Prendergast, S, Kotarinos, R. Treating vulodynia with manual physical therapy. National Vulvodynia Association News. 2008;Fall:2–6.

    Google Scholar 

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Author information

Authors and Affiliations

  1. The Pelvic and Sexual Health Institute, 207 No Broad St., 4th Floor, Philadelphia, PA, 19107, USA

    Amy Rejba Hoffmann M.S.N.

  2. Rebalance Physical Therapy, Philadelphia, PA, USA

    Hina M. Sheth M.S., P.T., O.C.S., M.T.C.

  3. Urology, Obstetrics/Gynecology and Female Pelvic Medicine and Reconstructive Surgery, Drexel University College of Medicine, Philadelphia, PA, USA

    Kristene E. Whitmore M.D.

Authors
  1. Amy Rejba Hoffmann M.S.N.
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  2. Hina M. Sheth M.S., P.T., O.C.S., M.T.C.
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  3. Kristene E. Whitmore M.D.
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Corresponding author

Correspondence to Amy Rejba Hoffmann M.S.N. .

Editor information

Editors and Affiliations

  1. University of Copenhagen, Department of Urology, Herlev Hospital, Herlev, 2730, Denmark

    Jørgen Nordling

  2. University Hospital Antwerp, Department of Urology, and Antwerp University, Edegem, 2650, Belgium

    Jean Jacques Wyndaele

  3. and Internal Medicine, Erasmus MC,, Departments of Immunology, University Medical Center Rotterdam, Rotterdam, 3141 XW, Netherlands

    Joop P. van de Merwe

  4. Koege Hospital, Department of Clinical Biochemistry, University of Copenhagen, Copenhagen, 4600, Denmark

    Pierre Bouchelouche

  5. Department Obstetrics and Gynecology, Department of Urogynecology S.Carlo-IDI, Catholic University, Rome, 00165, Italy

    Mauro Cervigni

  6. Institute of Clinical Sciences, Department of Urology, Sahlgrens Academy at University of Gothenburg, Göteborg, 41345, Sweden

    Magnus Fall

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Hoffmann, A.R., Sheth, H.M., Whitmore, K.E. (2013). Physiotherapy. In: Nordling, J., Wyndaele, J., van de Merwe, J., Bouchelouche, P., Cervigni, M., Fall, M. (eds) Bladder Pain Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6929-3_20

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  • DOI: https://doi.org/10.1007/978-1-4419-6929-3_20

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  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-6928-6

  • Online ISBN: 978-1-4419-6929-3

  • eBook Packages: MedicineMedicine (R0)

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