Extracorporeal shock wave therapy for treating dyspareunia: A prospective, randomized, double-blind, placebo-controlled study

Abstract

Background: Dyspareunia is a genital pain during or after penile-vaginal sexual intercourse. It is a painful spasm of the pelvic muscles that partly or entirely disables vaginal penetration.

Objectives: We examined the effect of extracorporeal shock wave therapy (ESWT) on idiopathic non-organic dyspareunia in women. A prospective, randomized, double-blind, placebo-controlled study was conducted.

Methods: The study included 62 women who reported dyspareunia. Patients in the treatment and placebo groups received ESWT perineally weekly for 4 consecutive weeks; placebo patients received placebo stand-off treatment. The grade of dyspareunia was estimated by using the Marinoff Dyspareunia Scale and subjective pain intensity on a visual analog scale (VAS) before and after treatment. Follow-ups were conducted 1, 4 and 12 weeks after the final ESWT session.

Results: The study included 61 women. The treatment but not placebo group differed by the Marinoff Dyspareunia Scale and VAS. Differences before and after treatment within groups were all P<0.001 and between groups, P<0.001. Pain reduction was always>30%. The effect sizes were both large: Marinoff 0.825 and VAS 0.883.

Conclusions: ESWT significantly reduced subjective pain in our women treated for dyspareunia.

Keywords: Dyspareunia; ESWT; Extracorporeal shock wave therapy; Pain; Sexual dysfunction; Vaginism.