Modified Thiele massage as therapeutic intervention for female patients with interstitial cystitis and high-tone pelvic floor dysfunction
Received 16 April 2004; accepted 28 June 2004.
Abstract
Objectives
To evaluate the effectiveness of transvaginal manual therapy of the pelvic floor musculature (Thiele massage) in symptomatic female patients with interstitial cystitis and high-tone dysfunction of the pelvic floor.
Methods
A total of 21 women with documented interstitial cystitis and high-tone pelvic floor dysfunction underwent transvaginal massage using the Thiele technique twice a week for 5 weeks. Symptoms were evaluated before massage, at protocol conclusion, and at a mean of 4.5 months after therapy completion (long-term follow-up). The response to treatment was evaluated through the O’Leary-Sant Interstitial Cystitis Symptom and Problem Indexes, Likert Visual Analogue Scales for urgency and pain, and Short-Form 12-item (SF-12) Quality-of-Life Scale, and through changes in the physical examination findings using a 5-point modified Oxford Scale to document pelvic floor tenderness.
Results
A statistically significant improvement was seen in the Symptom and Problem Indexes of the O’Leary-Sant Questionnaire (P = 0.015 and P = 0.039, respectively), Likert Visual Analogue Scales for urgency and pain (P = 0.001 and P = 0.005, respectively), the Physical and Mental Component Summary from the SF-12 Quality-of-Life Scale (P = 0.049 and P = 0.044, respectively), and the modified Oxford Scale (P <0.05) after protocol completion. At long-term follow-up, the O’Leary-Sant Interstitial Cystitis Symptom and Problem Indexes (P = 0.049 and P = 0.02, respectively), Likert Visual Analogue Scales for urgency and pain (P = 0.004 and P = 0.005, respectively), and modified Oxford Scale for three of four muscles in the pelvic floor (P <0.05) remained significantly improved.
Conclusions
Thiele massage appears to be very helpful in improving irritative bladder symptoms in patients with interstitial cystitis and high-tone pelvic floor dysfunction in addition to decreasing pelvic floor muscle tone.
aUniversity of Medicine and Dentistry New Jersey Robert Wood Johnson School of Medicine, Cooper Hospital, Camden, New Jersey, USA
bThe Pelvic Floor Institute, Graduate Hospital, Philadelphia, Pennsylvania, USA
cUrogynecology Associates of Colorado, Denver, Colorado, USA
dBody Rebuilders Physical Therapy, Bala Cynwyd, Pennsylvania, USA
Reprint requests: Ian A. Oyama, M.D., University of Medicine and Dentistry New Jersey Robert Wood Johnson School of Medicine, Cooper Hospital, 900 Centennial Boulevard, Suite L, Voorhees, NJ 08043
This study was supported by a grant from the Interstitial Cystitis Association.
ABSTRACT