In April of 2024, Pelvic Rehabilitation Medicine (PRM) conducted a study of patients who received the PRM Protocol™ before their endometriosis excision surgery. The PRM Protocol™ is a simple, office-based procedure that externally targets the inflamed nerves and spastic muscles of the pelvic floor under ultrasound guidance.
Our data shows that the PRM Protocol™ was successful in improving excision surgery outcomes, through desensitizing the pelvic floor. Post-operative outcomes were compared between patients who underwent the PRM Protocol™ before endometriosis surgery (Treatment Group), compared to patients who did not undergo the PRM Protocol™ before surgery (Control Group). The PRM Protocol™ data demonstrated that undergoing surgery prior to endometriosis surgery will enhance surgical outcomes.
Desensitizing the Pelvic Floor Before Excision Surgery Decreases Post-Op Pain
Both groups demonstrated a statistically significant improvement in pain post-operatively, however patients who received the PRM Protocol™ to desensitize the pelvic floor prior to excision surgery reported decreased pain almost 20% more than those who did not go through the protocol.
A Direct Treatment to the Pelvic Floor and Muscles Increases Endometriosis Patient Functionality
Using the Functional Pelvic Pain Scale (FPPS) which is a score that measures pelvic functionality, it was shown that while both the Treatment Group and the Control Group experienced improvement in their pelvic floor function, those who underwent the PRM Protocol™ reported improvement at almost 20% greater than those who did not undergo treatment.
PRM Reduces Endometriosis Patient’s Reliance on the Emergency Room
Of the endometriosis patients who received treatment through the PRM Protocol™ prior to their excision surgery reported a 74% decrease of needing to go to the emergency room for their post-op pain, while 65% could say the same in the control group who had surgery alone.
Additionally, desensitizing the pelvic floor prior to excision surgery proves to reduce an endometriosis patient’s reliance on opioids to manage their pelvic pain.
Sexual Function Improves with Desensitization Before Surgery
At PRM, we take every aspect of a patient’s lifestyle into consideration when approaching treatment, so it is important for us to understand your personal goals.
>As with chronic pelvic pain patients who seek treatment with PRM for other conditions, we are helping to improve the desired sexual function of endometriosis patients.
Endometriosis patients who received the PRM Protocol™ prior to their excision surgery reported an overall increase in sexual function by 41% – compared to only 9% for those in the control group who had endometriosis surgery alone.
These results were determined using the Modified Sexual Function Profile and asking the following questions in relation to the past 30 days:
- How would you rate the comfort of your vagina during sexual activity?
- How often have you had difficulty with sexual activity because of discomfort/pain in your vagina?
- How often have you stopped sexual activity because of discomfort/pain in your vagina
How are inflammation and endometriosis related?
Endometriosis is a systemic, inflammatory disease process. Every time there is a menstrual cycle, there is inflammation, healing, and scarring, repeatedly over a person’s lifetime. Endometriosis is commonly found hiding in small areas of the pelvis, leading to the pelvic floor muscles entering into a chronic guarding state, which squeezes the nerves of the pelvic floor and causes chronic pelvic pain. Over several years, the pelvic floor continues to become even more spastic and inflamed.
At PRM, we work to reverse the neurogenic inflammatory process in the pelvis because it helps to decrease the chances of endometriosis growing back. Endo grows when it is surrounded by inflammatory cytokines, so our goal is to keep that inflammation under control, and keep our patients pain-free and functioning. Again, this treatment is provided through the PRM Protocol™, a direct treatment to the inflamed nerves and spastic muscles of the pelvic floor.
Read blog: The Role of Inflammation in Endometriosis
Lifelong Endometriosis Management is Key
Because endometriosis is a disease that thrives on inflammation, we recommend that our endometriosis patients continue with treatment yearly to control their inflammation to help prevent the recurrence of endometriosis lesions.
Other ways to reduce inflammation in the body include adopting an anti-inflammatory diet (download our cookbook here), reducing stress through mindfulness meditation, and controlling hormonal imbalances.
Endometriosis is a lifelong disease, which requires lifelong management. Your pelvic pain and endometriosis specialists at Pelvic Rehabilitation Medicine are here for that journey.
