Self-reported efficacy of pelvic floor physical therapy in endometriosis patients before and after surgery: A cross-sectional study

Abstract

Introduction:

Among individuals with endometriosis, pelvic floor physical therapy (PFPT) is a recommended treatment, despite limited clinical evidence. This study aimed to evaluate whether PFPT is efficacious in patients with endometriosis, both before and after surgical intervention when surgery was performed.

Methods:

An anonymous online cross-sectional survey was administered to participants through convenience sampling (March 2024 to March 2025) to understand the self-reported efficacy of PFPT as a treatment for endometriosis before and after surgery. Measures included sociodemographics, Patient Global Impression of Change (PGIC) scores, and satisfaction scores.

Results:

Among our 198 participants, 83.8% had undergone excision or ablation surgery. Of the 165 responses, 9.7% of patients had completed PFPT before surgery, 40.6% had completed PFPT after surgery, and 49.7% had participated in both before and after surgery. The average PGIC scores were 4.8 before surgery and 5.1 after surgery, indicating no change or minimal improvement in symptoms of endometriosis pain. Satisfaction scores were also relatively low, averaging 5.8 before surgery and 6.5 after surgery, indicating minimal satisfaction. Additionally, 33.1% and 32.4% reported worsening of symptoms or no change before and after surgery, respectively. On average, participants required 5.6 PFPT sessions to first notice improvement in symptoms after surgery. Comorbidities, including adenomyosis (45.3%), migraines (68.7%), Ehlers-Danlos Syndrome (22.0%), and vulvodynia (24.7%), were highly prevalent, suggesting the need for more tailored approaches to care.

Conclusion:

Based on self-reported results, PFPT is a minimally effective and potentially harmful treatment, defined as worsening of symptoms, for those with endometriosis, regardless of surgery.