Deep infiltrative endometriosis (DIE) had been linked with chronic pelvic pain. As found from this cross-sectional study, women with DIE had pelvic floor muscle (PFM) and lower limb muscle (LLM) dysfunction along with more pelvic symptoms. Due to pain, the risk of PFM hypertonia was increased which caused trouble in PFM relaxation.

This study is based on the assumption that women with DIE may have dysfunctions of the PFM and LLM.

One hundred and sixty women (80 women each with DIE under hormonal therapy and; without DIE i.e. the Control group) were evaluated to determine the incidence of pelvic symptoms i.e. dysmenorrhea or menstrual cramps, chronic pelvic pain, deep/penetration dyspareunia, dysuria, dyschezia, and vulvodynia.

The PFM function (PERFECT- Power or Pressure, Endurance, Repetitions, Fast contractions, and finally Every Contraction Timed scheme; incidence of hypertonia and trigger points, and muscle contraction and relaxation), abdominal muscle pain via Carnett's test, and muscle shortening in LLM via Thomas, Pace, and Ober tests were also assessed.

The women with DIE had more chronic pelvic pain, dysuria, and dyschezia compared to the control group. They also had higher PFM hypertonia, weaker PFM contraction, and incomplete PFM relaxation. These women had an elevated rate of positive scores in the Carnett's test (Table 1):

Table 1: Difference in pelvic symptoms, PFM function, and abdominal muscle pain in women with DIE and without DIE

Furthermore, they had higher incidences of shortening of the anterior thigh (30% versus 10% in both LLM), piriformis (16.25% versus 6.25%), and iliotibial band muscles (bilateral).

As compared to the control group, the women with DIE had more pelvic symptoms and greater PFM and LLM dysfunction. The pain was linked with PFM hypertonia and trouble in PFM relaxation.