Comparação da massagem Thieli e eletroestimulação para alívio da dor crônica e disfunção sexual em mulheres com endometriose: um estudo de protocolo

Abstract

Introduction: Endometriosis is defined as an inflammatory, estrogen-dependent disease characterized by the presence of endometrial implants outside the peritoneal cavity that cause symptoms such as chronic pelvic pain and dyspareunia. Although there is still no specific treatment for painful symptoms, studies show that Thieli Massage and transcutaneous electrical neurostimulation (TENS) promote pain relief and improve sexual function. Objective: To design a clinical trial protocol according to the SPIRIT 2013 Guidelines to evaluate the action of Thieli and TENS massage on chronic pelvic pain and sexual dysfunction in women with endometriosis. Methods: Blind, controlled and randomized study, in which participants will be randomized into two groups: intervention and control. The intervention group will undergo thieli massage for 5 minutes, once a week for 8 weeks. Both groups will receive TENS in acupuncture mode and low frequency (8Hz, 250µs, intensity and frequency according to the patient's tolerance) for 30 minutes, once a week, for 8 weeks. Patients will be evaluated in three situations: at study admission, 1 month and 2 months after the end of the intervention to assess the maintenance of analgesic effects and sexual function. The evaluation and reassessments will be carried out through anamnesis, physical examination and application of the Female Sexual Function Index (FSFI), Numerical Pain Scale (NRS) (17), The World Health Organization Quality of Life (WHOQOL-bref), Endometriosis Health Profile Questionnaire (EHP-30) and Patient Global Impression (PGI). Results: Primary outcome: pain reduction demonstrated through NRS. Secondary outcome: resolution or improvement of sexual dysfunction through the FSFI score and improvement in quality of life through the scores of The World Health Organization Quality of Life (WHOQOL-bref), Endometriosis Health Profile Questionnaire (EHP-30). Conclusion: It is expected that both groups will present improvement in sexual function and chronic pelvic pain, with the maintenance of relief of painful symptoms, as it is found in the literature improvement of the condition using separately thieli and TENS massage techniques.