Study Aims to Quantify Pelvic Floor Muscle Dysfunction Underlying Myofascial Pelvic Pain 

Michele L. Torosis, MD

A UCLA OBGYN faculty member and colleagues from the UCLA Department of Urology are studying the ability of an innovative imaging approach they developed to provide the first objective measurement of pelvic floor muscle function. Their vaginal device, which uses near infrared spectroscopy (NIRS) to physiologically assess the pelvic floor in real time, has the potential to quantify the muscular dysfunction underlying myofascial pelvic pain (MPP), a frequently overlooked cause of chronic pelvic pain that affects an estimated 10-20% of adult women. 

In the absence of an objective tool to assess the pelvic floor muscles, MPP diagnosis is challenging, explains Michele Torosis, MD, UCLA OBGYN assistant clinical professor of urogynecology. “There’s no lab test for MPP, and it’s not something you’re going to see on imaging,” Dr. Torosis says. “Nothing on a physical exam points to it, other than the ability to assess the patient’s pelvic floor muscles, knowing that those are the areas that instigate this type of pain. But many providers aren’t trained to do a discriminant pelvic exam and screen for the condition.” As a result, Dr. Torosis notes, many patients undergo unnecessary testing and treatment that fails to provide relief — and the longer the condition is unaddressed, the more difficult it becomes to treat. 

In an effort to improve the diagnosis and treatment for this highly underserved patient population, the NIH’s National Center for Complementary and Integrative Health recently funded a team that includes Dr. Torosis and two UCLA Urology colleagues — Dr. Lynn Stothers and Dr. A. Lenore Ackerman (the project’s principal investigator) — for “Quantitative Assessment of Pelvic Floor Muscle Fitness in Myofascial Pelvic Pain.” The study aims to validate and refine the ability of an NIRS vaginal device, developed by Dr. Stothers at the University of British Columbia, to objectively measure pelvic floor muscle function and differentiate it in diseased and non-diseased states.  

For the first half of the four-year study, Dr. Torosis and her colleagues are recruiting asymptomatic controls and women seeking care for MPP in order to objectively distinguish muscle function differences in the two groups. Once the technology has been sufficiently refined, the second phase of the study will use the NIRS device to gauge changes in the pelvic floor muscles in MPP subjects following a range of myofascial-directed therapies. These include pelvic floor physical therapy, which is FDA-approved for MPP treatment, as well as vaginal muscle relaxants, pelvic-floor Botox injections, and biofeedback or electrical stimulation of the pelvic floor. 

“With these objective measures of pelvic floor function, we can provide the first direct evidence of the underlying of MPP,” Dr. Torosis says. “And then we can use it to test various treatment modalities to see which are the most effective.”