4.1. Main Findings
urinary dysfunctions, chronic pelvic pain, DIE lesions, urinary dysfunction, DIE, dyspareunia, pain, chronic constipation
DYSPAREUNIA, DYSFUNCTION
PFP does not seem to affect urinary, bowel, and sexual functions in women with DIE, despite the previously reported improvement in superficial dyspareunia, chronic pelvic pain, and PFM relaxation in the same cohort of women [With regard to sexual function, no significant differences were found between the experimental and control groups from first to second examination in the pain domain of FSFI questionnaire. This finding was surprising, especially considering the significant improvement in numeric rating scale (NRS) score of superficial dyspareunia found in women of the experimental group at the second examination [Concerning urinary function, no changes after PFP were detected. The women in the study were all women with deep posterior endometriotic lesions not surgically removed, so it is likely that the presence of the lesion itself may be responsible for urinary dysfunctions, which did not improve after physiotherapy. In fact, an increase in the density of nerve fibers and phenomena of perineural and intraneural invasion in DIE lesions have been demonstrated by immunochemistry [Previous studies investigating urinary function before and after surgery in patients with DIE detected the presence of urinary dysfunction before surgery and did not report improvement after surgery, suggesting a more complex physiopathology of the dysfunction itself [As regards bowel function, chronic constipation with difficult evacuation can be caused by inadequate PFM relaxation and altered coordination [Based on these findings and results of other outcomes analysis [