Evgeniia K. Astafeva’s research while affiliated with Moscow Medical and other places

Electromyography (EMG) effectively measures pelvic floor muscle (PFM) activity, revealing differences in muscle function in women with pelvic floor dysfunction (PFD). This study compares the efficacy of high-intensity focused electromagnetic (HIFEM) therapy and traditional electrical stimulation in treating PFD. Surface EMG and subjective assessments (Pelvic Floor Impact Questionnaire, PFIQ) were used to evaluate PFM strength, endurance, and relaxation changes. Results showed that HIFEM significantly improved muscle activation, relaxation, and endurance compared to electrical stimulation. The PFIQ scores also indicated a more significant improvement with HIFEM, suggesting it is more effective than electrical stimulation for restoring PFM strength and alleviating PFD symptoms. These findings highlight HIFEM’s superior efficacy in PFM rehabilitation, offering a promising alternative for postpartum women and those with urinary incontinence or sexual dysfunction.

Dyspareunia is a condition associated with a wide range of disorders. Pelvic floor dysfunction, manifesting as a myofascial syndrome or pelvic floor muscle hypertonia, may predict dyspareunia in women in different age groups. The review addresses the current view on the dyspareunia pathogenesis associated with pelvic floor muscle dysfunction.

Dyspareunia is a very common disorder that is manifested in painful sensation in the perineal and pelvic areas during sexual intercourse, before and after it. According to the modern paradigm, dyspareunia is not simply pain syndrome, but a predictor of symptomatic organic sexual dysfunction that negatively affects both physical and emotional state of the patient. The paper describes the risk factors of dyspareunia and their effects on the pelvic floor muscle tissue and the development of pelvic floor hypertonicity.

Objectives: Pelvic floor muscles (PFMs) weakening and urinary incontinence (UI) represent health issues that have a negative impact on daily life. This study compares the immediate efficiency of high-intensity focused electromagnetic (HIFEM) therapy and electrostimulation for the treatment of weakened PFMs, accompanied by the UI. Methods: Ninety-five parous women were considered for the study. Symptomatic patients received either HIFEM or electrostimulation treatment. Treated patients completed 10 therapies scheduled 2 to 3 times per week (HIFEM) or every other day (electrostimulation). Patients underwent examination by 3-dimensional transperienal ultrasound at the baseline and posttreatments. Levator-urethra gap, anteroposterior diameter, laterolateral diameter of levator hiatus, and hiatal area were measured. In addition, Pelvic Floor Disability Index 20 questionnaire and subjective evaluation of patient's intimate health were assessed. Results: Enrolled patients were divided into group I (n = 50, HIFEM), group II (n = 25, electrostimulation), and group III (n = 20, control) according the indication and treatment modality. Three-dimensional ultrasounds showed positive changes in dynamics of the pelvic floor posttreatment (decreased anteroposterior diameter, laterolateral diameter, and hiatal area). However, the significant (P < 0.05) changes of pelvic floor integrity were observed only in group I. In addition, group I achieved greater level of improvement in Pelvic Floor Disability Index 20 questionnaire compared with group II (52% and 18% respectively; P < 0.001). Substantially fewer patients in group I reported urine leakage after treatments. Conclusions: Posttreatment results suggest that HIFEM technology is suitable for treatment of PFMs weakening and showed to be more effective when compared with electrostimulation in short-term. Therefore, we recommend HIFEM as treatment option for weakened PFMs and UI.