This multicentre RCT evaluated whether Capacitive and Resistive Electric Transfer (CRET) diathermy, added to usual care, was superior to sham treatment in women aged ≥18 with chronic primary pelvic pain syndrome (CPPPS) and pelvic floor hypertonia (resting surface EMG >5 μV), assessed at post-treatment and 6-week follow-up.
In 44 completers, the CRET group had a median VAS pain reduction of ~40–50 mm versus placebo (p < 0.001), sustained at 6-week follow-up; McGill Pain Questionnaire scores, all WHOQOL-BREF domains, and resting pelvic floor EMG activity also improved significantly more in the active group, with no adverse events reported.
Small sample (n=44 completers) limits generalizability; blinding integrity was not formally assessed; follow-up was only 6 weeks, leaving long-term durability unknown.
CRET diathermy via a standardized intravaginal protocol appears to be a safe add-on for women with CPPPS and pelvic floor hypertonia, meaningfully reducing pain and improving quality of life beyond usual care alone. Clinicians managing refractory CPPPS with elevated resting pelvic floor tone may consider CRET as an adjunct while awaiting larger confirmatory trials.
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