Effectiveness of dry needling of rectus abdominis trigger points for the treatment of primary dysmenorrhoea: a randomised parallel-group trial.

OBJECTIVE: To compare the effectiveness of trigger point dry needling (TrP-DN) versus placebo needling, relative to an untreated control group, on pain and quality of life in primary dysmenorrhoea. METHODS: In this randomised, single blind, parallel-group trial, 56 females with primary dysmenorrhoea were randomly allocated to TrP-DN (n=19), placebo needling (n=18) or no treatment (n=19). Patients in both groups were asked to undertake a stretching exercise of the rectus abdominis daily. The needling group received a single session of TrP-DN to trigger points (TrPs) in the rectus abdominis, and the placebo group received placebo needling. The primary outcome was pain intensity (visual analogue scale). Secondary outcomes were quality of life, use of non-steroidal anti-inflammatory drugs, the number of days with pain, and self-perceived improvement, measured using a Global Rate of Change. Outcomes were assessed at baseline, and 1 and 2 months after the treatment. RESULTS: Females receiving TrP-DN exhibited greater decreases (P<0.001) in pain than those receiving placebo (1 month: Δ-19.8 mm, 25.9 to -13.7; 2 months: Δ-26.0 mm, -33.1 to -18.9) or assigned to the untreated control group (1 month: Δ-26.0mm, -32.5 to -19.5; 2 months: Δ-20.1 mm, -26.4 to -13.8). Females in the TrP-DN group also exhibited a greater decrease in the amount of medications (P<0.001). No differences in the number of days with pain or quality of life were found (all P>0.1). CONCLUSIONS: This trial suggests that a single session of TrP-DN of the rectus abdominis combined with stretching was more effective than placebo needling and stretching alone at reducing pain and the amount of medication used in primary dysmenorrhoea. TRIAL REGISTRATION NUMBER: ACTRN12616000170426 .

Natural history of histologically moderate cervical dysplasia in adolescent and young women.

BACKGROUND: Adolescent women are a special age group affected by human papilloma virus (HPV). Most guidelines recommend surgical treatment for high-grade cytological lesions. However, some reports have attempted to demonstrate that the immune system is fully capable of clearing the virus without using conization. Our aim in this study was to describe the outcome of women <25 years old with high-grade cytology pap smears and no histologically confirmed cervical intraepithelial neoplasm [CIN] III. METHODS: This prospective cohort study, carried out at the Department of Obstetrics and Gynecology, Hospital 12 de Octubre, included 29 women aged 25 years or younger with high-grade cytological lesions recruited in screening programs and were followed up at 15 months. This study describes the clinical course of the women, and we determined the percentage of cytological, histological, and microbiological lesions produced by HPV that were cleared without surgical treatment in these women during their follow-up. RESULTS: During follow-up, 63% of high-grade cytological lesions and all high-grade histological lesions were cleared. HPV was eliminated from 23% of patients with one HPV serotype and 27% with multiple HPV serotypes without any treatment. CONCLUSION: These results suggest that there is no need to use surgical treatment to clear high-grade cytological and cervical lesions in adolescent women, thus preventing damage to their reproductive future.