Efficacy of intravaginal biofeedback-assisted therapy in women with vaginismus

OBJECTIVE: To investigate the effect of relaxation of vaginal muscles with EMG measurements after transmucosal electrical nerve stimulation (TENS) application. We planned to implement a method that would allow our treatment success data to be easily collected and analyzed with instant digital EMG data. MATERIAL and METHODS: This study was conducted at our private clinic of between January 2022 and October 2024. The intravaginal device of the NeuroTrac MyoPlus2 Pro device (Verity Medical Ltd, Ireland) was placed into the vagina in an average of 30–45 seconds. Then, electromyography (EMG) measurements of voluntary contraction and relaxation were taken in the work and rest assessment mode, 5 seconds of contraction and 5 seconds of relaxation for 55 seconds. Then, intravaginal TENS was applied with the intravaginal apparatus in the current relaxation mode recorded in the device at 30 mA power for 20 minutes Then, EMG measurements of contraction and relaxation were taken during 5 seconds of voluntary contraction and 5 seconds of relaxation, for a total of 55 seconds. RESULTS: 135 patients who underwent intravaginal device of the NeuroTrac MyoPlus2 Pro for vaginismus were included in this study. At work, average and lowest EMG values were significantly lower after therapy (22.8 vs 17.8 mV, p=0.013; 9.8 vs 8.1 mV, p<0.001, respectively). Highest EMG value and maximum voluntary contraction (MVC) value were similar before and after therapy. At rest, average, lowest, highest and MVC values were statistically significantly higher after therapy (3.8 vs 1.9 mV; 1.2 vs 0.6 mV; 13.8 vs 10.3 mV and 16% vs 13%, p<0.001, respectively). CONCLUSION: The NeuroTrac MyoPlus2 Pro intravaginal device can be applied as an effective treatment modality in the management of vaginismus. Keywords: electromyography, intravaginal device, transmucosal electrical nerve stimulation, vaginismus