Implementation of a Postoperative Pelvic Floor Physical Therapy Telehealth Appointment Following Laparoscopic Surgery for Chronic Pelvic Pain: A Feasibility Study

Introduction: While laparoscopic surgery is the only way to definitely diagnosis pathology contributing to chronic pelvic pain (CPP), pelvic floor physical therapy (PFPT) is an option for CPP management. There is minimal data on the use of PFPT perioperatively and the benefits it may provide when managing CPP during the immediate postoperative period. This study assessed the feasibility of introducing a telehealth PFPT appointment in the first 3 days following laparoscopic surgery for CPP. Methods: Patients scheduled for laparoscopy for CPP with a fellowship-trained minimally invasive gynecologist who were also actively undergoing PFPT were recruited. Patients completed a Tampa Scale of Kinesiophobia (TSK) survey and a visual analog scale (VAS) for pain preoperatively and on postoperative days 1, 7, and 28. Patients underwent a 30-minute telehealth PFPT appointment within 3 days postoperatively. Results: A total of 11 patients were recruited. Eight patients (63.6%) had a decrease in TSK score from the preoperative period to postoperative day 28. Trends in VAS and TSK scores showed overall improvement throughout the postoperative period. Nine patients (81.8%) attended the immediate postoperative virtual PFPT session. Common symptoms reported by patients postoperatively included gas-related pain, constipation, and incisional pain. Discussion: Telehealth PFPT is feasible in the immediate postoperative period following laparoscopic surgery and is associated with improvement of pain and kinesiophobia in patients with CPP. Although this was a small pilot study, these findings support continued investigation of perioperative PFPT and telehealth visits in order to optimize care for the complex CPP patient.