Physical Therapy After Endometriosis Excision

The Role of a Postoperative Home Physical Therapy Program for the Treatment of Pelvic Pain in Patients Undergoing Endometriosis Excision

This is a randomized controlled pilot study comparing a home pelvic floor physical therapy program to routine post-operative care for patients undergoing endometriosis excisional surgery without hysterectomy. Quality of life and endometriosis symptoms will be compared following the recovery period.

Study Overview

• Status: Recruiting
• Conditions: Endometriosis; Surgery
• Intervention / Treatment: Behavioral: Standard Postoperative Instructions; Behavioral: Active Recovery

Detailed Description

This is a randomized controlled pilot study conducted at a single institution comparing a home pelvic floor physical therapy program to routine post-operative care for patients undergoing endometriosis excisional surgery without hysterectomy. Patients will be recruited from a referral gynecological surgery group specializing in the diagnosis and treatment of pelvic pain and endometriosis. The goal is to assess the role of the active recovery program on quality of life and on pain and endometriosis symptoms.

Subjects will be randomized to routine post-operative care or to a home physical therapy program, in which they will receive written instruct ions and videos of exercises to complete immediately after surgery. The home exercise program was developed by the Department of Urogynecology in conjunction with pelvic floor physical therapists, and includes videos created by the education communications division. Quality of life, pain score, and endometriosis symptoms will be assessed at their pre-operative appointment, and at 6 and 12 weeks postoperatively.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Women's Health Research Unit Department of OB/Gyn; Phone Number: 503-494-3666; Email: whru@ohsu.edu

Study Locations

• United States
  • Oregon
    • Portland, Oregon, United States, 97239
      • Recruiting
      • Oregon Health & Science University
      • Contact: Women's Health Research Unit; Phone Number: 503-494-3666; Email: whru@ohsu.edu
      • Principal Investigator: Jacqueline Wong

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Premenopausal
• English speaking
• Undergoing endometriosis excision surgery without hysterectomy at Legacy Health with subspecialty-trained surgeons specializing in endometriosis care
• History of chronic pelvic pain (defined as >= 6 months of pain in the anatomic pelvis)
• Diagnosis of high tone pelvic floor dysfunction on examiniation
• Have access to reliable email and phone for study-related communication

Exclusion Criteria:

• Non-English speaking
• Unable to consent
• Unable to sustain 30 minutes of moderate activity at baseline
• Uses a mobility assistive device at baseline
• Chronic opioid use
• No histologic diagnosis of endometriosis on surgical pathology
• Need for additional pelvic rest (>2 weeks) postoperatively
• Pregnancy or planning to pursue pregnancy or undergo fertility treatments within 12 weeks postoperatively

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Standard Postoperative Instructions; Participants will receive standard postoperative recovery instructions	Behavioral: Standard Postoperative Instructions; Standard of care postoperative instructions covering incision care, pain control, dietary instructions, and emergency precautions. Also includes guidelines regarding pelvic rest and lifting restrictions.
Experimental: Active Recovery; Participants will receive postoperative instructions to follow an active recovery protocol focused on increasing activity level, core strength exercises, and pelvic floor exercises focused on urinary and bowel symptoms. Exercises are to be completed twice per day for the 12 weeks following surgery.	Behavioral: Active Recovery; Participants will receive postoperative instructions to follow an active recovery protocol focused on increasing activity level, core strength exercises, and pelvic floor exercises focused on urinary and bowel symptoms. Exercises are to be completed twice per day for the 12 weeks following surgery.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Short Form Survey (SF-36)	The Short Form Survey (SF-36) is a 36-item survey regarding general health and pain and its impact on quality of life including physical activities, work, social activities, and emotional well-being over the last four weeks. Scores range from 0 to 100 with a higher score representing a more favorable health state.	Collected immediately following surgery, 6 weeks following surgery, and 12 weeks following surgery
Pelvic Floor Impact Questionnaire (PFIQ)	The Pelvic Floor Impact Questionnaire (PFIQ) asks about how bladder, bowel, and pelvic symptoms affect the ability to do physical activities as well as their impact on emotional well-being over the last 3 months. Scores range from 0 to 300 with a lower score representing a lesser impact on quality of life.	Collected immediately following surgery and 12 weeks following surgery

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Scores	Pain measured using a Visual Analog Scale (VAS). This scale asks patients to rate their pelvic pain and dyspareunia over the last 4 weeks. Responses are on a scale from 0 to 10, with 10 being the worst pain.	Collected at baseline, 6 weeks following surgery, and 12 weeks following surgery.
Endometriosis Health Profile (EHP-5)	The Endometriosis Health Profile (EHP-5) is a 5-item questionnaire asking about the perception of endometriosis symptoms on physical ability, emotional well-being, mood, social isolation, and appearance over the last four weeks. Scores range from 0 to 100 where 0 indicates the best health status.	Collected at baseline, 6 weeks following surgery, and 12 weeks following surgery.

Collaborators and Investigators

• Sponsor: Oregon Health and Science University
• Investigators: Principal Investigator: Jacqueline Wong, Oregon Health and Science University

Study record dates

Study Major Dates

• Study Start (Actual): August 28, 2025
• Primary Completion (Estimated): March 1, 2026
• Study Completion (Estimated): March 1, 2026

Study Registration Dates

• First Submitted: August 11, 2025
• First Submitted That Met QC Criteria: August 11, 2025
• First Posted (Actual): August 17, 2025

Study Record Updates

• Last Update Posted (Estimated): October 6, 2025
• Last Update Submitted That Met QC Criteria: September 30, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Active Recovery
• Additional Relevant MeSH Terms: Urogenital Diseases; Genital Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Genital Diseases, Female; Endometriosis
• Other Study ID Numbers: STUDY00028168

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No