Effectiveness of Multidisciplinary Treatment Compared to Single Discipline Treatment of Female Chronic Pelvic Pain: A Systematic Review and Meta-Analyses.

Abstract

BACKGROUND: Chronic pelvic pain (CPP) is persistent pain perceived to originate in the pelvis, lasting = 3 months. Due to its multifactorial presentation, multidisciplinary treatment may provide optimal care.

OBJECTIVE: Systematic review with meta-analysis of multidisciplinary (= 2 of medical, psychology, physiotherapy, nursing, or dietetics/nutrition disciplines) versus single discipline treatment for females = 13 years with CPP.

SEARCH STRATEGY: Search of six electronic databases, conducted in February 2025.

SELECTION CRITERIA: Randomised or non-randomised controlled trials were included if: participants had CPP = 3 months; they compared multidisciplinary to single discipline treatments; and reported pain, quality of life (QoL), sexual function, anxiety and depression, pelvic floor dysfunction, analgesia use and/or adverse events.

DATA COLLECTION AND ANALYSIS: Data selection, extraction and risk of bias (Cochrane ROBv2 tool) were completed independently by two reviewers. The GRADE approach was used to evaluate certainty of evidence.

MAIN RESULTS: Eight articles were synthesised. Meta-analysis found lower post-treatment pain scores (MD -2.19; 95% CI -3.17, -1.22) and greater improvements in sexual function (MD 2.47; 95% CI 1.06, 3.88) with multidisciplinary treatments, but no difference between groups for QoL (SMD -0.16; 95% CI -0.52, 0.20). Narrative synthesis was inconclusive for differences in outcomes of anxiety and depression. No between-group differences were found for pelvic floor dysfunction, analgesia use or adverse events. GRADE results showed moderate to very low certainty for all outcomes.

CONCLUSIONS: Multidisciplinary care may lead to lower pain intensity scores and greater sexual function than single discipline treatments, however future research may change the results and certainty of these findings.