Endometriose e fisioterapia: uma análise bibliométrica e narrativa

Abstract

Introduction: Endometriosis is defined by the presence and growth of endometrial tissue, both gland and stroma, external to the uterine cavity. A painful clinical condition that causes compromised quality of life. It is estimated to affect 5 to 10% of women of reproductive age worldwide, 10 to 15% in Brazil. Characteristic symptoms of endometriosis are infertility, dysmenorrhea, dyspareunia of depth, changes in bowel and urinary habits, and chronic pelvic pain. Multiprofessional approach becomes imperative. The physiotherapeutic treatment of endometriosis, part of the work of the physiotherapist in women's health, aims to improve symptoms, especially chronic pelvic pain and search for improved quality of life and sexual health. Objective: To map the indexed scientific production on physiotherapeutic techniques and resources and endometriosis, through bibliometric analysis methodology and theoretical corpus. Materials and Methods: This is a documental study, of the bibliometric review type with a quanti-qualitative approach. The VHL and PEDro databases were used, with the descriptors Endometriosis ("endometriosis" OR "endometrioses") and Physical Therapy ("physical therapy" OR "physical therapy modalities" OR "conservative therapy" OR "physical therapy treatments"); combined with the Boolean operator "AND". In the period from October to November 2021. Inclusion criteria included studies as clinical trials and reviews, published between 2000 and 2020, in Portuguese, English and Spanish, available in full and free of charge. Book chapters, theses, and dissertations were excluded, even if they used clinical trials; studies that exclusively addressed drug or surgical treatments. Results and Discussion: Initially 801 studies were identified, and after filtering according to the inclusion criteria 26 were left; 5 duplicates and 10 studies were excluded after full-text reading; leaving a total of 11 articles selected for data extraction synthesis. The virtual database with the largest number of studies was MEDLINE (90.9%), the most predominant country of affiliation of the authors was the United States with 5 articles (45.5%), followed by Brazil (18.2%), and 100% of the studies are in English; with a predominance of publication in Eur J Obstet Gynecol Reprod Biol (36.4%); and 54.5% of the studies are clinical trials. Acupuncture was the main method in more than four studies as the most mentioned therapy, mostly compared to placebo or conventional treatment; TENS was the only electrotherapy addressed in two articles; only one article used mobilization. All studies aimed to assess pain, and concluded that the proposed therapies are efficient in this outcome; only one study used lubrication and sexual function as an outcome observing improvement; several studies reported good influence in the quality of life of women with endometriosis after treatment. Conclusion: The United States leads in number of publications, Medline is a very important health database. The treatments and physiotherapeutic resources most used were acupuncture and electrotherapy, mainly as complementary therapies, so I conclude that there is no single therapy, all existing ones complement each other, however, the choice should be made based on the individuality of the patient and her main complaint, but more studies are still needed on the subject.