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.