Performed manually by a pelvic floor physiotherapist.

One 30-minute session per week for 12 weeks.

Self-administered perineal massage at home.

Three times per week, 10 minutes each session, over a 12-week period.

Self-administered perineal massage at home with Crescendo device.

Three times per week, 10 minutes each session, over a 12-week period.

The **Visual Analogue Scale (VAS)** will be used as the **primary outcome measure**. It consists of a horizontal line approximately 10 centimeters long. At each end of the line are the extreme expressions of pain: on the left, "no pain," and on the right, "worst imaginable pain." This tool allows us to measure the intensity of pain with high reproducibility between observers.

Visual Analogue Scale (VAS):

The Visual Analogue Scale is a psychometric response scale used to measure pain intensity. It typically consists of a 10-centimeter horizontal line anchored by two verbal descriptors: "no pain" (score = 0) and "worst imaginable pain" (score = 10).

Minimum score: 0 (no pain) Maximum score: 10 (worst imaginable pain) Interpretation: Higher scores indicate worse outcomes (i.e., more intense pain).

The Clinical Global Impression Scale (CGI) will be used as the secondary outcome measure.

The Global Impression Scale (GIC) is a subjective tool used to assess the overall perceived change in a patient's health status, particularly in clinical studies involving various conditions and treatments.

Clinical Global Impression - Change (CGI-C) Scale:

The Clinical Global Impression - Change scale is a clinician-rated tool used to assess changes in a patient's condition over time, relative to baseline.

Minimum score: 1 (very much improved) Maximum score: 7 (very much worse) Interpretation: Lower scores indicate better outcomes (i.e., greater clinical improvement), while higher scores indicate worsening.