scholarly journals Clinical picture and diagnosis of genital endometriosis

2016 ◽  
Vol 65 (5) ◽  
pp. 4-21 ◽  
Author(s):  
Maria I Yarmolinskaya ◽  
Elena I Rusina ◽  
Armine R Khachaturyan ◽  
Margarita S Florova
Keyword(s):  
Quality Of Life ◽  
Mental Disorders ◽  
Pelvic Pain ◽  
Clinical Picture ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Working Capacity ◽  
Costs Of Treatment ◽  
Gynecological Disease

Endometriosis is a widespread gynecological disease which affects every tenth woman of reproductive age. The main symptoms of disease are chronic pelvic pain, sterility and miscarriage, that leads to a reliable decline in quality of life and working capacity, mental disorders. Timely and complete diagnostics of endometriosis allows choosing the best option of treatment and minimizes the costs of treatment. This article describes in detail the existing methods of diagnosis of endometriosis. Modern literature and the results of own studies are summarized in the text.

scholarly journals Chronic Pelvic Pain and Associated Clinical Characteristics among Women in a Tertiary Care Center in Indonesia

2017 ◽  
pp. 154
Author(s):  
Kanadi Sumapradja ◽  
Thomas Chayadi
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Clinical Characteristics ◽  
Chronic Pelvic Pain ◽  
Reproductive Age ◽  
Domain Score ◽  
Health Clinic ◽  
Common Diagnosis ◽  
Hs Crp

Objective: To determine the prevalence and various aspects associated with female chronic pelvic pain. Methods: During the period of January to March 2016, a crosssectional study was conducted at the Women’s Health Clinic of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Subjects were female who complained of pelvic pain for more than 6 months. We performed history taking, physical examination, and laboratory investigations including hs-CRP serum examination. We calculate the prevalence and describe the clinical characteristics and diagnosis of the patient. Quality of life and levels of hs-CRP were compared between the group of mild and severe pain. Results: In this study, the prevalence of CPP was 9.78%. We found 96.9% of gynecological disorders, 1% of urological disorders, and 2.1% of musculo-skeletal disorders. The most common diagnosis is endometriosis. The Clinical characteristics of patients were found 62.9% suffer for 6 months - 1 year with the intensity of pain (VAS) 7-10 as much as 51.5%. Levels of hs-CRP serum was around 1.99 (0.00 - 404, 53). We found a decreased in the quality of life of the patient. The physical domain score was 56 (38-81); the psychology domain score was 56 (31-100); the domain of social relationships was 59 (25-75); and the environmental domain score was 56 (31-94). Conclusion: Endometriosis is the most common diagnosis in female chronic pelvic pain of reproductive age. The pain causes a decreased in quality of life who suffer from it. [Indones J Obstet Gynecol 2017; 5-3: 154-159] Keywords: chronic pelvic pain, hs- CRP, intensity of pain, quality of life

Endometriosis-related chronic pelvic pain: A mini review on pathophysiology and impact on mental health

2020 ◽  
Vol 12 (1) ◽  
pp. 35-40
Author(s):  
Thomas Vrekoussis ◽  
Vassiliki Siafaka ◽  
Alexandra Tsitou ◽  
Orestis Tsonis ◽  
Iordanis Navrozoglou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Central Nervous System ◽  
Nervous System ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Pain Perception ◽  
Reproductive Age ◽  
Current Evidence

Endometriosis-related chronic pelvic pain is a major component of the disease that affects quality of life in women of reproductive age suffering from endometriosis. The present review summarizes current evidence upon pathophysiology and its impact on mental health. It seems that endometriosis-related chronic pelvic pain is the result of chronic stress on the central nervous system as a consequence of chronic pelvic inflammation. Mental health issues may rise as a result of central nervous system derangement and further aggravate pain perception and therefore quality of life. Further properly designed studies are needed in order to elucidate the connection between mental disorders and endometriosis-related chronic pelvic pain.

scholarly journals Features of the vegetative status and quality of life in patients with external genital endometriosis and chronic pelvic pain syndrome

2019 ◽  
Vol 68 (4) ◽  
pp. 5-12
Author(s):  
Darya E. Kuznetsova ◽  
Semyon V. Prokopenko ◽  
Tatyana A. Makarenko
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Short Form ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Vegetative Status

Hypothesis/aims of study. Chronic pelvic pain syndrome (CPPS) in patients with external genital endometriosis (EGE) has a mixed pathogenetic mechanism of formation, including nociceptive and neuropathic components. However, there is still no clear correlation between the severity of pain and the degree of EGE. Of particular importance in pain chronization is the imbalanced autonomic nervous system (ANS) forming complex psychosomatic status, which patients experience as stress. This condition reduces the quality of life and causes social disadaptation, which exacerbates the pathological picture of the disease and diminishes the effect of pathogenetic treatment of EGE. We aimed to investigate the features of the vegetative status and assess the quality of life in patients with EGE complicated by CPPS and with a painless course of the disease. Study design, materials, and methods. The study included 135 patients of reproductive age with grade III/IV EGE (r-AFS classification): 105 of them with CPPS and 30 without this syndrome. All these individuals underwent special ANS function testing and were assessed for the quality of life according to the Medical Outcomes Study Questionnaire Short Form 36 Health Survey (SF-36). Results. The features of the vegetative status in patients with EGE complicated by CPPS were identified, such as the predominance of the sympathicotonic type of vegetative reactivity, high scores of vegetative dysfunction syndrome (in groups of patients with CPPS in almost 100% of cases), as well as high levels of reactive and personal anxiety (p < 0.05). In addition, women with EGE and CPPS have significantly reduced quality of life compared to patients with EGE and without CPPS. Conclusion. The presence of suprasegmental and segmental ANS disorders in women with EGE and CPPS partly explains the mechanisms of pain syndrome chronization. The identified features are likely to be the cause of ineffective relief of pain syndrome in the EGE pathogenetic treatment algorithms. The reduced quality of life of such patients dictates the need to develop an effective treatment regimen for EGE and CPPS. This therapy should include drugs of central action that stop the neuropathic component of the pain syndrome, which is based on the imbalance of ANS parameters.

87: Biopsychosocial Factors in Quality of Life in men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome

2007 ◽  
Vol 177 (4S) ◽  
pp. 31-31
Author(s):  
J. Curtis Nickel ◽  
Dean Tripp ◽  
Shannon Chuai ◽  
Mark S. Litwin ◽  
Mary McNaughton-Collins
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome

Histamine metabolism disorder in pathogenesis of chronic pelvic pain in patients with external genital endometriosis

2017 ◽  
pp. 56-60
Author(s):  
М.Р. Оразов ◽  
В.Е. Радзинский ◽  
М.Б. Хамошина ◽  
Е.Н. Носенко ◽  
Э.С. Токаева ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Peripheral Blood ◽  
Chronic Pelvic Pain ◽  
Pain Syndrome ◽  
Histamine Level ◽  
Life Assessment ◽  
Assay Method ◽  
Histamine Metabolism

Цель исследования - изучение особенностей обмена гистамина при хронической тазовой боли у пациенток с наружным генитальным эндометриозом. Методика. В сыворотке крови 100 пациенток методом высокоточного (в нг/мл) иммуноферментного твердофазного анализа определяли концентрацию гистамина. Использованы реактивы «Histamine ЕLISA», аппарат BAE-1000 Гистамин (Labor Diagnostika Nord - LDN, Германия). Оценка выраженности болевого синдрома осуществлялась по шкале ВАШ, оценка качества жизни - на основании опросника для оценки качества жизни при эндометриозе (EHR-30), оценка тревожности - опросника Спилбергера-Ханина. Результаты. Показано статистически значимое повышение уровня гистамина у пациенток с высокой интенсивностью болевого синдрома. Женщины с наружным генитальным эндометриозом, сопровождающимся интенсивным болевым синдромом в 100% случаев обнаруживали высокие уровни ситуативной и личностной тревожности, тогда как, лишь у 40% женщин (n = 16) контрольной группы выявлен умеренный уровень тревожности. Депрессивные расстройства выявлены у 58,3% женщин с хронической тазовой болью (n = 35), из них основную часть (n = 20) составили женщины с выраженной степенью болевого синдрома по ВАШ. Заключение. Психоэмоциональное состояние женщин с тазовой болью, ассоциированной с наружным генитальным эндометриозом, характеризуется высокими уровнями депрессивных и тревожных расстройств, значительным снижением уровня качества жизни. Выявлена прямая связь между интенсивностью болевого синдрома и уровнем гистамина в периферической крови пациенток с наружным генитальным эндометриозом. Objective. To study features of histamine metabolism in patients with chronic pelvic pain associated with external genital endometriosis. Methods. For quantitative assessment of histamine level in peripheral blood was taken from 100 patients which than was centrifuged. In blood serum histamine concentration was determined by enzyme-linked immunosorbent assay method with reagents «Histamine ЕLISA» on the machine BAE-1000 Histamine (Labor Diagnostika Nord - LDN, Hermany). A pain syndrome was assessed by Visual Analog Scale (VAS), quality of life assessment - by Endometriosis Health Profile Questionnaire (EHR-30), level of anxiety was determined by Spielberger-Khanin questionnaire. The results. Showed statistically higher histamine level in patients with severe pain according to VAS. After assessment of results obtained from Spielberger-Khanin questionnaire 100% experimental group’s women with external genital endometriosis (n = 60) were noted to be have high level of state and trait anxiety, then 40% women of control group (n = 16) have moderate level of anxiety. The incidence of depression in women with chronic pelvic pain was 58.3% (n = 35) and the main part (n = 20) were women with severe stage of pelvic pain according to VAS. Conclusions. Psycho emotional condition of women with external genital endometriosis associated pelvic pain characterized by higher depression and anxiety levels, with significant decrease quality of life. Direct relationship also was found between pain syndrome intensity and histamine level in peripheral blood in patients with external genital endometriosis.

O-168 Chronic pelvic pain is the most troublesome endometriosis pain symptom for women’s quality of life

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P Pijpops ◽  
S Apers ◽  
C Meuleman ◽  
C Tomassetti ◽  
E Dancet
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Pelvic Pain ◽  
General Health ◽  
Chronic Pelvic Pain ◽  
Pain Symptom ◽  
General Health Status ◽  
Pain Symptoms ◽  
Specific Health

Abstract Study question Which pre-operative endometriosis pain symptom is most troublesome for the quality-of-life of women assessed at different meta-levels? Summary answer Of five pain symptoms chronic pelvic pain is most troublesome or has the strongest correlation to women’s overall quality-of-life and overall and endometriosis-specific health status. What is known already Endometriosis affects women’s quality of life negatively, and its impact seems to depend more on women’s symptoms than on their degree of endometriosis. Experts proposed to include ‘the most troublesome symptom’ and ‘overall pain’ as core outcomes but did not define how to assess these outcomes. It would be interesting to find out which pain symptom (i.e. assessed for presence and intensity) has most impact on women’s quality-of-life assessed at different meta-levels, including: overall quality-of-life (depending on amongst others one’s professional and relational life besides health), general health status and endometriosis-specific health status. Study design, size, duration A prospective survey addressed 277 adult women scheduled for diagnostic and/or therapeutic surgery in a University endometriosis clinic between October 2016 and November 2019. Women were reminded twice of our request to fill out the coded but anonymous questionnaire package assessing five pain symptoms (i.e. chronic pelvic pain, dysmenorrhea, dyspareunia, dysuria and dyschezia) and assessing quality-of-life at three different meta-levels. Participants/materials, setting, methods Women scored five endometriosis symptoms between 0 (no pain) and 10 (worst imaginable pain), combined into ‘overall pain’ (0-50). ‘Overall quality-of-life’ was assessed with the Linear Analogue Scale (LAS; the higher, the better). General and endometriosis-specific health status were assessed with the overall scores of the EuroQol-5D and the Endometriosis-Health-Profile-30 (the higher, the better). Pearson correlation coefficients between the six pain scores and three measures of quality-of-life were computed (p = 0.003; 0.05/18 as Bonferroni correction). Main results and the role of chance A total of 227 women took part (participation rate=82%) and the data of 202 women (mean age 31±5 years old) with surgically confirmed endometriosis were analysed. In the previous six months, the majority of women reported chronic pelvic pain (56%), dyspareunia (55%), dysmenorrhea (56%) and/or dyschezia (58.4%), while only some reported dysuria (25%). Women’s mean overall pain score was 20 (±12). Women’s mean overall quality-of-life was 65 (±16). On average women rated their general health status to be 62 (±18) and their mean endometriosis-specific health status was 53 (±18). Only the pain symptom chronic pelvic pain was correlated (p &lt; 0.001) to assessments of quality-of-Life at all three meta-levels. The correlation for endometriosis-specific health status was large (r= -0.574), while the others were medium (r= -0.343 & r= -0.324). After taking account of the Bonferroni correction for multiple testing the remaining four pain symptoms only had a medium correlation (p &lt; 0.001) to endometriosis-specific health status (r= -0.356 – -0.265; p &lt; 0.001) and they were not correlated to overall quality-of-Life or general health status. Overall pain had a medium correlation (p &lt; 0.001) to Overall quality-of-Life (r= -0.270) and general health status (r= -0.259) and a strong correlation (p &lt; 0.001) to endometriosis-specific health status (r= -0.529). Limitations, reasons for caution The majority of patients (60%) of the recruiting University endometriosis clinic had severe endometriosis (AFS-IV) and this study could be repeated in another setting. Directly asking women which pain symptom is most troublesome to them would be interesting besides exploring correlations between pain symptoms and quality of life. Wider implications of the findings Nurses, midwives and other health care professionals should devote attention to chronic pelvic pain during the anamnesis and women-centred care as this pain symptom is most troublesome for women’s quality of life. Whether surgery decreases chronic pelvic pain and overall pain is currently followed-up in the studied prospective cohort. Trial registration number Not applicable

scholarly journals Once-daily 5 mg tadalafil oral treatment for patients with chronic prostatitis/chronic pelvic pain syndrome

2018 ◽  
Vol 10 (12) ◽  
pp. 377-381 ◽  
Author(s):  
Andrea Benelli ◽  
Simone Mariani ◽  
Virginia Varca ◽  
Andrea Gregori ◽  
Franco Barrese ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Once Daily ◽  
International Prostatic Symptom Score

Background: Chronic prostatitis/chronic pelvic pain syndrome (IIIB CP/CPPS) is a condition of unclear aetiology. Many approaches have been used without satisfactory results. The aim of this study is to evaluate the efficacy of once-daily 5 mg tadalafil in pain control and improving quality of life in patients affected by CP/CPPS. Methods: Twenty patients affected by chronic prostatitis according EAU (European Association of Urology) guidelines were evaluated for once-daily 5 mg tadalafil; 14 patients were eligible for the study. The validated Italian version of the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and the International Prostatic Symptom Score (IPSS) questionnaires were submitted to all the patients. Every patient underwent uroflowmetry and ultrasound prostatic volume at the beginning and at the end of the study. Results: All 14 patients eligible for the study reported an improvement of symptoms during therapy: statistically significant differences were reported in terms of NIH-CPSI ( p < 0.000002) and IPSS ( p < 0.0001) during follow-up evaluations. No statistically significant improvement of uroflowmetry parameters was reported during the treatment. Conclusions: In our study the daily use of 5 mg tadalafil improves symptoms and quality of life in patients affected by CP/CPPS after 4 weeks of therapy. A larger population of patients is needed to confirm the efficacy of this therapy in CP/CPPS.

scholarly journals MODERN METHODS OF COMPLEX CORRECTION OF PSYCHOSOMATIC DISORDERS IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS

2020 ◽  
Vol 73 (12) ◽  
pp. 2623-2626
Author(s):  
Nikolay A. Shcherbina ◽  
Liliya V Potapova ◽  
Irina N. Shcherbina ◽  
Oksana P. Lipko ◽  
Olga V. Mertsalova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Pain ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Quality Analysis ◽  
Psychological State ◽  
Pelvic Pain Syndrome ◽  
Psychosomatic Disorders ◽  
Pain Mechanisms

The aim: About 10% of socially active women of reproductive age suffer from endometriosis, is determined by the frequent occurrence of menstrual and reproductive functions disorders, and pelvic pain syndrome in patients. The difficulties of therapeutic treatment of chronic pain syndrome in external genital endometriosis (EGE) are associated with polymorphism of pain mechanisms, and delayed diagnosis and treatment. The aim of the study is to improve the effectiveness of the treatment of external genital endometriosis. Material and methods: We examined 60 female patients of reproductive age, 40 – with histologically verified diagnosis of external genital endometriosis and 20 healthy women. We used the following methods of examination: general clinical, instrumental, endoscopic, morphological, the Visual Analogue Scale (VAS) to quantify pain, the Beck Depression Scale and the SF-36 questionnaire. Results: Before the treatment of patients with EGE, VAS scale scores indicated pain in 100% of patients, the indicators of depression and level of anxiety go beyond the normative. The results of the pre-treatment questionnaire indicated lower quality of life scores on the scales of physical and mental health components. As a result of treatment there was significant decrease in the manifestations of pain, depression and anxiety, with women receiving complex therapy (hormone therapy got antidepressants and non-drug correction methods). Сonclusions: Chronic pelvic pain syndrome associated with EGE and accompanied by an unfavorable psychological state, depressive states, anxiety symptoms, and psychosomatic disorders. New approaches to the treatment of clinical manifestations of EGE are needed, taking into account patients’ psycho-emotional status and the life quality analysis. We pathogenetically justified the use of drugs that affect the psychosomatic status of patients with EGE and showed that they could significantly improve the quality of life.

scholarly journals CHC for pelvic pain in women with endometriosis: ineffectiveness or discontinuation due to side-effects

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Paul J Yong ◽  
Najla Alsowayan ◽  
Heather Noga ◽  
Christina Williams ◽  
Catherine Allaire ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Pelvic Floor ◽  
Pelvic Pain ◽  
Health Research ◽  
Reproductive Age ◽  
Surgical Data ◽  
History Of ◽  
Pelvic Floor Myalgia

Abstract STUDY QUESTION What are the use patterns and factors associated with combined hormonal contraception (CHC) ineffectiveness or discontinuation due to side-effects in patients with endometriosis and pelvic pain? SUMMARY ANSWER Worse chronic pelvic pain (CPP) severity and pelvic floor myalgia were associated with continuous CHC ineffectiveness, while poorer quality-of-life was associated with continuous CHC discontinuation due to side-effects. WHAT IS KNOWN ALREADY CHC is a first line of therapy for endometriosis-associated pelvic pain in women. However, some patients state that CHC is ineffective for their pain, while others have to discontinue CHC due to side-effects. STUDY DESIGN, SIZE, DURATION Analysis of a prospective patient database from a tertiary care referral center for patients with endometriosis and pelvic pain between December 2013 and April 2015 was carried out. PARTICIPANTS/MATERIALS, SETTING AND METHODS A total of 373 patients of reproductive age with endometriosis from the database were included in the study. Data included patient self-reported questionnaires, physical examination findings and validated instruments. There were four variables of interest: history of cyclical CHC ineffectiveness (yes/no), history of cyclical CHC discontinuation due to side-effects (yes/no), history of continuous CHC ineffectiveness (yes/no) and history of continuous CHC discontinuation due to side-effects (yes/no). The primary outcome was CPP severity for the past 3 months (score of 0–10), and secondary outcomes were other pelvic pain scores, quality-of-life on the Endometriosis Health Profile 30 (EHP-30) and underlying conditions including irritable bowel syndrome, painful bladder syndrome, abdominal wall pain, pelvic floor myalgia and depression, anxiety and pain catastrophizing. MAIN RESULTS AND THE ROLE OF CHANCE Among the 373 cases in the dataset, prior cyclical CHC use was reported by 228 (61.1%) women, of which 103 (27.6%) stated it was ineffective for their pain and 94 (25.2%) stated they discontinued CHC due to side-effects. Previous continuous CHC use was reported by 175 (46.9%) women, of which 67 (18.0%) stated it was ineffective and 59 (15.8%) stated they discontinued due to side-effects. Worse CPP severity in the last 3 months was associated with a history of continuous CHC ineffectiveness (P &lt; 0.001). Poorer quality-of-life was present in women who reported a history of continuous CHC discontinuation due to side-effects (P = 0.005). Among the underlying conditions, pelvic floor tenderness (as a marker of pelvic floor myalgia) was associated with CHC ineffectiveness. LIMITATIONS AND REASONS FOR CAUTION This study involved patient recall and no longitudinal follow-up. Also, we do not have data on the type of side-effect that led to discontinuation. Medication ineffectiveness was reported subjectively by the patient rather than using standardized criteria. Finally, the diagnosis of endometriosis was based on previous surgery or a current nodule or endometrioma on examination/ultrasound; without prospective surgical data on all the patients, it was not possible to do a sub-analysis by current surgical features (e.g. stage). WIDER IMPLICATIONS OF THE FINDINGS In women with endometriosis, CHC ineffectiveness was associated with worse CPP and pelvic floor myalgia, which suggests myofascial or nervous system contributors to CPP that does not respond to hormonal suppression. A tender pelvic floor, as a sign of pelvic floor myalgia, may be a clinical marker of patients with endometriosis who are less likely to have an optimal response to hormonal suppression. For women who discontinue CHC due to side-effects, research is needed to help alleviate these side-effects as these patients report worse quality-of-life. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by a Canadian Institutes of Health Research (CIHR) Transitional Open Operating Grant (MOP-142273) as well as BC Women’s Hospital and the Women’s Health Research Institute. PY is also supported by a Health Professional Investigator Award from the Michael Smith Foundation for Health Research. MB/CA has financial affiliations with Abbvie and Allergan; the other authors have no conflicts of interest.

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