Medical and social aspects in women of reproductive age with chronic pelvic pain

The objective: a study of the medical and social characteristics of women in reproductive age with chronic pelvic pain on the basis of retrospective analysis.Materials and methods. The analysis of medical documentation of 314 patients in reproductive age with a verified diagnosis of chronic pelvic pain (CPP) was performed on the basis of studying of case histories and outpatient cards. Data were analyzed: anthropometric data, age, body mass index, place of residence, gynecological pathology, duration and nature of the menstrual cycle, comorbidities, previous treatment, disease duration, pain intensity, bad habits, number of pregnancies and births, reproductive plans and other methods examination.Results. It was found that more than a third of women, who were treated for pathologies that cause CPP, need medical help again. 58 % of patients sought help for CPP for the first time, 42 % had already received treatment for CPP. Concomitant non-gynecological pathology is more often observed in such patients (48.7 %).The most commonly diagnosed were interstitial cystitis (42 %) and irritable bowel syndrome (34 %). The combination of gynecological, urological and surgical pathology was found in 22 % of patients. Patients with CPP had deficiency in vitamin D (68 % of the 162 patients tested for vitamin D) and had subjectively more severe pain. At the same time, the lack of routine examination of thyroid function and vitamin D status attracted attention. Simultaneously, women with CPP are much more likely than the general population to have infertility (56.4 %), and the incidence of miscarriage is twice as high as the population, with a tendency to recurrent pregnancy loss.Conclusions. Concomitant non-gynecological pathology, infertility, miscarriage, vitamin D deficiency and subjectively more severe pain are more common in women with chronic pelvic pain. However, the level of diagnosing thyroid pathology and determining the concentration of vitamin D in such patients is insufficient.

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Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126606 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6606

Author(s):

Jolanta Nawrocka-Rutkowska ◽

Iwona Szydłowska ◽

Aleksandra Rył ◽

Sylwester Ciećwież ◽

Magdalena Ptak ◽

...

Keyword(s):

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Pelvic Pain ◽

Predictive Value ◽

Chronic Pelvic Pain ◽

Reproductive Age ◽

Pelvic Surgery ◽

History Of Surgery ◽

Previous Surgery ◽

History Of

Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

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Chronic pelvic pain in patients of reproductive age with endometriosis

Problemy reproduktsii ◽

10.17116/repro20212701146 ◽

2021 ◽

Vol 27 (1) ◽

pp. 46

Author(s):

E.N. Andreeva ◽

E.V. Sheremetyeva

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Reproductive Age

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The prevalence of chronic pelvic pain and irritable bowel syndrome in two university clinics

Journal of Psychosomatic Obstetrics & Gynecology ◽

10.1080/0167482x.1991.11742721 ◽

1991 ◽

Vol 12 (sup1) ◽

pp. 65-75 ◽

Cited By ~ 38

Author(s):

E. A. Walker ◽

W. J. Katon ◽

J. Jemelka ◽

H. Alfrey ◽

M. Bowers ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Irritable Bowel

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Adolescent endometriosis

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20173440 ◽

2017 ◽

Vol 6 (8) ◽

pp. 3213

Author(s):

Meenu P. Nanthakumar ◽

Sendhil C. Arumugam

Keyword(s):

Adverse Effects ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Reproductive Age ◽

Age Group ◽

Women Of Reproductive Age ◽

Surgical Options ◽

Reproductive Age Group

Endometriosis is predominantly a disease of women of reproductive age group. Endometriosis is not uncommon in adolescents. Presentation tends to focus on pain, especially intractable dysmenorrhea and chronic pelvic pain. In around 60% of patients with endometriosis symptoms start in adolscence. Pain unresponsive to treatment is the usual indication for a Laproscopy. The appearance of endometriotic lesions is different from that of adults. Medical and surgical options for treatment are available. Endometriosis may be progressive and adverse effects may go beyond pain and cause infertility.

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Chronic pelvic pain and gynecological symptoms in women with irritable bowel syndrome

Journal of Psychosomatic Obstetrics & Gynecology ◽

10.3109/01674829609025662 ◽

1996 ◽

Vol 17 (1) ◽

pp. 39-46 ◽

Cited By ~ 80

Author(s):

E. A. Walker ◽

A. N. Gelfand ◽

M. D. Gelfand ◽

C. Green ◽

Wj Katon

Keyword(s):

Irritable Bowel Syndrome ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Irritable Bowel

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PD20-04 CHRONIC PROSTATITIS/CHRONIC PELVIC PAIN SYNDROME IS ASSOCIATED WITH IRRITABLE BOWEL SYNDROME: A POPULATION-BASED STUDY

The Journal of Urology ◽

10.1016/j.juro.2016.02.1417 ◽

2016 ◽

Vol 195 (4S) ◽

Author(s):

Shyi-Chun Yii ◽

Chun-Hou Liao ◽

Shiu-dong Chung ◽

Herng-Ching Lin

Keyword(s):

Irritable Bowel Syndrome ◽

Pelvic Pain ◽

Chronic Prostatitis ◽

Chronic Pelvic Pain ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Population Based ◽

Pelvic Pain Syndrome ◽

Population Based Study ◽

Irritable Bowel

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Psychiatric Comorbidity in Women with Chronic Pelvic Pain

CNS Spectrums ◽

10.1017/s1092852912000156 ◽

2011 ◽

Vol 16 (2) ◽

pp. 29-35 ◽

Cited By ~ 11

Author(s):

Samantha Meltzer-Brody ◽

Jane Leserman

Keyword(s):

Chronic Pain ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Psychiatric Comorbidity ◽

Multidisciplinary Treatment ◽

Stressful Events ◽

Reproductive Age ◽

Pain Syndromes ◽

Increased Risk ◽

Chronic Pain Syndromes

AbstractChronic pain syndromes are often treatment refractory and pose an enormous burden of suffering for the individual. Chronic pelvic pain (CPP) is generally defined as noncyclic pain of at least 6 months duration and severe enough to require medical care or cause disability. CPP has been estimated to have a prevalence of 15% among women of reproductive age. Women are at increased risk for both major depression and chronic pain syndromes such as CPP, and are more likely to report antecedent stressful events, have higher rates of physical and sexual abuse, and subsequently develop posttraumatic stress disorder. High rates of sexual and physical abuse and other trauma have been shown among women with CPP, including symptoms of dyspareunia (pain during intercourse), dysmenorrhea (pain during menstruation), and vulvar pain. A detailed and comprehensive evaluation of the patient with CPP should include a thorough gynecologic exam and a full mental health assessment. Treatment of CPP must include an integrated approach targeted at both the psychiatric comorbidity and pain symptoms. A multidisciplinary treatment team offers the best chance for success with CPP, and it is critical to suggest psychiatric treatment (psychopharmacology and/or psychotherapy) in addition to traditional medical and surgical approaches.

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