scholarly journals The role of the multi-disciplinary team and multi-disciplinary therapeutic protocol in the management of the chronic pelvic pain: There is strenght in numbers!

2021 ◽  
Vol 93 (2) ◽  
pp. 211-214
Author(s):  
Antonella Centemero ◽  
Lorenzo Rigatti ◽  
Donatella Giraudo ◽  
Guglielmo Mantica ◽  
Davide De Marchi ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Trigger Points ◽  
Non Invasive ◽  
Patient Global Impression ◽  
Strict Diet ◽  
Voiding Diary ◽  
Group A ◽  
Group B ◽  
Multi Disciplinary Team

Introduction: The aim of the study is to evaluate the effectiveness of a Multi-disciplinary team (MDT) and multi-disciplinary approach in the treatment of Chronic Pelvic Pain (CPP). Methods: The data of all consecutive patients referred for a CPP from 11/2016 to 2/2019 has been prospectively collected. The sample was divided in two groups: Group A, made by patients managed after the institution of our MDT, and Group B, made of patients managed before this date. The MDT is composed by three urogynecologists, a psychologist and a physiotherapist. All Group A patients underwent a weekly bladder instillation with dimethyl sulfoxide (DMSO), kinesiotherapy for trigger points and Percutaneous Tibial Nerve Stimulation for 10 consecutive weeks. Patients were asked to perform a self-treatment following the Stanford Protocol and to adhere to a specific diet. All Group B patients were managed only with DMSO instillations and a strict diet. Results: The Group A was made of 41 females and 6 males while the Group B was made of 38 females and 5 males. The Group A patients showed a statistically significant improvement in the Pelvic Pain Urgency Frequency, in the frequency times reported at the 6 months voiding diary, and a better Patient Global Impression of Improvement. Conclusions: Our data support the efficacy of the MDT in the management of CPP. The multimodal approach might represent an effective and reproducible non-invasive option to manage successfully CPP.

scholarly journals A phase II, randomized, single-blinded, placebo-controlled clinical trial on the efficacy of Curcumina and Calendula suppositories for the treatment of patients with chronic prostatitis/chronic pelvic pain syndrome type III

2017 ◽  
Vol 89 (2) ◽  
pp. 110 ◽  
Author(s):  
Giuseppe Morgia ◽  
Giorgio Ivan Russo ◽  
Daniele Urzì ◽  
Salvatore Privitera ◽  
Tommaso Castelli ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Peak Flow ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Syndrome Type ◽  
Group A ◽  
Group B

Objective: The management of chronic prostatitis/ chronic pelvic pain syndrome type III (CP/CPPS) has been always considered complex due to several biopsychological factors underling the disease. In this clinical study, we aimed to evaluate the efficacy of the treatment with Curcumin and Calendula extract in patients with CP/CPPS III. Material and methods: From June 2015 to January 2016 we enrolled 60 consecutive patients affected by CP/CPPS III in our institution. Patients between 20 and 50 year of age with symptoms of pelvic pain for 3 months or more before study, a total National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) score ≥ 15 point and diagnosed with NIH category III. Patients were then allocated to receive placebo (Group A) or treatment (Group B). Treatment consisted of rectal suppositories of Curcumin extract 350 mg (95%) and Calendula extract 80 mg (1 suppository/die for 1 month). Patients of Group B received 1 suppository/die for 1 month of placebo. The primary endpoint of the study was the reduction of NIH-CPSI. The secondary outcomes were the change of peak flow, IIEF-5, VAS score and of premature ejaculation diagnostic tool (PEDT). Results: A total of 48 patients concluded the study protocol. The median age of the all cohort was 32.0 years, the median NIH-CPSI was 20.5, the median IIEF-5 was 18.5, the median PEDT was 11.0, the median VAS score was 7.5 and the median peak flow was 14.0. After 3 months of therapy in group A we observed a significant improvement of NIH-CPSI (-5.5; p < 0.01), IIEF-5 (+ 3.5; p < 0.01), PEDT (-6.5; p < 0.01), peak flow (+2.8; p < 0.01) and VAS (-6.5; p < 0.01) with significant differences over placebo group (all p-value significant). Conclusions: In this phase II clinical trial we showed the clinical efficacy of the treatment with Curcumin and Calendula in patients with CP/CPPS III. The benefits of this treatment could be related to the reduction of inflammatory cytokines and of inflammatory cells. These results should be confirmed in further studies with greater sample size.

scholarly journals Feasibility of Ultrasound-Guided Peritoneal Perfusion with Ozone in the Treatment of Chronic Pelvic Pain: A Bicenter Retrospective Analysis

2021 ◽  
pp. E367-E375
Author(s):  
Jian Xiong An
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Anxiety And Depression ◽  
Injection Pain ◽  
Ultrasound Guided ◽  
Volume Group ◽  
Group A ◽  
Peritoneal Perfusion ◽  
Vas Scores ◽  
Group B

Background: Numerous therapies have been developed for the treatment of chronic pelvic pain (CPP). Oxygen-ozone therapy is a new method for the treatment of CPP. Objectives: This article evaluated the feasibility of ultrasound-guided peritoneal perfusion with ozone in patients with CPP. Study Design: This is a bicenter retrospective study. Setting: The study was conducted at 2 pain centers of a university hospital. Methods: The medical records of patients with CPP (n = 60) from March 2016 until October 2018 were collected and reviewed. Group A contained 19 patients who were treated with a 1500 mcg dose of ozonated water (10 mcg/mL concentration and 150 mL volume), group B contained 23 patients using the same dose of ozonated water but a 15 mcg/mL concentration and 100 mL volume. Group C included 18 patients using a similar ozone dose but delivered in an oxygen-ozone mixture (15 mcg/mL concentration and 100 mL volume oxygen-ozone mixture). Visual Analog Scale (VAS) scores for pain of the 3 groups were compared at pretreatment, posttreatment, 1, 3, and 6 months posttreatment. The injection pain was evaluated using a 4-point verbal rating scale. Quality of life (QoL), anxiety, and depression were assessed at pretreatment and at 6 months posttreatment. Results: The VAS scores of the 3 groups decreased over time following treatment. Group A showed much higher pain scores compared with groups B and C at 1, 3, and 6 months posttreatment. However, the injection pain for groups B and C was higher than group A, but there was no difference seen between group B and C. At 6 months posttreatment, the QoL for all patients improved compared with pretreatment, whereas the anxiety and depression did not demonstrate differences. Limitations: The main limitations of this study are the retrospective study design, limited case number, and short follow-up period. Conclusions: Ultrasound-guided peritoneal perfusion with ozone is a feasible therapy for patients with CPP. Key words: Chronic pelvic pain, ozone, peritoneal perfusion

Pelvic-floor relaxation techniques using biofeedback – more effective therapy for chronic prostatitis/chronic pelvic pain syndrome

2020 ◽  
Vol 13 (6) ◽  
pp. 454-459
Author(s):  
Manish Pandey ◽  
Vaibhav Shrivastava ◽  
Vijay Patidar ◽  
Sabby Dias ◽  
Sameer Trivedi
Keyword(s):  
Pelvic Floor ◽  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Pelvic Floor Muscle ◽  
Muscle Relaxation ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Pelvic Pain Syndrome ◽  
Group A ◽  
Group B

Objective: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic pain and voiding symptoms, the management of which is challenging. The present study was designed to assess the efficacy of biofeedback and pelvic-floor relaxation treatment for CP/CPPS. Methods: A total of 84 patients diagnosed with CP/CPPS were randomly assigned to one of the two groups: conventional therapy (group A) and pelvic-floor muscle relaxation and biofeedback (group B). The Biofeedback and Electrical Stimulation apparatus was used for pelvic-floor muscle electrical stimulation and relaxation with biofeedback. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were evaluated at the start of therapy, after 3 months of treatment and at 6 months (3 months after last treatment received). Results: At 3 months, patients in both groups had a significant decrease (improvement in symptoms) in NIH-CPSI scoring. However, at 6 months, only 19 (47.5%) patients in group A maintained a fall in NIH-CPSI score >6 compared with 37 (94.8%) patients in group B ( p<0.05). At 6 months, there was significant decrease in NIH-CPSI score in group B, whereas in group A, scores had increased (worsening of symptoms). Conclusions: Pelvic-floor muscle relaxation and biofeedback training is a safe and effective treatment for CP/CPPS with sustained efficacy.

scholarly journals Oral versus intravenous maternal hydration in isolated third trimester oligohydramnios

2020 ◽  
Vol 8 (10) ◽  
pp. 3449
Author(s):  
Humaira Zafar ◽  
Mubashra Naz ◽  
Umber Fatima ◽  
Uzma Shahzad ◽  
Anees Fatima ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
P Value ◽  
Amniotic Fluid Index ◽  
Oral Hydration ◽  
Non Invasive ◽  
Invasive Method ◽  
Intravenous Hydration ◽  
Group A ◽  
Group B ◽  
Hydration Therapy

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria.  Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al.  In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method.

scholarly journals EFFECTIVENESS OF ISCHEMIC COMPRESSION ON TRIGGER POINTS FOR REDUCTION OF PAIN AND SPASM OF TRAPEZIUS MUSCLE

2018 ◽  
Vol 7 (1) ◽  
pp. 21-27
Author(s):  
Mubarra Rao ◽  
Sadia Shafaq
Keyword(s):  
Trigger Point ◽  
Trapezius Muscle ◽  
Trigger Points ◽  
Ultrasound Therapy ◽  
Myofascial Trigger Point ◽  
Myofascial Trigger Points ◽  
Reduction Of Pain ◽  
Group A ◽  
Group B ◽  
Hot Pack

Myofascial trigger point is a hyperirritable nodule present in a palpable taut band of skeletal muscle, often results from muscle injury or repetitive strain that cause pain and tightness. Myofascial trigger points are one of the most common causes of chronic neck pain. This study aims to determine the efficacy of ischemic compression in comparison with myofascial stretching on trigger points of trapezius muscle for reduction of pain and spasm. Randomized Control Trial. The study was conducted in Ziauddin Hospital. 96 participants were enrolled in the study. Participants were divided into two groups equally and randomly, Group (A) an intervention group treated with hot pack, ultrasound therapy and ischemic compression, Group (B) a control group treated with hot pack, ultrasound therapy and myofascial stretching. This regime was followed thrice a week for three weeks. Statistically significant (P < 0.05) changes in the values were found in Group A and Group B for Visual Analog scale and Penn spasm frequency scale post treatment. The results showed that there is significant difference found after both interventions for the treatment of pain and spasm caused by myofascial trigger point. It cannot be said that ischemic compression is more effective than myofascial stretching for the treatment of myofascial trigger points of trapezius muscle.

scholarly journals Outcome of Pushback Stenting and ESWL Versus in Situ ESWL for Upper Ureteric Stone -A Comparative Study

KYAMC Journal ◽  
2017 ◽  
Vol 8 (1) ◽  
pp. 4-9
Author(s):  
Md Mostafizur Rahman ◽  
Maruf Ahmed ◽  
Md Rokonuzzaman Khan ◽  
Md Shamim Hossain ◽  
Khan Nuzrul Islam ◽  
...  
Keyword(s):  
Urinary Calculi ◽  
Urinary Stones ◽  
Ureteric Stone ◽  
Medical College ◽  
Non Invasive ◽  
Quasi Experimental ◽  
Group A ◽  
Urological Disorders ◽  
Group B

Background: Urolithiasis is one of the most prevalent urological disorders and the prevalence of urinary stones has increased world wide1. The management of urinary calculi was revolutionized by the introduction of extracorporeal shockwave lithotripsy (ESWL) in 1980 and the first successful ESWL treatment was accomplished in Germany by Dr. Christian Chaussy using a Dornier HM1 lithotripter. ESWL is a safe, effective and non-invasive method2.Purpose: To observe the outcome of pushback stenting and ESWL versus in situ ESWL for upper ureteric stone.Materials and methods: It was a quasi-experimental study. The study was under went in the department of urology, Dhaka Medical College and Hospital, between July'2012 to June'2014. Total 60 patients of single upper ureteric stone who satisfy inclusion and exclusion criteria were enrolled in this study. Selected patients were dived into two groups, group A and group B. Group-A for pushback stenting and ESWL and group-B for in situ ESWL. Results were compared in terms of clearance rates, number of shock waves, sessions, incidence of complications and failure rate.Results: Failure of ESWL was significantly higher in Group B (23.33%) than Group A (10%). These results were statistically significant.Conclusion: Pushback stenting and ESWL is better than in situ ESWL for upper ureteric stone.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 4-9

Painful Myofascial Trigger Points and Pain Sites in Men With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

2009 ◽  
Vol 182 (6) ◽  
pp. 2753-2758 ◽  
Author(s):  
Rodney U. Anderson ◽  
Timothy Sawyer ◽  
David Wise ◽  
Angie Morey ◽  
Brian H. Nathanson
Keyword(s):  
Pelvic Pain ◽  
Chronic Prostatitis ◽  
Chronic Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Trigger Points ◽  
Pelvic Pain Syndrome ◽  
Myofascial Trigger Points

scholarly journals Complementary Approaches for Military Women with Chronic Pelvic Pain: A Randomized Trial

2021 ◽  
Author(s):  
Carol D Crisp ◽  
Robert Baldi ◽  
Matthew Fuller ◽  
Eduardo Abreu ◽  
Andrea G Nackley
Keyword(s):  
Pelvic Pain ◽  
Stress Reduction ◽  
Chronic Pelvic Pain ◽  
Behavioral Treatment ◽  
Pain Perception ◽  
Healthy Lifestyle ◽  
Military Women ◽  
Gm Csf ◽  
Non Invasive ◽  
Cytokine Levels

Abstract Introduction: Active-duty (AD) women suffer with chronic pelvic pain (CPP) while providers tackle diagnoses and treatments to keep them functional without contributing to the opioid epidemic. The purpose of this study was to determine the effectiveness of non-invasive, self-explanatory mindfulness-based stress reduction (MBSR) or self-paced healthy lifestyle (HL) interventions on CPP in AD women.Methods: We conducted a six-week interventional prospective study with AD women aged 21–55 at Mountain Home (MTHM), Idaho. Women were randomly assigned to MBSR (N = 21) or HL (N = 20) interventions. The primary outcome was pain perception. Secondary outcomes were depression and circulating cytokine levels.Results: Women in the MBSR group exhibited reduced pain interference (P < .01) and depression (P < .05) alongside decreased IL-4 (P < .05), IL-6 (P < .05), eotaxin (P < .05), MCP-1 (P = .06), and IL-1ra (P < .01) and increased VEGF (P < .05). Those in the HL group did not have changes in pain, however, did exhibit reduced depression (P < .05) alongside decreased GM-CSF (P < .05) and increased TNFα (P < .05), SDF-1 (P < .01), and IL-1ra (P < .01).Conclusion: AD women receiving MBSR or HL had reduced depression scores and altered circulating cytokine levels, however only those receiving MBSR had reduced pain perception. Findings support MBSR as an effective and viable behavioral treatment for AD women suffering from CPP.

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