PRACTICAL ASPECTS OF MANAGEMENT OF PATIENT WITH CHRONIC PELVIC PAIN
Notice bibliographique
Résumé
The problem of optimizing the management of women with chronic pelvic pain syndrome (CPP) is actual due to the high frequency of this pathology, unclear many aspects of the pathogenesis, negative impact on quality of life, as well as difficulties in diagnosing the leading factor and effective treatment. Aim. Optimization of the diagnostic algorithm of managing women with chronic pelvic pain (CPP) and pelvic congestion syndrome (PCS). Materials and methods. A prospective study was carried out at Ivano-Frankivsk City Clinical Perinatal Center, Ukraine. 112 patients with CPP and 53 women without pain and symptoms of gynecological pathology as a control group have been included. Exclusion criteria are as follows: pelvic tumors, genital endometriosis, acute inflammatory diseases of the pelvic organs and specific inflammatory diseases of the pelvic organs. Clinical and laboratory examination, ultrasound and Doppler ultrasound of the main pelvic veins: uterine, ovarian, internal iliac and arcuate veins, Valsalva᾽s test have been performed, which helps to detect venous diameter and reflux, for all patients. Short Pain Assessment Scale, the McGill Pain Questionnaire (SF-MPQ), and the Visual Analog Scale (VAS) were used for pain assessment. The tests were conducted in the form of interviews and questionnaires. The results were statistically analyzed using Statistica 7.0 program pack (StatSoft Inc., USA) and Microsoft Excel statistical analysis package. The differences between the selections were considered statistically reliable at p<0.05 (Tukey’s test). Results. Pain duration, examination and treatment of chronic pelvic inflammatory disease were in average 3.8±2.4 years at the time of the first visit. The study has proved that the risk factors for CPP and PCS are high parity (3 or more deliveries), prolonged work in prolong standing or sitting position, interrupted intercourse. 69.6 % of women noted a deterioration in general activity, 43.8 % impaired gait, 79.5 % had difficulties in performing daily work and professional activities, 71.4 % of patients had increased pain in the second phase of the menstrual cycle, and in 83.9 % after prolonged standing. Half of women have sleep disorders, 80.4 % – emotional lability, a third group have periods of depression, and 71.4 % – a negative impact on sexual life according to the results of a Short Pain Assessment Scale. Based on SF-MPQ, it was found that the sensory characteristics of pain were different. 69 (61.6 %) women had convulsive, aching and moderate pain, 16.1 % – severe and burning pain, 8.9% of patients suffered on prickly pain. Evaluation of the emotional scale showed that PCS caused exhaustion in more than half of women, nausea in a third of cases, while 5 (4.5 %) patients reported severe pain that led to despair. Pain intensity due to VAS was 4.44±1.15. Ultrasound revealed an increased diameters of the main pelvic venous collectors, decreased peak systolic bleeding rate in women with CPP and PCS compared with the results of women of the control group (p<0,05). Valsalva᾽s test showed that the presence of reno-ovarian reflux was found in 15.2 % patients of the main group, including bilateral in 23.53 %, isolated left – in 64.7 %. Conclusions. Women with CPP, especially in the presence of risk factors and the specific clinical picture of pelvic congestion should undergo ultrasound and Doppler ultrasound examination of the uterine, ovarian, internal iliac and arcuate veins. Pain assessment scales have the prognostic value of routine pain assessment to analyze the treatment results.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».