Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation

Passavanti, Maria Beatrice; Pota, Vincenzo; Sansone, Pasquale; Aurilio, Caterina; Nardis, Lorenzo De; Pace, Maria Caterina

doi:10.1155/2017/9472925

Cited by 35 publications

(27 citation statements)

References 151 publications

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“…Therefore, one of the motivations was to conduct research on the female urethra. In any case, the problems of correct and quick diagnosis and the appointment of effective treatment for UPS in men there remain the same [5]. An idea to diagnose male UPS by using ultrasound and CP OCT devices seems to be reasonable and appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…The European Association of Urology defines UPS as the occurrence of chronic or recurrent episodic pain lasting for more than 6 months, and felt in the urethra, in the absence of proven infection or other obvious local pathology. It is often associated with negative cognitive, behavioral, sexual or emotional consequences [ 4 ], as well as with symptoms suggestive of lower urinary tract, sexual, intestinal, or gynecological dysfunction [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

et al. 2020

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Introduction: Urethral pain syndrome (UPS) is still a pathology in which the diagnosis is formulated as a “diagnosis of exclusion”. The exact pathogenetic mechanisms are not yet fully understood and clear recommendations for the prevention and treatment of UPS are absent. Methods and Participants: A clinical and laboratory evaluation of 55 patients with established UPS included history taking, basic laboratory tests (e.g., complete blood count and clinical urine test), physical examination, uroflowmetry, and cystourethroscopy. Additionally, transvaginal ultrasound (TVUS) with compression elastography and cross-polarization optical tomography (CP OCT) were performed in 24 and 33 patients with UPS, respectively. The control group consisted of 14 patients with no complaints from the urinary system. Results: TVUS showed an expansion in the diameter of the internal lumen of the urethra, especially in the proximal region compared with the norm. Compression elastography revealed areas with increased stiffness (presence of fibrosis) in urethral and surrounding tissues. The performed CP OCT study showed that in UPS, the structure of the tissues in most cases was changed: trophic alterations in the epithelium (hypertrophy or atrophy) and fibrosis of underlying connective tissue were observed. The proximal fragment of the urethra with UPS underwent changes identical to those of the bladder neck. Conclusion: This paper showed that the introduction of new technology—CP OCT—in conjunction with TVUS will allow verification of structural changes in tissues of the lower urinary tract at the level of their architectonics and will help doctors understand better the basics of the UPS pathogenesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

et al. 2020

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“…The CPP affects women more often than men due to the genetic, hormonal, sociocultural and other factors. Most CPP cases are accompanied by psychosocial adaptation disorders, worsening of mood, reduction of sexual activity and general life quality, cognitive-neurological disorders included [4].…”

Section: практична медицина / Practical Medicinementioning

confidence: 99%

Особенности Верификации Хронических Тазовых Болей В Клинической Ортопедической Практике

Orlyk¹

2021

PJS

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Chronic pelvic pain is a complex of pathological and biomechanical changes in the human body that requires a multidisciplinary approach to diagnosis and treatment, due to the high prevalence, underestimation and multifactorial development of this pathological condition. The article provides the overview information and a brief algorithm for chronic pelvic pain verification in men and women for clinical use in medical practice taking into account a comprehensive multidisciplinary approach by physicians of various specialties, including an orthopedist. Diagnostic features and key criteria for specific and nonspecific pelvic pain, pathophysiological mechanisms of chronic pain involving the central, peripheral and autonomic nervous systems, their relationship with the psychoemotional disturbances are described. The special attention is paid to musculoskeletal pathology as a possible reason for pain and pelvic dysfunction, as well as its secondary changes against the background of gynecological, urological and proctological diseases. The participation of an orthopedist in the process of differentiation of both specific and non-specific pelvic pain is justified. The features of pelvic pain verification are based on international multidisciplinary protocols for its management indicating the pain syndromes according to II Classification of IASP Pain and possible classification diagnoses and codes, respectively, ICD-10.

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“…Pelvic floor therapy and acupuncture may also help CSP patients in reducing pain levels. 45,46 If conservatives treatment fails to provide the CSP patients with satisfactory pain relief, if they have recurrent pain, or if the patients do not want to keep taking medications, or if physical therapy sessions, or if the patients simply would like to try more permanent solutions, then surgical interventions may be pursued.…”

Section: Conservative or Non-surgical Treatment Optionsmentioning

confidence: 99%

<p>Management of Chronic Orchialgia: Challenges and Solutions – The Current Standard of Care</p>

Parekattıl¹,

Ergun²,

Güdeloğlu³

2020

RRU

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Introduction Chronic scrotal content pain (CSP) or chronic orchialgia can be debilitating for patients and difficult to treat. There is a paucity of structured treatment algorithms to approach this difficult condition. Methods A review of the literature was performed. Conservative treatment options are presented and then targeted surgical interventions that the urologist may perform are then presented in a structured algorithm format. Many of these patients may obtain a significant reduction in pain with some of these treatments. Results This review presents the pathophysiology, a new assessment tool, and various treatment options available for CSP patients, such as targeted spermatic cord blocks, targeted and standard microsurgical denervation of the spermatic cord (77–100% success rates), ultrasound-guided peri-spermatic cord and ilioinguinal cryoablation (59–75% success rates), scrotox (botox) (56–72% success rates), targeted ilioinguinal and iliohypogastric peripheral nerve stimulation (72% success rate), radical orchiectomy (20–75% success rate), targeted robotic-assisted intra-abdominal denervation (71% success rate) and vasectomy reversal (69–100% success rates). Conclusion A structured and evidence-based approach to help urologists manage patients with chronic orchialgia or scrotal content pain is presented.

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Chronic Pelvic Pain: Assessment, Evaluation, and Objectivation

Cited by 35 publications

References 151 publications

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

New Approaches in the Study of the Pathogenesis of Urethral Pain Syndrome

Особенности Верификации Хронических Тазовых Болей В Клинической Ортопедической Практике

<p>Management of Chronic Orchialgia: Challenges and Solutions – The Current Standard of Care</p>

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