Chronic Pelvic Pain in an Interdisciplinary Setting: 1-Year Prospective Cohort

Allaire, Catherine; Williams, Christina; Bodmer‐Roy, Sonja; Zhu, Sean; Arion, Kristina; Ambacher, Kristin; Wu, Jessica; Yosef, Ali; Wong, Fabian; Noga, Heather; Britnell, Susannah; Yager, Holly; Albert, Arianne; Lisonkova, Sarka; Yong, Paul J.

doi:10.1097/ogx.0000000000000552

Cited by 27 publications

(32 citation statements)

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“…showed a decrease in those with PPP needing ED visits from 24% to 11% ( P < 0.001) 12 months post their interdisciplinary clinic attendance. This study also found a reduction in general physician visits from 73% to 36% ( P < 0.001) and improvement in self‐reported pain scores, although these are outcomes that were not measured through our study 9 …”

Section: Discussionmentioning

confidence: 46%

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Impact of a Persistent Pelvic Pain Clinic: Emergency attendances following multidisciplinary management of persistent pelvic pain

Wilkinson

Wynn-Williams

Jung

et al. 2021

Aust NZ J Obst Gynaeco

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Persistent pelvic pain (PPP) is an important cause of psychological distress and productivity loss in women. In 2017, a multidisciplinary clinic was established to care for Queensland women with PPP. By analysing clinic and emergency department data, we found 19% fewer patients required any presentation to the emergency department for exacerbations of pelvic pain (P = 0.003) within 12 months of clinic attendance. There was also a reduction in number of presentations, short stay admissions and daily opiate use in regular users. The Persistent Pelvic Pain Clinic (PPPC) made a difference to these women and reduced resource burden on a busy emergency department.

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Section: Discussionmentioning

confidence: 46%

“…Patients are discharged to their general practitioners after six months. A multidisciplinary approach to PPP has been shown to improve self‐reported pain and reduce emergency department (ED) presentations in other centres 8–10 …”

Section: Introductionmentioning

confidence: 99%

Impact of a Persistent Pelvic Pain Clinic: Emergency attendances following multidisciplinary management of persistent pelvic pain

Wilkinson

Wynn-Williams

Jung

et al. 2021

Aust NZ J Obst Gynaeco

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“…Similarly, exercise has been successfully incorporated into multidisciplinary treatment programmes to treat female CPP [4,27]. Available evidence suggests that physical activity/ exercise as an intervention is associated with few adverse events and may improve pain intensity, physical function and consequently quality of life [28].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of clinical practice guidelines (CPG) on the management of female chronic pelvic pain (CPP) using the AGREE II instrument

et al. 2021

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Introduction and hypothesis Variations in guidelines may result in differences in treatments and potentially poorer health-related outcomes. We aimed to systematically review and evaluate the quality of national and international guidelines and create an inventory of CPG recommendations on CPP. Methods We searched EMBASE and MEDLINE databases from inception till August 2020 as well as websites of professional organizations and societies. We selected national and international CPGs reporting on the diagnosis and management of female CPP. We included six CPGs. Five researchers independently assessed the quality of included guidelines using the AGREE II tool and extracted recommendations. Results Two hundred thirty-two recommendations were recorded and grouped into six categories: diagnosis, medical treatment, surgical management, behavioural interventions, complementary/alternative therapies and education/research. Thirty-nine (17.11%) recommendations were comparable including: a comprehensive pain history, a multi-disciplinary approach, attributing muscular dysfunction as a cause of CPP and an assessment of quality of life. Two guidelines acknowledged sexual dysfunction associated with CPP and recommended treatment with pelvic floor exercises and behavioural interventions. All guidelines recommended surgical management; however, there was no consensus regarding adhesiolysis, bilateral salpingo-oophorectomy during hysterectomy, neurectomy and laparoscopic uterosacral nerve ablation. Half of recommendations (106, 46.49%) were unreferenced or made in absence of good-quality evidence or supported by expert opinion. Based on the AGREE II assessment, two guidelines were graded as high quality and recommended without modifications (EAU and RCOG). Guidelines performed poorly in the “Applicability”, “Editorial Independence” and “Stakeholder Involvement” domains. Conclusion Majority of guidelines were of moderate quality with significant variation in recommendations and quality of guideline development.

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“…The effectiveness of the MDTs in the management of CPP has been evaluated and confirmed by the very few available reports (22)(23)(24)(25)(26). Gupta et al (22) reported the experience of the Beaumont Health System, with the creation of a Multi-disciplinary Women's Urology Center, including not only urologists but also gynecologists, experts in pelvic floor physical therapies, colorectal surgeons, integrative medicine practitioners who provide alternative therapies such as acupuncture, and pain psychologists.…”

Section: Discussionmentioning

confidence: 89%

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!

Centemero

Rigatti

Giraudo

et al. 2021

Arch Ital Urol Androl

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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.

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Chronic Pelvic Pain in an Interdisciplinary Setting: 1-Year Prospective Cohort

Abstract: (Abstracted from Am J Obstet Gynecol 2018;218:114.e1–114.e12) Chronic pelvic pain (CPP) is a common clinical problem among women. Its etiology is complex and involves an interplay of gynecologic, urologic, gastrointestinal, musculoskeletal, and psychosocial comorbidities.

Cited by 27 publications

References 0 publications

Impact of a Persistent Pelvic Pain Clinic: Emergency attendances following multidisciplinary management of persistent pelvic pain

Impact of a Persistent Pelvic Pain Clinic: Emergency attendances following multidisciplinary management of persistent pelvic pain

Evaluation of clinical practice guidelines (CPG) on the management of female chronic pelvic pain (CPP) using the AGREE II instrument

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!

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