Opioids and Alternatives in Female Chronic Pelvic Pain

Valentine, Lindsey N.; Deimling, T.

doi:10.1055/s-0038-1676102

Cited by 9 publications

(23 citation statements)

References 58 publications

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“…8 In addition, evidence suggests more benefits with non-pharmacological treatment and with non-opioid pharmacological treatment when compared to the chronic use of opioids, including fewer side effects. 144 …”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Current Challenges in the Management of Chronic Pelvic Pain in Women: From Bench to Bedside

Siqueira-Campos¹,

Deus²,

Neto³

et al. 2022

IJWH

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Chronic pelvic pain (CPP) affects a significant proportion of women worldwide And has a negative impact on several aspects of these women’s lives including mental health, work, relationships and sexual function, among others. This set of factors ultimately reflects negatively on quality Of life. The physiopathology of CPP is complex and remains to be fully clarified; however, recent advances have increased understanding of the mechanisms involved in chronic pain in general, and more specifically, CPP. Nonetheless, even when a detailed clinical history is obtained, meticulous physical examination is performed and imaging resources are appropriately used, the organic cause of the pain may still fail to be identified in a substantial number of women with CPP. Management of CPP may therefore be challenging. This narrative review was aimed at adding to the available literature on the subject, presenting and discussing the principal characteristics of CPP in women. The paper highlights gaps in the literature while providing the most up-to-date evidence associated with the physiopathology and classification of pain, its diagnosis and treatment. In addition, current challenges in the management of women with CPP are discussed.

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Section: Pharmacological Treatmentmentioning

confidence: 99%

Current Challenges in the Management of Chronic Pelvic Pain in Women: From Bench to Bedside

Siqueira-Campos¹,

Deus²,

Neto³

et al. 2022

IJWH

View full text Add to dashboard Cite

show abstract

“…[21] Considering the limited therapeutic effect of PFPT, patients with CPP should be advised in the initial treatment to be aware of the potential etiology, illness duration, possible delayed discomfort effect and time commitment. [7]…”

Section: Pelvic Floor Physical Therapy (Pfpt)mentioning

confidence: 99%

“…[3] However, the etiology of CPP is poorly understood, because not only 1 factor or disorder is attributed to pain. [6,7] According to the American College of Obstetricians and Gynecologists guidelines, CPP may be caused by multiple factors that interact with each other, including visceral etiologies, neuromusculoskeletal disease, and psychosocial status. [1] CPP is related to both gynecological and non-gynecological disorders such as endometriosis, intra-abdominal adhesions, irritable bowel syndrome (IBS), and interstitial cystitis/painful bladder syndrome.…”

Section: Introductionmentioning

confidence: 99%

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Non-pharmacological therapies for treating chronic pelvic pain in women: A review

et al. 2022

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Chronic pelvic pain (CPP) is an intricate condition with multiple etiologies that lead to indefinite pain mechanisms. Physicians and researchers are challenged in its treatment, and the combined therapy of pharmacologic and non-pharmacologic treatment has been recognized as a multidisciplinary approach cited by guidelines and adopted in clinical practice. As an alternative therapy for CPP, nonpharmacologic therapies benefit patients and deserve further study. This study reviews the literature published from January 1991 to April 2022 on non-pharmacologic therapies for CPP in adult women. Based on a survey, this review found that the most commonly used non-pharmacological therapies for CPP include pelvic floor physical therapy, psychotherapy, acupuncture, neuromodulation, and dietary therapy. By evaluating the efficacy and safety of each therapy, this study concluded that non-pharmacological therapies should be included in the initial treatment plan because of their high degree of safety and low rate of side effects. To fill the lack of data on non-pharmacologic therapies for CPP, this study provides evidence that may guide treatment and pain management.

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“…At present, analgesics, antibiotics, hormone modulating agents, antidepressants, and anticonvulsants are extensively used in the treatment of CPP; nonpharmacologic therapies such as pelvic physiotherapy, psychotherapy, acupuncture, and neuromodulation are also broadly used, but these methods are nonspecific, and their effect is limited (4,5). Moreover, deleterious side-effects of opioids can affect the gastrointestinal tract, and there are many adverse reactions related to psychiatric drugs that can affect the quality of life (QoL) of patients.…”

mentioning

confidence: 99%

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

Zhang¹,

Qian

et al. 2021

Pain Phys

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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

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Opioids and Alternatives in Female Chronic Pelvic Pain

Cited by 9 publications

References 58 publications

Current Challenges in the Management of Chronic Pelvic Pain in Women: From Bench to Bedside

Current Challenges in the Management of Chronic Pelvic Pain in Women: From Bench to Bedside

Non-pharmacological therapies for treating chronic pelvic pain in women: A review

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

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