The Management of Chronic Pelvic Pain

McDonald, John S.; Elliott, Mark L.

doi:10.1097/00000542-199209001-00871

Cited by 6 publications

(7 citation statements)

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“…Evidence-based medicine denies using intuition as the sole basis of clinical decision-making and requires critical review of available literature. [ 68 ] Further research in terms of properly conducted prospective blinded RCTs is warranted to lay down the indications and clinical scenarios in which these interventions are going to be most useful.…”

Section: Discussionmentioning

confidence: 99%

“…[ 67 ] de Leon-Casasola et al , employed fluoroscopy during classic approach, with 69% of patients achieving satisfactory pain relief. [ 61 ] Several techniques to overcome the anatomic barriers (L5 transverse process and high iliac crest) encountered during classic approach have been described including transvascular,[ 68 ] transdiscal,[ 69 ] USG, and CT-guided anterior and posterior approach. [ 65 66 ] The complications include injury to common iliac vessels, pelvic viscera, L5 nerve root, and discitis which are rare and can be avoided with proper attention to technique, preoperative antibiotics, and image guidance.…”

Section: Interventional Pain Management Guidelines According To Clinimentioning

confidence: 99%

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Evidence-based clinical practice guidelines for interventional pain management in cancer pain

Bhatnagar¹,

Gupta²

2015

Indian J Palliat Care

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Intractable cancer pain not amenable to standard oral or parenteral analgesics is a horrifying truth in 10–15% of patients. Interventional pain management techniques are an indispensable arsenal in pain physician's armamentarium for severe, intractable pain and can be broadly classified into neuroablative and neuromodulation techniques. An array of neurolytic techniques (chemical, thermal, or surgical) can be employed for ablation of individual nerve fibers, plexuses, or intrathecalneurolysis in patients with resistant pain and short life-expectancy. Neuraxial administration of drugs and spinal cord stimulation to modulate or alter the pain perception constitutes the most frequently employed neuromodulation techniques. Lately, there is a rising call for early introduction of interventional techniques in carefully selected patients simultaneously or even before starting strong opioids. After decades of empirical use, it is the need of the hour to head towards professionalism and standardization in order to secure credibility of specialization and those practicing it. Even though the interventional management has found a definite place in cancer pain, there is a dearth of evidence-based practice guidelines for interventional therapies in cancer pain. This may be because of paucity of good quality randomized controlled trials (RCTs) evaluating their safety and efficacy in cancer pain. Laying standardized guidelines based on existing and emerging evidence will act as a foundation step towards strengthening, credentialing, and dissemination of the specialty of interventional cancer pain management. This will also ensure an improved decision-making and quality of life (QoL) of the suffering patients.

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Section: Discussionmentioning

confidence: 99%

Section: Interventional Pain Management Guidelines According To Clinimentioning

confidence: 99%

Evidence-based clinical practice guidelines for interventional pain management in cancer pain

Bhatnagar¹,

Gupta²

2015

Indian J Palliat Care

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“…There are several technical problems in performing SHPB by a traditional approach such as large iliac crest and the transverse process of fifth lumber vertebra. Modification in this traditional approach has been suggested by several authors to overcome these technical difficulties such as a CT‐guided posterior placement of the needle , transvascular approach , transvaginal approach and anterior approach .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of the Anterior Ultrasound-Guided Superior Hypogastric Plexus Neurolysis in Pelvic Cancer Pain in Advanced Gynecological Cancer Patients

et al. 2013

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“…In den letzten 10 Jahren sind neurolytische Blockaden des oberen hypogastrischen Plexus zur Behandlung des tumorbedingten Unterleibsschmerzes beschrieben worden [13,36]. Diese Verfahren werden von verschiedenen Autoren auch zur Diagnose und Behandlung des chronischen nichtmalignen Schmerzes vorgeschlagen [31,53]. Bei der Plexusblockade werden sowohl afferente viszerale Nervenfasern als auch sympathische efferente Fasern, die den Beckenbereich versorgen, mit einem Lokalanästhetikum blockiert (s.Abb.…”

Section: Anästhesiologische Verfahrenunclassified

Klinik und Pathophysiologie der Schmerzen der Beckenorgane bei der Frau

Wesselmann

2002

Der Schmerz

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Chronic pelvic pain is a common and debilitating problem that can significantly impair the quality of life of a woman. Patients with chronic pelvic pain are usually evaluated and treated by gynecologists, gastroenterologists, urologists, and internists. Although these patients seek medical care because they are looking for help to alleviate their pelvic discomfort and pain, in many cases the only focus is on finding and possibly treating the underlying pelvic disease.However, often the examination and work-up remain unrevealing and no specific cause of the pain can be identified. At this point patients are frequently told, that no etiology for their chronic pain syndrome can be found and that nothing can be done. In these cases it is important to recognize that pain is not only a symptom of pelvic disease, but that the patient is suffering from a chronic pelvic pain syndrome. Knowledge of the clinical characteristics of visceral pain will guide the health care provider in making a diagnosis of chronic pelvic pain and in sorting it out from the lump diagnosis of idiopathic pain. Once the diagnosis of chronic pelvic pain is made, treatment should be directed towards symptomatic pain management.This conceptualization of chronic pelvic pain is very important, because chronic pelvic pain is a treatable condition! Effective treatment modalities are available to lessen the impact of pain and offer reasonable expectations of an improved functional status.

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The Management of Chronic Pelvic Pain

Cited by 6 publications

References 0 publications

Evidence-based clinical practice guidelines for interventional pain management in cancer pain

Evidence-based clinical practice guidelines for interventional pain management in cancer pain

Efficacy of the Anterior Ultrasound-Guided Superior Hypogastric Plexus Neurolysis in Pelvic Cancer Pain in Advanced Gynecological Cancer Patients

Klinik und Pathophysiologie der Schmerzen der Beckenorgane bei der Frau

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