A complex approach to the diagnosis and treatment of pelvic pain in women: clinical and economic aspects

Abstract

Aim. To improve the results of treatment of chronic pelvic pain in women secondary to chronic nonspecific salpingoophoritis and chronic cystitis. Methods. Examined were 91 women of reproductive age suffering from pelvic pain. The patients comprised two groups. The first group included 68 women in the treatment of which physical exercise therapy, electromagnetic resonance radiation and laser treatment were used. The comparison group included 23 women who received conventional therapy. Used were the generally accepted clinical and special methods of investigation: determined was the content of gonadotropic and steroid hormones, conducted were sonographic, urodynamic studies, laser Doppler flowmetry, assessed was the heart rate variability by the R.M. Baevskiy technique. The medical and psychological examination of women included a study of a women’s personality traits with the help of classical psycho-diagnostic methods. Results. Chronic pelvic pain in women is accompanied by a disturbance of the autonomic balance, increase in the activity of the regulatory systems and psychoemotional disorders, in the structure of which anxiety and depression conditions dominate. The influence of these disturbances on the major categories of quality of life has been established. After treatment was completed marked improvement was observed in the women of the main group; herein the disappearance of major symptoms, normalization of laboratory data, ultrasound investigation data, indicators of microcirculation occurred in a shorter time; the duration of treatment decreased. In the long-time registered was a decrease of the frequency of exacerbations of the disease in the main group of women by 2.6 times relative to the comparison group of patients. The economic effectiveness of the proposed methods of treatment was 40.2%. Conclusion. The usage of physiotherapy techniques in the treatment of pelvic pain made it possible to reduce the treatment time, reduce the frequency of exacerbations of the disease, to establish an economic effect.