Abstract
BACKGROUND AND OBJECTIVES:Chronic pelvic pain is prevalent, presents difficult treatment and has been poorly investigated. The objective of this study was to analyze 230 patients from the chronic pelvic pain ambulatory of Hospital das Clinicas, Federal University of Goias.METHODS:Cross-sectional and intervention study, from 2007-2011.RESULTS:Mean age was 38.3±10.0 years. Most women were mulatto, married/cohabitating, attended elementary school, financially dependent, had an income of up to five minimum wages, normal body mass index, up to three children and sexual activity. Almost 30% had abortions, 15.8%, physical abuse and 11%, sexual abuse. Previous surgeries were common. Most had normal bowel and bladder function. Pain lasted over 16 days/month; it worsened in perimenstrual period and started, on average, 6.7 years before. In over 70% of cases there was a coincident event with the onset of pain, and conflict and/or trauma were the most commonly reported. Physical examination and ultrasound were normal in most of these women. Adhesion and/or endometriosis were found in almost 2/3 of 41 laparoscopies performed. There was an average reduction of 39.2% of the pain scale (3.1/7.9) with various adopted treatments (drugs, psychotherapy and laparoscopy) p<0.001. History of sexual abuse and abortion was associated with less pain reduction.CONCLUSION:This study adds epidemiological and clinical information on women with chronic pelvic pain in Brazil. Clinical and psychotherapeutic treatments induced significant reduction of the pain scale between the first and last visit of patients. Laparoscopy did not potentiate the reduction of pain.
Highlights
Chronic pelvic pain (CPP) is a non-cyclic pain lasting for six months or more, located in the anatomic pelvis, in the abdominal wall below the umbilicus or in the gluteus region, with enough intensity to interfere with daily activities and/or to require medical assistance[1,2]
Analysis of 230 women with chronic pelvic pain assisted at a public hospital school, received up to five minimum wages, were financially dependent and had normal BMI (Table 1)
Our study has observed a high frequency of surgical pelvic cavity background, being laparotomic tubal ligation (50.4%) and Cesarean section (48.7%) the most frequent surgical procedures; we have found adhesions in approximately 1/3 of laparoscopies performed in the service, data which are similar to the literature[1,16]
Summary
Chronic pelvic pain (CPP) is a non-cyclic pain lasting for six months or more, located in the anatomic pelvis, in the abdominal wall below the umbilicus or in the gluteus region, with enough intensity to interfere with daily activities and/or to require medical assistance[1,2]. It has direct impact on marital, social and professional lives of these patients[4,5], which makes CPP a serious public health problem[4,6]. Especially with laparoscopy, has been indicated for diagnosis and treatment of endometriosis and pelvic adhesions[1,2], but is being increasingly challenged[13,14]. The objective of this study was to analyze 230 patients from the chronic pelvic pain ambulatory of Hospital das Clínicas, Federal University of Goiás. There was an average reduction of 39.2% of the pain scale (3.1/7.9) with various adopted treatments (drugs, psychotherapy and laparoscopy) p
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