Abstract
JUSTIFICATIVA E OBJETIVOS: A prevalência de dor pélvica crônica no sexo feminino é de aproximadamente 4%, similar à prevalência da enxaqueca (2,1%), asma (3,7%) e dor lombar (4,1%). Seu diagnóstico e tratamento constitui um grande desafio para a equipe de saúde. Este estudo teve por objetivo mostrar a dificuldade no diagnóstico e tratamento de dor pélvica crônica e a importância da equipe multidisciplinar no alívio do quadro doloroso. RELATO DO CASO: Paciente de 45 anos, com quadro de dor pelviperineal há 6 anos, após histeroscopia para exérese de pólipo uterino. A dor que iniciou no pós-operatório imediato, de forte intensidade, evoluiu ao longo desse período sem melhora e motivou-a a buscar o Ambulatório de Dor Abdominal, Pélvica e Perineal Crônica do Centro Interdisciplinar de Dor do Hospital de Clínicas da Faculdade de Medicina da Universidade de São Paulo. CONCLUSÃO: O tratamento multidisciplinar que abrangeu o uso de fármacos, inativação dos pontos-gatilho (infiltração com anestésicos, agulhamento seco, acupuntura), fisioterapia, reeducação postural e suporte psicossocial, proporcionou melhora significativa da dor e da qualidade de vida da paciente.
Highlights
Chronic pelvic pain (CPP) is a non-cyclic pain located in the pelvis, abdominal wall anterior and inferior to umbilicus, lumbar and gluteus regions
In Brazil, pelviperineal pain is responsible for 10% of gynecological consultations, 17% of hysterectomies and 40% of laparoscopies and its prevalence is estimated to be higher than that found in developed countries[3]
The prevalence of CPP in females is approximately 4% and similar to the prevalence of migraine (2.1%), asthma (3.7%) and low back pain (4.1%)
Summary
Chronic pelvic pain (CPP) is a non-cyclic pain located in the pelvis, abdominal wall anterior and inferior to umbilicus, lumbar and gluteus regions. The integrated model of multidisciplinary management with simultaneous or sequential therapeutic interventions to rescue physical-psychosocial interaction, associated to analgesics and adjuvants, rehabilitation, anesthetic and neurosurgical procedures, occupational therapy, acupuncture and psychotherapy, when rationally applied, may relieve symptoms and improve quality of life[3,7]. This report aimed at showing the difficulty of diagnosing and managing chronic pelvic pain and the importance of the multidisciplinary team for pain relief. CONCLUSION: Multidisciplinary management, involving drugs, inactivation of trigger-points (anesthetic infiltration, dry needling, acupuncture), physiotherapy, postural reeducation and psychosocial support, has provided patient’s significant pain relief and improved quality of life.
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