Adrian Zegrea, Emilia Ojala, Pia Suvitie, Pirita Varpe, Heikki Huhtinen, Johanna Mäkelä-Kaikkonen, Tero Rautio, Päivi Härkki, Sinikka Salmenkylä, Mika Ukkonen, Maija Lavonius, Tarja Pinta
{"title":"子宫内膜异位症的骶神经调控-慢性盆腔疼痛的一种有前途的治疗选择。","authors":"Adrian Zegrea, Emilia Ojala, Pia Suvitie, Pirita Varpe, Heikki Huhtinen, Johanna Mäkelä-Kaikkonen, Tero Rautio, Päivi Härkki, Sinikka Salmenkylä, Mika Ukkonen, Maija Lavonius, Tarja Pinta","doi":"10.1111/aogs.14690","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Chronic pelvic pain (CPP) affects over one fifth of women worldwide, and endometriosis is one of the most common causes. In the present study, we examined whether sacral neuromodulation (SNM) is effective in the treatment of refractory chronic pelvic pain in women with endometriosis.</p>\n </section>\n \n <section>\n \n <h3> Material and methods</h3>\n \n <p>This multicenter prospective pilot study was started in 2017 and includes patients with chronic pelvic pain with no other obvious pathology than endometriosis. Other treatment options have been tried or they are unsuitable. Patients underwent SNM implantation. The main outcome was postoperative pain reduction and secondary outcome was quality of life. The following questionnaires were used to assess the outcomes: Brief pain inventory (BPI), clinical global impression - improvement (CGI-I), 15D-measure of health-related quality of life, and Biberoglu and Behrman (B&B) score.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 35 patients underwent the SNM procedure and, at the time of analysis, 15 patients had returned one-year questionnaires. The patients had a history of endometriosis for a median of 5.5 (interquartile range 2–9) years, with no correlation between the severity of symptoms and the duration of the disease (<i>p</i> = 0.158). A total of 31 patients (89%) were implanted with the internal pulse generator. There were statistically significant changes in BPI pain-related items. Worst experienced daily pain decreased among those who returned 12-month questionnaires from median 9 to 5 (<i>p</i> = 0.006), average daily pain from 6 to 3.5 (<i>p</i> = 0.004), and least daily pain from 3 to 1 (<i>p</i> = 0.004). Based on the CGI questionnaire (<i>n</i> = 14), at 12 months nine patients (60%) experienced great improvement in their symptoms, three patients (20%) much improvement and two patients (13%) minimal improvement. None of the patients experienced worsening of their symptoms. There was a statistically significant change in overall 15D score at 1 month (<i>p</i> < 0.001), 6 months (<i>p</i> = 0.001) and 12 months (<i>p</i> = 0.018), when the results were compared to baseline values. Median B&B score also improved significantly and decreased from a baseline value of 8 (4–12) to 4.5 (0–6), <i>p</i> = 0.002.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Based on the preliminary findings of our study, SNM might be a promising treatment of CPP in endometriosis patients.</p>\n </section>\n </div>","PeriodicalId":6990,"journal":{"name":"Acta Obstetricia et Gynecologica Scandinavica","volume":"102 12","pages":"1634-1642"},"PeriodicalIF":3.5000,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Sacral neuromodulation in endometriosis – A promising treatment option for chronic pelvic pain\",\"authors\":\"Adrian Zegrea, Emilia Ojala, Pia Suvitie, Pirita Varpe, Heikki Huhtinen, Johanna Mäkelä-Kaikkonen, Tero Rautio, Päivi Härkki, Sinikka Salmenkylä, Mika Ukkonen, Maija Lavonius, Tarja Pinta\",\"doi\":\"10.1111/aogs.14690\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Chronic pelvic pain (CPP) affects over one fifth of women worldwide, and endometriosis is one of the most common causes. In the present study, we examined whether sacral neuromodulation (SNM) is effective in the treatment of refractory chronic pelvic pain in women with endometriosis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Material and methods</h3>\\n \\n <p>This multicenter prospective pilot study was started in 2017 and includes patients with chronic pelvic pain with no other obvious pathology than endometriosis. Other treatment options have been tried or they are unsuitable. Patients underwent SNM implantation. The main outcome was postoperative pain reduction and secondary outcome was quality of life. The following questionnaires were used to assess the outcomes: Brief pain inventory (BPI), clinical global impression - improvement (CGI-I), 15D-measure of health-related quality of life, and Biberoglu and Behrman (B&B) score.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 35 patients underwent the SNM procedure and, at the time of analysis, 15 patients had returned one-year questionnaires. The patients had a history of endometriosis for a median of 5.5 (interquartile range 2–9) years, with no correlation between the severity of symptoms and the duration of the disease (<i>p</i> = 0.158). A total of 31 patients (89%) were implanted with the internal pulse generator. There were statistically significant changes in BPI pain-related items. Worst experienced daily pain decreased among those who returned 12-month questionnaires from median 9 to 5 (<i>p</i> = 0.006), average daily pain from 6 to 3.5 (<i>p</i> = 0.004), and least daily pain from 3 to 1 (<i>p</i> = 0.004). Based on the CGI questionnaire (<i>n</i> = 14), at 12 months nine patients (60%) experienced great improvement in their symptoms, three patients (20%) much improvement and two patients (13%) minimal improvement. None of the patients experienced worsening of their symptoms. There was a statistically significant change in overall 15D score at 1 month (<i>p</i> < 0.001), 6 months (<i>p</i> = 0.001) and 12 months (<i>p</i> = 0.018), when the results were compared to baseline values. Median B&B score also improved significantly and decreased from a baseline value of 8 (4–12) to 4.5 (0–6), <i>p</i> = 0.002.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Based on the preliminary findings of our study, SNM might be a promising treatment of CPP in endometriosis patients.</p>\\n </section>\\n </div>\",\"PeriodicalId\":6990,\"journal\":{\"name\":\"Acta Obstetricia et Gynecologica Scandinavica\",\"volume\":\"102 12\",\"pages\":\"1634-1642\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2023-10-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Obstetricia et Gynecologica Scandinavica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/aogs.14690\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Obstetricia et Gynecologica Scandinavica","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/aogs.14690","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Sacral neuromodulation in endometriosis – A promising treatment option for chronic pelvic pain
Introduction
Chronic pelvic pain (CPP) affects over one fifth of women worldwide, and endometriosis is one of the most common causes. In the present study, we examined whether sacral neuromodulation (SNM) is effective in the treatment of refractory chronic pelvic pain in women with endometriosis.
Material and methods
This multicenter prospective pilot study was started in 2017 and includes patients with chronic pelvic pain with no other obvious pathology than endometriosis. Other treatment options have been tried or they are unsuitable. Patients underwent SNM implantation. The main outcome was postoperative pain reduction and secondary outcome was quality of life. The following questionnaires were used to assess the outcomes: Brief pain inventory (BPI), clinical global impression - improvement (CGI-I), 15D-measure of health-related quality of life, and Biberoglu and Behrman (B&B) score.
Results
A total of 35 patients underwent the SNM procedure and, at the time of analysis, 15 patients had returned one-year questionnaires. The patients had a history of endometriosis for a median of 5.5 (interquartile range 2–9) years, with no correlation between the severity of symptoms and the duration of the disease (p = 0.158). A total of 31 patients (89%) were implanted with the internal pulse generator. There were statistically significant changes in BPI pain-related items. Worst experienced daily pain decreased among those who returned 12-month questionnaires from median 9 to 5 (p = 0.006), average daily pain from 6 to 3.5 (p = 0.004), and least daily pain from 3 to 1 (p = 0.004). Based on the CGI questionnaire (n = 14), at 12 months nine patients (60%) experienced great improvement in their symptoms, three patients (20%) much improvement and two patients (13%) minimal improvement. None of the patients experienced worsening of their symptoms. There was a statistically significant change in overall 15D score at 1 month (p < 0.001), 6 months (p = 0.001) and 12 months (p = 0.018), when the results were compared to baseline values. Median B&B score also improved significantly and decreased from a baseline value of 8 (4–12) to 4.5 (0–6), p = 0.002.
Conclusions
Based on the preliminary findings of our study, SNM might be a promising treatment of CPP in endometriosis patients.
期刊介绍：
Published monthly, Acta Obstetricia et Gynecologica Scandinavica is an international journal dedicated to providing the very latest information on the results of both clinical, basic and translational research work related to all aspects of women’s health from around the globe. The journal regularly publishes commentaries, reviews, and original articles on a wide variety of topics including: gynecology, pregnancy, birth, female urology, gynecologic oncology, fertility and reproductive biology.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
