国际盆腔疼痛学会2021年盆腔疼痛年度科学会议摘要

IF 3.4 Q2 NEUROSCIENCES
F. Tu
{"title":"国际盆腔疼痛学会2021年盆腔疼痛年度科学会议摘要","authors":"F. Tu","doi":"10.1097/PR9.0000000000001002","DOIUrl":null,"url":null,"abstract":"After endless COVID-19 we were finally able to meet in person at the 24th International Pelvic Pain Society (IPPS) the The 2021 program featured several interesting and innovative research projects conducted by investigators around the globe, while the hybrid format allowed for both virtual and in-person collaboration. The abstracts presented here underwent a rigorous peer review process, whereby each abstract was evaluated by at least 2 members of the Scientific Program, Abstract, or Research IPPS committees. Abstracts were rejected if they were incomplete, if they had inadequate statistical analysis, or if the topic was not relevant to pain. Case reports were accepted for presentation but are excluded from this publication. Methods: This study followed PROMIS guidelines. We created potential PROM items in reference to IMMPACT recommenda-tions. These items were iteratively reviewed by a panel of dyspareunia experts: patient partners (n 5 4), gynecologists (n 5 2), and a psychiatrist (n 5 1). Panelists voted for inclusion, modification, or exclusion of items based on clarity and relevance. Panelists also provided suggestions for revisions or new items. Items that reached consensus ( $ 80% inclusion votes) were accepted into the PROM. New and modified items appeared on subsequent survey iterations alongside the associated votes and comments from the preceding survey. Results: Panelists reviewed 163 items. Items with $ 80% inclusion votes fell into categories of pain location, intensity, quality, timing, or effect of pain on behaviors, cognitions, affect, and sexuality. Conclusions: Items that reached consensus displayed clarity, clinical relevance, experiential relevance, and comprehensive-ness about the dyspareunia experience. The e-Delphi process contributes to establishing PROM content validity by using expert opinion to reach a consensus. Future work should use qualitative and psychometric testing to further establish validity and reliability. in a prospective study of menstrual pain. Visual and visceral sensitivity was experimentally quantified in a cohort of women (n 147) at greater risk for developing CPP (ie, mild-to-severe dysmenorrhea). Scalp EEG (electroencephalography) was recorded while participants were presented with a periodic pattern-reversal checkerboard stimulus across 5 brightness intensities to measure the visual cortex activity. Visual sensitivity was assessed using visual unpleasantness ratings provided after each brightness intensity. Visceral sensitivity was assessed using our validated bladder-filling task and visual analog scale ratings of menstrual pain. 117 participants), hypnotherapy (1 study and 36 participants), local anesthetic trigger point injections (1 study and 29 participants), and oxytocin nasal spray (1 study and 21 participants). Conclusions: Many studies showed a placebo effect possibly indicating that simple acknowledgement of pain symptoms with a treatment plan can improve pain. Physical therapy showed significant improvement in pain and sexual functioning compared with controls. Botulinum toxin A was not proven to be beneficial for pelvic floor myalgia and hypertonicity. and pelvic floor PM&R residents 17) in of 40% , manual muscle P , 0.001). and pretest P , and confidence of pelvic floor evaluation mL for 48 hours in endometriotic cells. In this dose and time period, we observed no cytotoxic effect on healthy cells. Annexin V staining for apoptosis analysis on endometriotic cell results revealed that more than 50% of the cells were apoptotic at the concentration of 150 m g/mL for 48 hours. Conclusions: These results suggest that the combination has a selective effect on endometriotic cell proliferation and apoptosis. Taken together, our results support the further investigation of these natural substances for use in the treatment of endometriosis. there was a statistical difference in 3 themes: commonality, mentorship, and desire. greater than 2, whereas 45.4% of patients in the PFTPI -only group had a change in the VAS score greater than 2 ( P 5 0.029). Conclusions: PFTPI immediately followed by PFPT offers better pain improvement for patients with pelvic floor tension myalgia. This may be due to tolerance of deeper physical therapy immediately after injections. enhance pain therapeutic development by performing phase 2 clinical trials of novel, nonaddictive pain therapies. EPPIC-Net evaluates new, as well as repurposed, small molecules, biologics, drugs, natural products, and devices submitted by industry, academic, or other partners for studies across the age and pain condition spectrum. EPPIC-Net infrastructure includes a clinical coordinating center, a data coordinating center, and 12 specialized clinical sites with access to broad, inclusive patient populations to provide phase 2 clinical trials, incorporating proof-of-concept testing, biomarkers validation, novel study design, and protocol development and implementation. Results: EPPIC-Net provides a robust and readily acces-sible infrastructure with a network comprised of pain experts to enhance the design, conduct, and analysis of experimental pain therapeutic phase 2 trials at no cost to the asset provider. Ultimately, EPPIC-Net will reduce reliance on opioids by accelerating development of nonaddictive pain therapeutics. Conclusions: This presentation describes EPPIC-Net, an initiative charged with evaluating pain therapeutics in early phase clinical development. EPPIC-Net is open to researchers world-wide, with applications accepted on a rolling basis. Introduction: It is suggested that central sensitization (CS) may be present in patients with chronic pelvic pain, and treatment may need to be adjusted considering CS. To indicate its possible presence in patients, the Central Sensitization Inventory (CSI), a validatedself-reportedscalefortheidentificationofCS,canbeused. This study aims to analyze the influencing factors of the CSI score in patients with chronic pelvic pain of various origins. Methods: In a retrospective study, 35 men and 233 women with pelvic pain at a tertiary pain center are analyzed by univariate and multivariate regression. The influencing factors on the CSI score are investigated for age, sex, body mass index (BMI), each of the central sensitivity syndromes (CSS) based on the CSI-part B and total number of CSS, pain severity, pain duration, quality of life (EQ5D-5L), and psychological symptoms (BSI). Results: A univariate regression shows a significant effect for the number of CSS, pain severity, pain duration, quality of life, and psychological symptoms. Multivariate regression with all the CSS showsasignificanteffectforrestlesslegsyndrome,temporomandibular joint disorder, irritable bowel syndrome, and depression. A backward multivariate regression with all the factors results in number of CSS, quality of life, and psychological symptoms as influencing factors. Conclusions: This study shows that the CSI score in patients with pelvic pain is influenced by the number of CSS, quality of life scores, and psychological symptoms. Age, sex, BMI, pain severity, and pain duration did not influence the CSI score. underwent hysterectomy. Narcotics was the most used phar-macologic therapy (24.7%) and twice as common as the neuromodulator use (12%). All P values 5 , 0.0001. Conclusions: This study confirms the increased prevalence of COPCs in patients with CPP. CPP health care utilization is significantly greater, including high-cost settings such as ED use. While interventional therapies and neuromodulators were used by this cohort, narcotics continued to be the most used pharmacotherapy. patients able to experience vulvar pleasure since their pelvic pain began scored highest on the total FSFI score (mean: 16.26%, 89.1% below cutoff), as well as on 5 domains of the FSFI, compared with patients who had never experienced vulvar pleasure (mean: 13.7%, 84.6% below cutoff) and with patients who had not experienced vulvar pleasure since their pelvic pain began (mean: 7.79%,100%belowcutoff;thisgroupscoredhighestonthe € œ pain € domain). There were significant differences among the 3 groups in total FSFI score and all FSFI domains except desire. Conclusions: This novel study focuses on the intersections among chronic genitopelvic pain, vulvar pleasure, and sexual functioning, introducing the importance of incorporating vulvar pleasure in genitopelvic pain treatment approaches. the polypropylene of chronic pelvic pain in patients who undergone mesh implantation have been reported to be as high as 40%. There an increased interest in the use of botulinum toxin for the treatment of pain and pelvic floor dysfunction. Here, we report the results of the injection of local anesthetic and botulinum toxin(BONT-A)forthetreatmentofchronicmesh-inducedpelvicpain. Eleven patients mesh-induced pelvic pain were the study. Patients underwent examination and were asked to fill in the Pelvic Pain Assessment Form (PPAF). Patients then underwent injection of a mixture of 0.75% levobupivacaine and BONT-A into several points along the course of the bulbospongiosus muscle. Patients were once again asked to fill in the PPAF and were examined at 1, 3, and 6 months postprocedure. Results: At baseline, most of the patients reported dyspareunia and painscoresof 8 to 10/10. After the procedure, 10 of the patients had . 50% pain relief, with 8 patients reporting . 70% relief. bulbospongiosus muscle a of and a therapeutic for the of chronic mesh-induced 5 –1.7, D 5 0.6; and overall pelvic pain 6.5 (SD 6 2.3) to 4.5 (SD 6 2.5), MCID 5 2 2, D 5 0.8. Conclusions: In this cohort of women with vulvodynia, clinically meaningful improvements in vulvar pain, dyspareunia, and overall pelvic pain were noted after 9 TV-PBMT treatments. This is a small uncontrolled study, and additional research is needed to confirm these findings. endometriosis by laparoscopy and assessed by transabdominal and transvaginal ultrasounds at Rutgers. The normal g","PeriodicalId":52189,"journal":{"name":"Pain Reports","volume":" ","pages":""},"PeriodicalIF":3.4000,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Abstracts from the International Pelvic Pain Society Annual Scientific Meeting on Pelvic Pain 2021\",\"authors\":\"F. Tu\",\"doi\":\"10.1097/PR9.0000000000001002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"After endless COVID-19 we were finally able to meet in person at the 24th International Pelvic Pain Society (IPPS) the The 2021 program featured several interesting and innovative research projects conducted by investigators around the globe, while the hybrid format allowed for both virtual and in-person collaboration. The abstracts presented here underwent a rigorous peer review process, whereby each abstract was evaluated by at least 2 members of the Scientific Program, Abstract, or Research IPPS committees. Abstracts were rejected if they were incomplete, if they had inadequate statistical analysis, or if the topic was not relevant to pain. Case reports were accepted for presentation but are excluded from this publication. Methods: This study followed PROMIS guidelines. We created potential PROM items in reference to IMMPACT recommenda-tions. These items were iteratively reviewed by a panel of dyspareunia experts: patient partners (n 5 4), gynecologists (n 5 2), and a psychiatrist (n 5 1). Panelists voted for inclusion, modification, or exclusion of items based on clarity and relevance. Panelists also provided suggestions for revisions or new items. Items that reached consensus ( $ 80% inclusion votes) were accepted into the PROM. New and modified items appeared on subsequent survey iterations alongside the associated votes and comments from the preceding survey. Results: Panelists reviewed 163 items. Items with $ 80% inclusion votes fell into categories of pain location, intensity, quality, timing, or effect of pain on behaviors, cognitions, affect, and sexuality. Conclusions: Items that reached consensus displayed clarity, clinical relevance, experiential relevance, and comprehensive-ness about the dyspareunia experience. The e-Delphi process contributes to establishing PROM content validity by using expert opinion to reach a consensus. Future work should use qualitative and psychometric testing to further establish validity and reliability. in a prospective study of menstrual pain. Visual and visceral sensitivity was experimentally quantified in a cohort of women (n 147) at greater risk for developing CPP (ie, mild-to-severe dysmenorrhea). Scalp EEG (electroencephalography) was recorded while participants were presented with a periodic pattern-reversal checkerboard stimulus across 5 brightness intensities to measure the visual cortex activity. Visual sensitivity was assessed using visual unpleasantness ratings provided after each brightness intensity. Visceral sensitivity was assessed using our validated bladder-filling task and visual analog scale ratings of menstrual pain. 117 participants), hypnotherapy (1 study and 36 participants), local anesthetic trigger point injections (1 study and 29 participants), and oxytocin nasal spray (1 study and 21 participants). Conclusions: Many studies showed a placebo effect possibly indicating that simple acknowledgement of pain symptoms with a treatment plan can improve pain. Physical therapy showed significant improvement in pain and sexual functioning compared with controls. Botulinum toxin A was not proven to be beneficial for pelvic floor myalgia and hypertonicity. and pelvic floor PM&R residents 17) in of 40% , manual muscle P , 0.001). and pretest P , and confidence of pelvic floor evaluation mL for 48 hours in endometriotic cells. In this dose and time period, we observed no cytotoxic effect on healthy cells. Annexin V staining for apoptosis analysis on endometriotic cell results revealed that more than 50% of the cells were apoptotic at the concentration of 150 m g/mL for 48 hours. Conclusions: These results suggest that the combination has a selective effect on endometriotic cell proliferation and apoptosis. Taken together, our results support the further investigation of these natural substances for use in the treatment of endometriosis. there was a statistical difference in 3 themes: commonality, mentorship, and desire. greater than 2, whereas 45.4% of patients in the PFTPI -only group had a change in the VAS score greater than 2 ( P 5 0.029). Conclusions: PFTPI immediately followed by PFPT offers better pain improvement for patients with pelvic floor tension myalgia. This may be due to tolerance of deeper physical therapy immediately after injections. enhance pain therapeutic development by performing phase 2 clinical trials of novel, nonaddictive pain therapies. EPPIC-Net evaluates new, as well as repurposed, small molecules, biologics, drugs, natural products, and devices submitted by industry, academic, or other partners for studies across the age and pain condition spectrum. EPPIC-Net infrastructure includes a clinical coordinating center, a data coordinating center, and 12 specialized clinical sites with access to broad, inclusive patient populations to provide phase 2 clinical trials, incorporating proof-of-concept testing, biomarkers validation, novel study design, and protocol development and implementation. Results: EPPIC-Net provides a robust and readily acces-sible infrastructure with a network comprised of pain experts to enhance the design, conduct, and analysis of experimental pain therapeutic phase 2 trials at no cost to the asset provider. Ultimately, EPPIC-Net will reduce reliance on opioids by accelerating development of nonaddictive pain therapeutics. Conclusions: This presentation describes EPPIC-Net, an initiative charged with evaluating pain therapeutics in early phase clinical development. EPPIC-Net is open to researchers world-wide, with applications accepted on a rolling basis. Introduction: It is suggested that central sensitization (CS) may be present in patients with chronic pelvic pain, and treatment may need to be adjusted considering CS. To indicate its possible presence in patients, the Central Sensitization Inventory (CSI), a validatedself-reportedscalefortheidentificationofCS,canbeused. This study aims to analyze the influencing factors of the CSI score in patients with chronic pelvic pain of various origins. Methods: In a retrospective study, 35 men and 233 women with pelvic pain at a tertiary pain center are analyzed by univariate and multivariate regression. The influencing factors on the CSI score are investigated for age, sex, body mass index (BMI), each of the central sensitivity syndromes (CSS) based on the CSI-part B and total number of CSS, pain severity, pain duration, quality of life (EQ5D-5L), and psychological symptoms (BSI). Results: A univariate regression shows a significant effect for the number of CSS, pain severity, pain duration, quality of life, and psychological symptoms. Multivariate regression with all the CSS showsasignificanteffectforrestlesslegsyndrome,temporomandibular joint disorder, irritable bowel syndrome, and depression. A backward multivariate regression with all the factors results in number of CSS, quality of life, and psychological symptoms as influencing factors. Conclusions: This study shows that the CSI score in patients with pelvic pain is influenced by the number of CSS, quality of life scores, and psychological symptoms. Age, sex, BMI, pain severity, and pain duration did not influence the CSI score. underwent hysterectomy. Narcotics was the most used phar-macologic therapy (24.7%) and twice as common as the neuromodulator use (12%). All P values 5 , 0.0001. Conclusions: This study confirms the increased prevalence of COPCs in patients with CPP. CPP health care utilization is significantly greater, including high-cost settings such as ED use. While interventional therapies and neuromodulators were used by this cohort, narcotics continued to be the most used pharmacotherapy. patients able to experience vulvar pleasure since their pelvic pain began scored highest on the total FSFI score (mean: 16.26%, 89.1% below cutoff), as well as on 5 domains of the FSFI, compared with patients who had never experienced vulvar pleasure (mean: 13.7%, 84.6% below cutoff) and with patients who had not experienced vulvar pleasure since their pelvic pain began (mean: 7.79%,100%belowcutoff;thisgroupscoredhighestonthe € œ pain € domain). There were significant differences among the 3 groups in total FSFI score and all FSFI domains except desire. Conclusions: This novel study focuses on the intersections among chronic genitopelvic pain, vulvar pleasure, and sexual functioning, introducing the importance of incorporating vulvar pleasure in genitopelvic pain treatment approaches. the polypropylene of chronic pelvic pain in patients who undergone mesh implantation have been reported to be as high as 40%. There an increased interest in the use of botulinum toxin for the treatment of pain and pelvic floor dysfunction. Here, we report the results of the injection of local anesthetic and botulinum toxin(BONT-A)forthetreatmentofchronicmesh-inducedpelvicpain. Eleven patients mesh-induced pelvic pain were the study. Patients underwent examination and were asked to fill in the Pelvic Pain Assessment Form (PPAF). Patients then underwent injection of a mixture of 0.75% levobupivacaine and BONT-A into several points along the course of the bulbospongiosus muscle. Patients were once again asked to fill in the PPAF and were examined at 1, 3, and 6 months postprocedure. Results: At baseline, most of the patients reported dyspareunia and painscoresof 8 to 10/10. After the procedure, 10 of the patients had . 50% pain relief, with 8 patients reporting . 70% relief. bulbospongiosus muscle a of and a therapeutic for the of chronic mesh-induced 5 –1.7, D 5 0.6; and overall pelvic pain 6.5 (SD 6 2.3) to 4.5 (SD 6 2.5), MCID 5 2 2, D 5 0.8. Conclusions: In this cohort of women with vulvodynia, clinically meaningful improvements in vulvar pain, dyspareunia, and overall pelvic pain were noted after 9 TV-PBMT treatments. This is a small uncontrolled study, and additional research is needed to confirm these findings. endometriosis by laparoscopy and assessed by transabdominal and transvaginal ultrasounds at Rutgers. 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摘要

在无休止的COVID-19之后,我们终于能够在第24届国际盆腔疼痛学会(IPPS)上亲自见面。2021年的计划以全球研究人员进行的几个有趣和创新的研究项目为特色,而混合形式允许虚拟和面对面的合作。摘要经过严格的同行评议,每篇摘要至少由科学计划、摘要或研究IPPS委员会的2名成员进行评估。摘要如果不完整,统计分析不充分,或者主题与疼痛无关,则会被拒绝。病例报告被接受,但不包括在本出版物中。方法:本研究遵循PROMIS指南。我们参照impact的建议创建了潜在的PROM项。这些项目由性交困难专家小组反复审查:患者伴侣(n 5.4)、妇科医生(n 5.2)和精神科医生(n 5.1)。小组成员根据清晰度和相关性投票决定是否纳入、修改或排除项目。小组成员还对修订或新增项目提出了建议。达成共识的项目($ 80%的包含投票)被接受进入舞会。新的和修改的项目出现在随后的调查迭代中,同时出现的还有来自前一次调查的相关投票和评论。结果:小组成员回顾了163个项目。包含80%选票的项目分为疼痛位置、强度、质量、时间或疼痛对行为、认知、情感和性的影响。结论:达成共识的条目显示出关于性交困难经历的清晰度、临床相关性、经验相关性和全面性。e-Delphi过程有助于通过专家意见达成共识来建立PROM内容效度。未来的工作应采用定性和心理测试来进一步建立效度和信度。在经期疼痛的前瞻性研究中。在发生CPP(即轻度至重度痛经)风险较高的一组女性(n 147)中,通过实验量化了视觉和内脏敏感性。研究人员对受试者进行5个亮度强度的周期性模式反转棋盘刺激,并记录下受试者的头皮脑电图(EEG)。视觉敏感度评估使用视觉不愉快评分后提供的每个亮度强度。内脏敏感性评估使用我们验证的膀胱填充任务和月经疼痛的视觉模拟量表评分。117名参与者),催眠疗法(1项研究,36名参与者),局部麻醉触发点注射(1项研究,29名参与者),催产素鼻喷雾剂(1项研究,21名参与者)。结论:许多研究表明,安慰剂效应可能表明,简单地承认疼痛症状和治疗方案可以改善疼痛。与对照组相比,物理治疗显示疼痛和性功能有显著改善。肉毒杆菌毒素A未被证明对骨盆底肌痛和高张力有益。骨盆底PM&R患者(17)的患病率为40%,手肌P = 0.001)。以及子宫内膜异位症细胞48小时内盆底评估mL的置信度。在此剂量和时间段内,我们没有观察到对健康细胞的细胞毒性作用。膜联蛋白V染色对子宫内膜异位症细胞进行凋亡分析结果显示,在150 m g/mL浓度下作用48小时,超过50%的细胞凋亡。结论:联合用药对子宫内膜异位症细胞增殖和凋亡具有选择性作用。综上所述,我们的结果支持对这些天然物质用于治疗子宫内膜异位症的进一步研究。在共性、师徒关系和欲望三个主题上存在统计学差异。而PFTPI组45.4%的患者VAS评分变化大于2 (P < 0.05)。结论:盆底紧张性肌痛患者即刻行PFPT后疼痛改善效果较好。这可能是由于注射后立即进行更深层次物理治疗的耐受性。通过进行新型非成瘾性疼痛治疗的2期临床试验,增强疼痛治疗的发展。EPPIC-Net评估工业界、学术界或其他合作伙伴提交的用于年龄和疼痛状况研究的新产品,以及重新利用的小分子、生物制剂、药物、天然产物和设备。EPPIC-Net基础设施包括一个临床协调中心、一个数据协调中心和12个专门的临床站点,这些站点可以获得广泛的、包容性的患者群体,以提供2期临床试验,包括概念验证测试、生物标志物验证、新研究设计以及方案开发和实施。 结果:EPPIC-Net提供了一个强大且易于访问的基础设施,由疼痛专家组成的网络可以增强实验性疼痛治疗2期试验的设计、实施和分析,而不需要资产提供商支付任何费用。最终,EPPIC-Net将通过加速非成瘾性疼痛疗法的发展来减少对阿片类药物的依赖。结论:本报告描述了EPPIC-Net,一个在早期临床开发阶段评估疼痛治疗的倡议。EPPIC-Net向全世界的研究人员开放,接受滚动申请。提示慢性盆腔疼痛患者可能存在中枢致敏(CS),治疗可能需要根据CS进行调整。为了表明其在患者中可能存在,可以使用中央致敏性量表(CSI),这是一种经过验证的自我报告的cs识别量表。本研究旨在分析不同原因慢性盆腔疼痛患者CSI评分的影响因素。方法:回顾性研究35名男性和233名女性在三级疼痛中心进行骨盆疼痛单因素和多因素回归分析。研究影响CSI评分的因素包括年龄、性别、体重指数(BMI)、基于CSI- B部分的各中枢敏感综合征(CSS)及其总次数、疼痛严重程度、疼痛持续时间、生活质量(EQ5D-5L)和心理症状(BSI)。结果:单变量回归显示CSS次数、疼痛严重程度、疼痛持续时间、生活质量和心理症状有显著影响。所有CSS的多因素回归显示对不宁腿综合征、颞下颌关节紊乱、肠易激综合征和抑郁症有显著影响。对所有因素进行多元回归分析,结果显示CSS次数、生活质量和心理症状是影响因素。结论:本研究表明盆腔疼痛患者的CSI评分受CSS次数、生活质量评分和心理症状的影响。年龄、性别、体重指数、疼痛严重程度和疼痛持续时间对CSI评分没有影响。接受了子宫切除术。麻醉药是使用最多的药物治疗(24.7%),是神经调节剂使用的两倍(12%)。P值均为5,0.0001。结论:本研究证实了CPP患者中COPCs的患病率增加。CPP医疗保健的利用率明显更高,包括ED使用等高成本环境。当介入治疗和神经调节剂被使用时,麻醉品仍然是最常用的药物治疗。与从未体验过外阴愉悦的患者(平均:13.7%,低于临界值84.6%)和自盆腔疼痛开始以来没有体验过外阴愉悦的患者(平均:7.79%,低于临界值100%)相比,自盆腔疼痛开始以来能够体验外阴愉悦的患者在FSFI总评分(平均:16.26%,低于临界值89.1%)以及FSFI的5个领域得分最高(平均:7.79%,低于临界值100%)。三组间FSFI总分及除欲望外各FSFI域均有显著差异。结论:本研究关注慢性外阴疼痛、外阴快感和性功能之间的交叉关系,介绍了将外阴快感纳入治疗方法的重要性。据报道,在接受补片植入的患者中,慢性盆腔疼痛的聚丙烯发生率高达40%。在使用肉毒杆菌毒素治疗疼痛和盆底功能障碍的兴趣增加。在这里,我们报告注射局麻药和肉毒杆菌毒素(BONT-A)治疗慢性盆腔疼痛的结果。研究对象为11例网状物引起的盆腔疼痛。患者接受检查并填写骨盆疼痛评估表(PPAF)。然后将0.75%左布比卡因和BONT-A的混合物注射到沿球海绵肌的几个点。患者再次被要求填写PPAF,并在术后1、3和6个月进行检查。结果:在基线时,大多数患者报告性交困难和疼痛评分为8至10/10。手术后,有10名患者。疼痛缓解50%,8例患者报告。70%的救济。球海绵肌a和a对慢性网状诱导5 -1.7,D 5 - 0.6;整体盆腔疼痛6.5 (SD 6 2.3)至4.5 (SD 6 2.5), MCID 5 22, d5 0.8。结论:在这组患有外阴痛的女性中,经过9次TV-PBMT治疗后,外阴疼痛、性交困难和整体盆腔疼痛均有临床意义的改善。这是一项小型的非对照研究,需要进一步的研究来证实这些发现。 子宫内膜异位症的腹腔镜检查和经腹部和阴道超声评估罗格斯大学。法向g
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Abstracts from the International Pelvic Pain Society Annual Scientific Meeting on Pelvic Pain 2021
After endless COVID-19 we were finally able to meet in person at the 24th International Pelvic Pain Society (IPPS) the The 2021 program featured several interesting and innovative research projects conducted by investigators around the globe, while the hybrid format allowed for both virtual and in-person collaboration. The abstracts presented here underwent a rigorous peer review process, whereby each abstract was evaluated by at least 2 members of the Scientific Program, Abstract, or Research IPPS committees. Abstracts were rejected if they were incomplete, if they had inadequate statistical analysis, or if the topic was not relevant to pain. Case reports were accepted for presentation but are excluded from this publication. Methods: This study followed PROMIS guidelines. We created potential PROM items in reference to IMMPACT recommenda-tions. These items were iteratively reviewed by a panel of dyspareunia experts: patient partners (n 5 4), gynecologists (n 5 2), and a psychiatrist (n 5 1). Panelists voted for inclusion, modification, or exclusion of items based on clarity and relevance. Panelists also provided suggestions for revisions or new items. Items that reached consensus ( $ 80% inclusion votes) were accepted into the PROM. New and modified items appeared on subsequent survey iterations alongside the associated votes and comments from the preceding survey. Results: Panelists reviewed 163 items. Items with $ 80% inclusion votes fell into categories of pain location, intensity, quality, timing, or effect of pain on behaviors, cognitions, affect, and sexuality. Conclusions: Items that reached consensus displayed clarity, clinical relevance, experiential relevance, and comprehensive-ness about the dyspareunia experience. The e-Delphi process contributes to establishing PROM content validity by using expert opinion to reach a consensus. Future work should use qualitative and psychometric testing to further establish validity and reliability. in a prospective study of menstrual pain. Visual and visceral sensitivity was experimentally quantified in a cohort of women (n 147) at greater risk for developing CPP (ie, mild-to-severe dysmenorrhea). Scalp EEG (electroencephalography) was recorded while participants were presented with a periodic pattern-reversal checkerboard stimulus across 5 brightness intensities to measure the visual cortex activity. Visual sensitivity was assessed using visual unpleasantness ratings provided after each brightness intensity. Visceral sensitivity was assessed using our validated bladder-filling task and visual analog scale ratings of menstrual pain. 117 participants), hypnotherapy (1 study and 36 participants), local anesthetic trigger point injections (1 study and 29 participants), and oxytocin nasal spray (1 study and 21 participants). Conclusions: Many studies showed a placebo effect possibly indicating that simple acknowledgement of pain symptoms with a treatment plan can improve pain. Physical therapy showed significant improvement in pain and sexual functioning compared with controls. Botulinum toxin A was not proven to be beneficial for pelvic floor myalgia and hypertonicity. and pelvic floor PM&R residents 17) in of 40% , manual muscle P , 0.001). and pretest P , and confidence of pelvic floor evaluation mL for 48 hours in endometriotic cells. In this dose and time period, we observed no cytotoxic effect on healthy cells. Annexin V staining for apoptosis analysis on endometriotic cell results revealed that more than 50% of the cells were apoptotic at the concentration of 150 m g/mL for 48 hours. Conclusions: These results suggest that the combination has a selective effect on endometriotic cell proliferation and apoptosis. Taken together, our results support the further investigation of these natural substances for use in the treatment of endometriosis. there was a statistical difference in 3 themes: commonality, mentorship, and desire. greater than 2, whereas 45.4% of patients in the PFTPI -only group had a change in the VAS score greater than 2 ( P 5 0.029). Conclusions: PFTPI immediately followed by PFPT offers better pain improvement for patients with pelvic floor tension myalgia. This may be due to tolerance of deeper physical therapy immediately after injections. enhance pain therapeutic development by performing phase 2 clinical trials of novel, nonaddictive pain therapies. EPPIC-Net evaluates new, as well as repurposed, small molecules, biologics, drugs, natural products, and devices submitted by industry, academic, or other partners for studies across the age and pain condition spectrum. EPPIC-Net infrastructure includes a clinical coordinating center, a data coordinating center, and 12 specialized clinical sites with access to broad, inclusive patient populations to provide phase 2 clinical trials, incorporating proof-of-concept testing, biomarkers validation, novel study design, and protocol development and implementation. Results: EPPIC-Net provides a robust and readily acces-sible infrastructure with a network comprised of pain experts to enhance the design, conduct, and analysis of experimental pain therapeutic phase 2 trials at no cost to the asset provider. Ultimately, EPPIC-Net will reduce reliance on opioids by accelerating development of nonaddictive pain therapeutics. Conclusions: This presentation describes EPPIC-Net, an initiative charged with evaluating pain therapeutics in early phase clinical development. EPPIC-Net is open to researchers world-wide, with applications accepted on a rolling basis. Introduction: It is suggested that central sensitization (CS) may be present in patients with chronic pelvic pain, and treatment may need to be adjusted considering CS. To indicate its possible presence in patients, the Central Sensitization Inventory (CSI), a validatedself-reportedscalefortheidentificationofCS,canbeused. This study aims to analyze the influencing factors of the CSI score in patients with chronic pelvic pain of various origins. Methods: In a retrospective study, 35 men and 233 women with pelvic pain at a tertiary pain center are analyzed by univariate and multivariate regression. The influencing factors on the CSI score are investigated for age, sex, body mass index (BMI), each of the central sensitivity syndromes (CSS) based on the CSI-part B and total number of CSS, pain severity, pain duration, quality of life (EQ5D-5L), and psychological symptoms (BSI). Results: A univariate regression shows a significant effect for the number of CSS, pain severity, pain duration, quality of life, and psychological symptoms. Multivariate regression with all the CSS showsasignificanteffectforrestlesslegsyndrome,temporomandibular joint disorder, irritable bowel syndrome, and depression. A backward multivariate regression with all the factors results in number of CSS, quality of life, and psychological symptoms as influencing factors. Conclusions: This study shows that the CSI score in patients with pelvic pain is influenced by the number of CSS, quality of life scores, and psychological symptoms. Age, sex, BMI, pain severity, and pain duration did not influence the CSI score. underwent hysterectomy. Narcotics was the most used phar-macologic therapy (24.7%) and twice as common as the neuromodulator use (12%). All P values 5 , 0.0001. Conclusions: This study confirms the increased prevalence of COPCs in patients with CPP. CPP health care utilization is significantly greater, including high-cost settings such as ED use. While interventional therapies and neuromodulators were used by this cohort, narcotics continued to be the most used pharmacotherapy. patients able to experience vulvar pleasure since their pelvic pain began scored highest on the total FSFI score (mean: 16.26%, 89.1% below cutoff), as well as on 5 domains of the FSFI, compared with patients who had never experienced vulvar pleasure (mean: 13.7%, 84.6% below cutoff) and with patients who had not experienced vulvar pleasure since their pelvic pain began (mean: 7.79%,100%belowcutoff;thisgroupscoredhighestonthe € œ pain € domain). There were significant differences among the 3 groups in total FSFI score and all FSFI domains except desire. Conclusions: This novel study focuses on the intersections among chronic genitopelvic pain, vulvar pleasure, and sexual functioning, introducing the importance of incorporating vulvar pleasure in genitopelvic pain treatment approaches. the polypropylene of chronic pelvic pain in patients who undergone mesh implantation have been reported to be as high as 40%. There an increased interest in the use of botulinum toxin for the treatment of pain and pelvic floor dysfunction. Here, we report the results of the injection of local anesthetic and botulinum toxin(BONT-A)forthetreatmentofchronicmesh-inducedpelvicpain. Eleven patients mesh-induced pelvic pain were the study. Patients underwent examination and were asked to fill in the Pelvic Pain Assessment Form (PPAF). Patients then underwent injection of a mixture of 0.75% levobupivacaine and BONT-A into several points along the course of the bulbospongiosus muscle. Patients were once again asked to fill in the PPAF and were examined at 1, 3, and 6 months postprocedure. Results: At baseline, most of the patients reported dyspareunia and painscoresof 8 to 10/10. After the procedure, 10 of the patients had . 50% pain relief, with 8 patients reporting . 70% relief. bulbospongiosus muscle a of and a therapeutic for the of chronic mesh-induced 5 –1.7, D 5 0.6; and overall pelvic pain 6.5 (SD 6 2.3) to 4.5 (SD 6 2.5), MCID 5 2 2, D 5 0.8. Conclusions: In this cohort of women with vulvodynia, clinically meaningful improvements in vulvar pain, dyspareunia, and overall pelvic pain were noted after 9 TV-PBMT treatments. This is a small uncontrolled study, and additional research is needed to confirm these findings. endometriosis by laparoscopy and assessed by transabdominal and transvaginal ultrasounds at Rutgers. The normal g
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来源期刊
Pain Reports
Pain Reports Medicine-Anesthesiology and Pain Medicine
CiteScore
7.50
自引率
2.10%
发文量
93
审稿时长
8 weeks
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