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 Clínicas, Federal University of Goiás. 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...
JUSTIFICATIVA E OBJETIVOS: A dor pélvica crônica é prevalente, apresenta tratamento difícil e tem sido pouco investigada. O objetivo deste estudo foi analisar 230 pacientes do ambulatório de dor pélvica crônica do Hospital das Clínicas da Universidade Federal de Goiás. MÉTODOS: Estudo de corte transversal e de intervenção realizado entre 2007 e 2011. RESULTADOS: A média de idade das mulheres foi de 38,3±10,0 anos. A maioria das mulheres era parda, casada/amasiada, cursou ensino fundamental, dependente financeiramente, tinha renda de até cinco salários mínimos, índice de massa corpórea normal, até três filhos e atividade sexual ativa. Aborto ocorreu em 30%, abuso físico em 15,8% e abuso sexual em 11%. A maioria sofreu cirurgia prévia e possuía função intestinal e urinária normais. A dor permanecia por mais de 16 dias/mês, piorava no período perimenstrual e começou, em média, 6,7 anos antes. Em mais de 70% dos casos foi percebido um evento coincidente com o início da dor, sendo conflitos e/ou traumas os mais citados. Os exames físico e ultrassonográfico foram normais na grande maioria dessas mulheres. Aderências e/ou endometriose foram encontrados em quase 2/3 das 41 laparoscopias realizadas. Houve redução média de 39,2% da escala de dor (3,1/7,9) com as várias condutas adotadas (farmacológica, laparoscópica e psicoterápica) p<0,001. História de abuso sexual e de aborto provocado associou-se a menor redução da dor. CONCLUSÃO: Este estudo acrescenta informações epidemiológicas e clínicas sobre mulheres com dor pélvica crônica no Brasil. O tratamento clínico e psicoterápico promoveu redução significativa da escala de dor entre a primeira e a última...
Subject(s)
Humans , Epidemiology , Pelvic Pain , Psychotherapy , Signs and Symptoms , TherapeuticsABSTRACT
Objective: To investigate the prevalence of chronic symptoms among patients who underwent breast cancer treatment, and to determine the factors that might be related to these symptoms. Material and Methods: A questionnaire was applied to 87 patients undergoing breast cancer follow-up. It evaluated the length of time since treatment, therapeutic procedure (type of surgery, chemotherapy, radiotherapy and/or endocrine therapy), use of analgesic medication, location and intensity of pain and presence of paresthesia, fatigue and upper-limb edema. Results: The patients mean age was 54.46 years; the mean interval between locoregional treatment and the interview was 52.95 months. The prevalence of paresthesia symptoms was 65.5 percent; fatigue, 49.4 percent; edema, 31 percent; and pain, 31 percent. From multivariate analysis, we observed that fatigue was influenced by mastectomy (OR = 2.680; 95 percent CI = 1.127 - 6.373), radiotherapy (OR = 3.028; 95 percent CI = 1.142 - 8.030) and chemotherapy (OR = 5.271; 95 percent CI = 1.067 - 26.034), and was lower among patients who underwent endocrine therapy (OR = 0.407; 95 percent CI = 0.171 - 0.967). Paresthesia, edema and pain were not influenced by any of the therapeutic types. Conclusions: There was high prevalence of complaints among the patients who had undergone breast cancer treatment. Fatigue was the only symptom influenced by the different treatments.