Chronic Pelvic Pain in Women: A Retrospective Analysis at a Tertiary Care Centre in Bihar

Introduction: Chronic pelvic pain (CPP) is common amongwomen of reproductive age group. Prevalence of chronicpelvic pain vary widely depending on the definition usedand range from 2% to 27% of adult females worldwide.Theobjective of this study was to know the ‘period prevalence ‘ ofCPP from December 15th 2018 to May 15 th 2019 along with asecondary aim to identify the associated risk factors.Material and methods: The retrospective study was carriedout in the department of Obstetrics and Gynaecology,at atertiary care teaching hospital. The study period was for sixmonths (Dec ’18-May’19).Results: The prevalence of chronic pelvic pain was 25%(n=1413) in women > 18 years with a maximum prevalenceof 34% (n=484) in women of 30-39 years age group. Thirtyseven percent(n=530) were associated with irritable bowelsyndrome; Psychosocial factors were seen in 35% cases;31%(n=438) suffered from constipation; 30% had associatedurinary symptoms; 0.2% (n=4) had varicose veins in innerthigh and vulval region, 9% (n=127) had chronic PID.3% hadsuspected nerve entrapment and another 3% had adhesions.Eight percent had pain related to musuloskeletal system.6%(n= 84) with no other associated symptom had usg finding ofendometriosis.Conclusion: The prevalence appears to be high (25%) in ourpart of the country. Owing to its multifactorial aetiology, thegynaecologists should develop the habit of looking beyond theuterus.

Lombalgia gestacional: prevalência e incapacidade em gestantes atendidas na rede pública de saúde no município de Juína/MT / Gestational low back pain: prevalence and disability in pregnant women served in the public health network in the municipality of Juína/MT

Introdução: A lombalgia é comum durante a gestação e afeta a realização das atividades de vida diária. Objetivos: Verificar a prevalência de lombalgia, descrever principais características, identificar incapacidades e fatores a ela associados em gestantes atendidas na rede pública de saúde no município de Juína/MT. Material e métodos: Realizou-se um estudo observacional transversal analítico com gestantes que aguardavam pela consulta de pré-natal, em seis unidades básicas de saúde. Aplicou-se um questionário para registros sociodemográficos, clínicos e relacionados à lombalgia; Escala Visual Analógica de dor (EVA) e Questionário de Incapacidade de Oswestry (QIO). Resultados: Participaram do estudo 105 gestantes, com idade entre 18 e 37 anos, 55,2% estavam no 2º trimestre e 44,8% no 3º trimestre gestacional. Foi relatada lombalgia em 78,1% das gestantes. Foi verificada pela EVA, intensidade dolorosa de 4,73 ± 2,61 pontos. Pelo QIO, a maioria (54,9%) apresentou incapacidade lombar mínima e nenhuma apresentou incapacidade total. Conclusão: Verificou-se alta prevalência de lombalgia, porém as incapacidades foram consideradas mínimas. Muitas gestantes eram jovens, donas de casas, que necessitavam de mais conhecimento e auxílio da rede pública de saúde para prevenção e alívio da lombalgia.

Introduction: Low back pain is common during gestation and affects the performance of daily living activities. Objectives: To verify the prevalence of low back pain, to describe the main characteristics, to identify disabilities and associated factors in pregnant women attending the public health network in the city of Juína/MT. Methods: An analytic cross-sectional observational study was carried out with pregnant women awaiting the prenatal visit in six basic health units. A questionnaire was applied to sociodemographic, clinical and lumbar related records; visual analog pain scale (EVA) and Oswestry Disability Questionnaire (ODQ). Results: 105 women were enrolled in the survey, aged between 18 and 37 years, 55.2% were in the second trimester and 44.8% were in the third trimester. Lumbar pain was reported in 78.1% of pregnants. It was verified by the EVA, pain intensity of 4.73 ± 2.61 points. From the QIO, the majority (54.9%) presented minimal lumbar incapacity and none presented total disability. Conclusion: There was a high prevalence of low back pain, but the disabilities were considered minimal. Many pregnant were young, housewives, who need more knowledge and help from the public health network for the prevention and relief of low back pain.

Prevalência e características de dor em pacientes internados em hospital português / Pain prevalence and characteristics in patients admitted to a Portuguese hospital

JUSTIFICATIVA E OBJETIVOS: Os estudos de prevalência da dor apontam, sistematicamente, para valores elevados. Embora não comparáveis, a análise global permite inferir que em cada dois pacientes internados, um tem dor. Este estudo teve como principais objetivos determinar a prevalência da dor, suas características, tratamento analgésico e satisfação de usuários internados num hospital da Zona Centro de Portugal face à avaliação e tratamento da dor. MÉTODOS: Estudo transversal e observacional realizado com 141 pacientes, internados há pelo menos 24 horas, em unidades cirúrgicas e médicas (excluídos os não comunicantes), com idade média de 69 anos, de ambos os gêneros, a quem foi realizada uma entrevista após o cumprimento dos respetivos procedimentos formais e éticos. RESULTADOS: Obteve-se prevalência de dor nas 24 horas anteriores ao estudo de 52,5% (28,8% dor intensa). Na altura da entrevista, a prevalência diminuiu para 41,1% (2,7% de dor intensa). Os pacientes com mais dor estavam internados nos serviços cirúrgicos e o tipo de dor era sobretudo musculoesquelética. A maioria dos pacientes com dor esperou, no máximo, 10 minutos para lhe ser administrado um analgésico. Dos 57 que referiram dor no momento da coleta dos dados, 46 (80,7%) não desejaram outro fármaco e 91,3% mostraram-se satisfeitos com o seu tratamento. CONCLUSÃO: Nessa instituição houve prevalência e abordagem da dor semelhantes às da literatura, mas a dor ainda se encontra subtratada. Esses dados permitirão a definição e implementação de um programa de controle de dor mais dirigida e eficaz.

BACKGROUND AND OBJECTIVES: Studies on pain prevalence systematically point to high values. Although not comparable, a global analysis allows inferring that from every two hospitalized patients, one is in pain. This study aimed at determining pain prevalence, its characteristics, analgesic treatment and satisfaction of patients admitted to a hospital in the Center of Portugal with regard to pain evaluation and treatment. METHODS: This is a transversal and observational study with 141 patients admitted for at least 24 hours to surgical and medical units (excluded those unable to communicate), with mean age of 69 years, of both genders, who were interviewed after compliance with respective formal and ethic procedures. RESULTS: Pain prevalence in the 24 hours previous to the study was 52.5% (28.8% severe pain). During interviews, prevalence has decreased to 41.1% (2.7% severe pain). Patients with more severe pain were admitted to surgical services and pain was primarily musculoskeletal. Most patients with pain have waited no more than ten minutes before analgesics were administered. From 57 patients referring pain during data collection, 46 (80.7%) did not require a different drug and 91.3% were happy with their treatment. CONCLUSION: In this institution, there has been pain prevalence and approach similar to the literature, but pain remains undertreated. Such data shall allow the definition and implementation of a more focused and effective pain control program.

Avaliação de dor e do perfil epidemiológico, de pacientes atendidos no pronto-socorro de um hospital universitário / Pain and epidemiologic evaluation of patients seen by the first aid unit of a teaching hospital

JUSTIFICATIVA E OBJETIVOS: Dor é um dos principais motivos de procura por pronto-atendimento. No entanto, nem sempre é bem avaliada, documentada e tratada. O objetivo deste estudo foi descrever o perfil epidemiológico, caracterização da dor, tratamento analgésico instituído e satisfação de pacientes atendidos no pronto-socorro (PS) de um Hospital Universitário (HC). MÉTODO: Estudo prospectivo, transversal, realizado com 309 pacientes atendidos no PS/HC da Universidade Federal do Triângulo Mineiro (UFTM). As informações foram coletadas a partir de instrumento contendo identificação, dados sócio-demográficos, avaliação de dor pela escala numérica de dor (END), prescrição de analgésicos, satisfação com a analgesia. RESULTADOS: Houve predomínio do sexo masculino, cor branca e com ensino fundamental. Média de idade 46,7 anos. Desempregados: 10% e 15% aposentados. Prevalência de dor 45,6%. Principais causas: traumatismos, dor abdominal, cefaleia, picada por animais peçonhentos, vasculopatias. Cerca de 5% dos pacientes foram atendidos com menos de 1h de dor e 40% com mais de 72h. A localização mais comum foi abdômen (25,2%) e membros inferiores (MMII) (23,4%). A dor foi intensa em dois terços dos pacientes, com intensidade média na admissão de 7,8 ± 2,1 pela END. Tempo de melhora após analgesia: menor que 30 minutos para 25% dos pacientes. Em 17,7% dos casos de dor, não houve prescrição analgésica. O analgésico mais prescrito foi a dipirona, com ou sem associação. Apenas 30% tiveram resolução da dor. Apesar destes dados, metade dos pacientes, disseram-se satisfeitos com a analgesia. CONCLUSÃO: A dor foi altamente prevalente no pronto-atendimento, pouco valorizada, mal avaliada e subtratada, com baixa resolutividade e prescrição inadequada de analgésicos.

BACKGROUND AND OBJECTIVES: Pain is s major reason for seeking emergency care. However it is not always accurately evaluated, documented and managed. This study aimed at describing the epidemiologic profile, the characterization of pain, the analgesic treatment instituted and the satisfaction of patients seen by the first aid unit (FA) of a Teaching Hospital (TH). METHOD: This is a prospective transversal study carried out with 309 patients seen by the FA/TH of the Federal University, Triângulo Mineiro (UFTM). Information was collected as from a tool with identification, socio-demographic data, pain evaluation by the pain numerical scale (PNS), analgesics prescription and satisfaction with analgesia. RESULTS: There has been predominance of Caucasian males with basic education. Mean age was 46.7 years. Unemployed were 10% and retired 15%. Pain prevalence was 45.6%. Major causes: traumas, abdominal pain, headache, bites by venomous animals and vasculopathies. Approximately 5% of patients were seen with less than 1 hour of pain and 40% with more than 72 hours. Most common sites were abdomen (25.2%) and lower limbs (MMII) (23.4%). Pain was severe in two thirds of patients, with mean intensity at admission of 7.8 ± 2.1 by PNS. Improvement time after analgesia: less than 30 minutes for 25% of patients. There has been no analgesic prescription for 17.7% of cases. Most prescribed analgesic was dipirone, with or without association. Only 30% had pain resolution. In spite of these data, half the patients reported being happy with analgesia. CONCLUSION: Pain was highly prevalent during first aid visits, was poorly valued and undertreated, with low resolution rate and inadequate analgesics prescription.

Dolor pélvico crónico en mujeres: una revisión sistemática de estudios de la prevalencia poblacional 2004-2009 / A systematic review of population prevalence studies regarding chronic pelvic pain in females, 2004-2009

Introducción: el dolor pélvico crónico (DPC) es un síndrome de alta prevalencia en mujeres de la población general y una de las causas más frecuentes de consulta a los servicios de salud. Sin embargo, no hay disponibles revisiones sistemáticas recientes de la prevalencia de DPC en la comunidad general en los últimos cinco años. Objetivo: conocer la prevalencia de DPC en mujeres de la población general en estudios publicados entre enero de 2005 y diciembre de 2009. Materiales y métodos: se realizó una revisión sistemática de artículos que informaron la prevalencia de DPC en mujeres adultas de la población general. Se incluyeron artículos que se publicaron en español, inglés o portugués, entre enero de 2005 y diciembre de 2009. Se excluyeron las revisiones sistemáticas. Se realizó la búsqueda en BIREME, EBSCO, IMBIOMED, LILACS, MEDLINE, Ovid y ProQuest. Los Descriptores en Ciencias de la Salud que se usaron fueron: dolor pélvico (crónico) ("chronic pelvic pain"; "dor pélvica"), mujeres ("women"o "female"; "mulheres"), adulto ("adult"; "adulto"), epidemiología ("epidemiology"; "epidemiologia") y prevalencia ("prevalence"; "prevalência"). Se realizó un análisis cualitativo de los datos. Resultados: se encontraron 79 títulos de los cuales se incluyeron cuatro estudios de algunas comunidades de Australia, Estados Unidos, Austria y Nueva Zelanda que encontraron prevalencias de DPC entre 5,7 y 26,5%. Conclusiones: la prevalencia de DPC es variable en mujeres. Se necesitan más estudios en población general, en países desarrollados y en vía de desarrollo.

Introduction: chronic pelvic pain (CPP) is a syndrome having high prevalence in females in the general population and is one of the most frequent causes for them to consult health services. However, there have been no recent systematic reviews of CPP prevalence in the general community during the last five years. Objective: ascertaining CPP prevalence in females in the general population in studies published between January 2005 and December 2009. Materials and methods: a systematic review was made of articles reporting CPP prevalence in adult females in the general population. Articles were included which had been published in Spanish, English or Portuguese between January 2005 and December 2009. Systematic reviews were excluded. The search was carried out in BIREME, EBSCO, IMBIOMED, LILACS, MEDLINE, Ovid and ProQuest.The Health Sciences Descriptors used were: dolor pélvico (crónico) ("chronic pelvic pain"; "dor pélvica"), mujeres ("women" o "female"; "mulheres"), adulto ("adult"; "adulto"), epidemiología ("epidemiology"; "epidemiologia") and prevalencia ("prevalence"; "prevalência"). A qualitative analysis was made of the data. Results: 79 titles were found, of which 4 studies were included which dealt with some communities in Australia, the USA, Austria and New Zealand which found 5.7% to 26.5% CPP prevalence. Conclusions: CPP prevalence is variable in females. More studies should be carried out in the general population in both developed and developing countries.