ABSTRACT
BACKGROUND: Myofascial pain syndrome of the pelvic floor (MPSPF) is a common disease in the context of chronic pelvic pain (CPP); however, there is currently no gold-standard test to diagnose it. OBJECTIVE: To validate the turns-amplitude analysis (TAA) as a diagnostic test for MPSPF in patients with CPP. METHODS: A case-control study was performed, and patients were consecutively sampled within a specified period of time. A total of 128 patients were included: 64 patients with CPP (32 men and 32 women) and 64 control patients (32 men and 32 women). The same operator conducted all tests. Electromyography of the TAA is based on the collection of motor unit potentials that measure the number of changes in the signal and the mean amplitude of the changes. The electromyogram transfers the data to a graphical point cloud, which enables the patient's results to be compared with the results of the healthy subjects. RESULTS: In patients and control subjects, the sensitivity and specificity of the proposed diagnostic test showed a marked clinical significance: the sensitivity was 83%, and the specificity was 100%. A positive predictive value of 1 (95% CI 1 to 1) and a negative predictive value of 0.85 (95% CI 0.77 to 0.93) were observed. CONCLUSION: TAA is a reliable diagnostic test to detect MPSPF. Further studies are needed to reproduce these results.
Subject(s)
Chronic Pain/diagnosis , Electromyography/methods , Myofascial Pain Syndromes/diagnosis , Pain Measurement/methods , Pelvic Pain/diagnosis , Adult , Case-Control Studies , Chronic Pain/epidemiology , Chronic Pain/physiopathology , Female , Humans , Male , Middle Aged , Myofascial Pain Syndromes/epidemiology , Myofascial Pain Syndromes/physiopathology , Pelvic Pain/epidemiology , Pelvic Pain/physiopathologyABSTRACT
OBJECTIVES: The aim of this paper is to analyze the clinical profile of patients with chronic pelvic pain (CPP) to obtain a more accurate and fast clinical diagnosis. METHODS: In this retrospective and descriptive cross-sectional study, we recruited 64 patients with CPP (32 men and 32 women. Patients had confirmed diagnosis of CPP. History was done including past medical history, prior abdominal and pelvic surgery, practice of risk sports, start and evolution of the pain, and number of physicians visited. We evaluated pain intensity with a VAS scale, neuropathic characteristics of the pain with the DN4 questionnaire, anxiety and depression with the HAD Scale (HADS) and disability with the Oswestry Disability Index (ODI ). Pelvic floor evaluation integrated intrapelvic and extrapelvic muscles assessment. RESULTS: Average number of doctors visited was 6.4 for men and 10 for women. The VAS for men was 5.43 (± 2.29), for women 6.89 (± 1.89). The DN4 for men was 4.53 (± 2.2), for women 4.44 (± 2.2). The mean anxiety in men was 10.18 (±4.27) and for women 9 (± 4.6) and mean depression in men was 7.31 (± 4.88) and for women 7.16 (± 4). ODI for men was 26.7% (±2.2), for women 33.75% (± 2.2). CONCLUSION: We have defined a clinical profile of patients with CPP that can enable a better approach to the reality of these patients with diminished quality of life.
Subject(s)
Chronic Pain , Pelvic Pain , Quality of Life , Chronic Pain/diagnosis , Chronic Pain/etiology , Cross-Sectional Studies , Female , Humans , Male , Pain Measurement , Pelvic Pain/diagnosis , Pelvic Pain/etiology , Retrospective StudiesABSTRACT
OBJETIVO: Definir el perfil clínico de los pacientes con dolor pélvico crónico (DPC). MÉTODOS: Estudio trasversal retrospectivo y descriptivo. Se reclutaron 64 pacientes con DPC (32 hombres y 32 mujeres). A los pacientes se les confirmó el diagnóstico de DPC. Se exploraron músculos intrapélvicos y extrapélvicos. Fueron historiados sobre sus antecedentes personales, cirugía abdomino-pélvica, práctica de deportes de riesgo, inicio del dolor, y sus localizaciones más frecuentes, y número de médicos visitados. Se valoraron la intensidad del dolor con la EVA, las características neuropáticas con el cuestionario DN4, la ansiedad y depresión con la Escala HAD (EHAD) y la discapacidad con el Índice de discapacidad de Oswestry (IDO). RESULTADOS: Los hombres visitaron 6,4 médicos de media por 10 las mujeres. La EVA para los hombres fue 5,43 (± 2,29), para las mujeres 6,89 (± 1,89). El DN4 para los hombres fue 4,53 (± 2,2), para las mujeres 4,44 (± 2,2). La media de la ansiedad en los hombres fue de un 10,18 (± 4,27) y para las mujeres fue de un 9 (± 4,6).La media de la depresión en los hombres fue de un 7,31 (± 4,88) y para las mujeres fue de un 7,16 (± 4).El IDO para los hombres fue de un 26,7 % (± 2,2), para las mujeres 33,75 % (± 2,2). CONCLUSIÓN: Se ha definido un perfil clínico de los pacientes con DPC que puede permitir un mejor acercamiento a la realidad de estos pacientes con una mermada calidad de vida
OBJECTIVES: The aim of this paper is to analyze the clinical profile of patients with chronic pelvic pain (CPP) to obtain a more accurate and fast clinical diagnosis. METHODS: In this retrospective and descriptive cross-sectional study, we recruited 64 patients with CPP (men and 32 women). Patients had confirmed diagnosis of CPP. History was done including past medical history, prior abdominal and pelvic surgery, practice of risk sports, start and evolution of the pain, and number of physicians visited. We evaluated pain intensity with a VAS scale, neuropathic characteristics of the pain with the DN4 questionnaire, anxiety and depression with the HAD Scale (HADS) and disability with the Oswestry Disability Index (ODI). Pelvic floor evaluation integrated intrapelvic and extrapelvic muscles assessment. RESULTS: Average number of doctors visited was 6.4 for men and10 for women. The VAS for men was 5.43 (± 2.29), for women 6.89 (± 1.89). The DN4 for men was 4.53 (± 2.2), for women 4.44 (± 2.2). The mean anxiety in men was 10.18 (± 4.27) and for women 9 (± 4.6); and mean depression in men was 7.31 (± 4.88) and for women 7.16 (± 4). ODI for men was 26.7% (± 2.2), for women 33.75% (± 2.2). CONCLUSION: We have defined a clinical profile of patients with CPP that can enable a better approach to the reality of these patients with diminished quality of life
Subject(s)
Humans , Male , Female , Health Profile , Pelvic Pain/epidemiology , Pelvic Pain/prevention & control , Depression/diagnosis , Pelvic Pain/physiopathology , Quality of Life , Pelvic Pain/complications , Pelvic Pain/diagnosis , Cross-Sectional Studies/methods , Retrospective Studies , Pain Management , Pain Measurement/methods , Pain Measurement , Acute Pain/therapy , Anxiety/complications , Depression/complicationsABSTRACT
OBJECTIVES: Chronic pelvic pain syndrome (CPPS) is a poorly understood and ill-treated condition. It is accompanied by the shortening and increase in tone of the pelvic floor muscles and is closely related to myofascial pain syndrome (MPS). This study aims to evaluate the utility of an anal stretching device (ASD) for improving the pain manifestations of chronic prostatitis (CP) and CPPS. METHODS: Thirty-one men(38.6 years ± 8.2) were consecutively recruited with an average monitoring period of 14.4 months (± 8.2). The treatment duration was between six months and three years. A clinical history was compiled along with a physical examination and neurophysiological tests. To evaluate pain, the Visual Analogue Scale (VAS) was used before and after treatment; at the final visit, the Clinical Global Impression of Improvement scale (CGI-I) was administered. The ASD is a device that is commercially available in different diameters and lengths. RESULT: Patients were diagnosed with MPS using neurophysiological tests. Significant differences were found before and after the treatment when evaluating the intensity of the pain using the VAS (6.1±2.1 vs. 1.9±1.3; p < .001). The CGI-I showed a total of 21 patients (70%) whose symptoms were improved or very much improved. Only one patient was worse after the treatment. CONCLUSIONS: ASD appears to be a safe and useful tool to treat the pain manifestations of CPPS without notable side effects.
Subject(s)
Anal Canal/anatomy & histology , Pelvic Pain/therapy , Prostatitis/therapy , Aged , Chronic Disease , Dilatation , Equipment and Supplies , Female , Humans , Male , Middle Aged , Pain Measurement , Patient Positioning , Treatment OutcomeABSTRACT
OBJETIVO: El síndrome de dolor pélvico crónico (SDPC) es una entidad pobremente definida, entendida y tratada, siempre va acompañada de un acortamiento y un aumento del tono de los músculos del suelo pélvico y está estrechamente relacionada con el síndrome de dolor miofascial (SDM). Este estudio trata de valorar si el dispositivo anal (DAE) para estiramientos es útil para mejorar el dolor en la prostatitis crónica/SDPC. MÉTODOS: 31 hombres (38,6 años ± 8,2) se reclutaron de forma consecutiva y con un seguimiento medio de 14, 4 meses (± 8,2). La duración del tratamiento fue entre seis meses y tres años. Se realizó historia clínica, examen físico y tests neurofisiológicos. En la evaluación del dolor se utilizó la escala visual analógica antes y después del tratamiento y en la última visita se completo con la escala de impresión de mejoría global del paciente (CGI-I). El DAE es un dispositivo disponible en el mercado en diferentes anchos y longitudes. RESULTADO: los pacientes fueron diagnosticados de SDM después de realizarles los tests neurofisiológicos. Se encontraron diferencias significativas antes y después con la EVA al evaluar la intensidad del dolor (6, 1±2.1 vs. 1, 9±1.3; p < 0.001) y el CGI-I mostró un total de 21 pacientes (70%) estar mucho mejor o muchísimo mejor. Solo un paciente empeoro durante el tratamiento. CONCLUSIONES: El DAE perece una herramienta segura y útil para mejorar el dolor del SDPC, sin efectos secundarios reseñables(AU)
OBJECTIVES: Chronic pelvic pain syndrome (CPPS) is a poorly understood and ill-treated condition. It is accompanied by the shortening and increase in tone of the pelvic floor muscles and is closely related to myofascial pain syndrome (MPS). This study aims to evaluate the utility of an anal stretching device (ASD) for improving the pain manifestations of chronic prostatitis (CP) and CPPS. METHODS: Thirty-one men (38.6 years ± 8.2) were consecutively recruited with an average monitoring period of 14.4 months (± 8.2). The treatment duration was between six months and three years. A clinical history was compiled along with a physical examination and neurophysiological tests. To evaluate pain, the Visual Analogue Scale (VAS) was used before and after treatment; at the final visit, the Clinical Global Impression of Improvement scale (CGI-I) was administered. The ASD is a device that is commercially available in different diameters and lengths. RESULT: Patients were diagnosed with MPS using neurophysiological tests. Significant differences were found before and after the treatment when evaluating the intensity of the pain using the VAS (6.1±2.1 vs. 1.9±1.3; p <0 .001). The CGI-I showed a total of 21 patients (70%) whose symptoms were improved or very much improved. Only one patient was worse after the treatment. CONCLUSIONS: ASD appears to be a safe and useful tool to treat the pain manifestations of CPPS without notable side effects(AU)
