Abstracts from the International Pelvic Pain Society Annual Scientific Meeting on Pelvic Pain 2021

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