Pub Date : 2023-03-01DOI: 10.1177/22840265231161129
Aida Lopez-Brull, Borja Pérez-Domínguez, Maria Plaza-Carrasco, J. Casaña
Objective: The aim of this study was to analyze the characteristics, availability, quality and reliability of the information found in educational videos about dyspareunia. Methods: A systematic search was carried out on YouTube searching for educational videos about dyspareunia. Video quality scores were assessed with the DISCERN instrument, Global Quality Scale (GQS) and QUEST tool. Video popularity was evaluated with the Video Power Index (VPI). Interobserver agreement and statistical correlations of the assessment scores were also carried out. Results: The first 150 videos that appeared were selected. The mean number of views was 35,513.1 views (SD 71,443.9), the mean video length was 05:39 (SD 04:38), the mean days online was 1,396.3 days (SD 706), the mean view ratio was 29.8 (SD 68.1), the mean Like count was 333 likes (SD 1000.6), the mean Dislike count was 13 dislikes (SD 25.3) and the mean VPI Index was 92.1% (SD 16.4%). The mean values for the DISCERN instrument were for Observer-1 40.9 points (SD 9.9) and for Observer-2 39.3 points (SD 8.5). Mean values for the GQS score were for Observer-1 3.1 points (SD 0.9) and for Observer-2 3.0 points (SD 0.8). Finally, mean values for the QUEST tool were for Observer-1 13.3 points (SD 4.1) and for Observer-2 13.1 points (SD 4.2). Conclusions: The quality of the videos found on YouTube about dyspareunia, according to DISCERN, GQS, and QUEST scores, are average. Videos with high quality scores were produced by Academic Institutions, despite having lower frequency visit rates.
{"title":"Educational videos about dyspareunia and the assessment of their quality and reliability: An observational study","authors":"Aida Lopez-Brull, Borja Pérez-Domínguez, Maria Plaza-Carrasco, J. Casaña","doi":"10.1177/22840265231161129","DOIUrl":"https://doi.org/10.1177/22840265231161129","url":null,"abstract":"Objective: The aim of this study was to analyze the characteristics, availability, quality and reliability of the information found in educational videos about dyspareunia. Methods: A systematic search was carried out on YouTube searching for educational videos about dyspareunia. Video quality scores were assessed with the DISCERN instrument, Global Quality Scale (GQS) and QUEST tool. Video popularity was evaluated with the Video Power Index (VPI). Interobserver agreement and statistical correlations of the assessment scores were also carried out. Results: The first 150 videos that appeared were selected. The mean number of views was 35,513.1 views (SD 71,443.9), the mean video length was 05:39 (SD 04:38), the mean days online was 1,396.3 days (SD 706), the mean view ratio was 29.8 (SD 68.1), the mean Like count was 333 likes (SD 1000.6), the mean Dislike count was 13 dislikes (SD 25.3) and the mean VPI Index was 92.1% (SD 16.4%). The mean values for the DISCERN instrument were for Observer-1 40.9 points (SD 9.9) and for Observer-2 39.3 points (SD 8.5). Mean values for the GQS score were for Observer-1 3.1 points (SD 0.9) and for Observer-2 3.0 points (SD 0.8). Finally, mean values for the QUEST tool were for Observer-1 13.3 points (SD 4.1) and for Observer-2 13.1 points (SD 4.2). Conclusions: The quality of the videos found on YouTube about dyspareunia, according to DISCERN, GQS, and QUEST scores, are average. Videos with high quality scores were produced by Academic Institutions, despite having lower frequency visit rates.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"3 - 11"},"PeriodicalIF":0.5,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43097321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/22840265231159704
Linda Li, K. Lou, A. Chu, Emily O'Brien, Andrea Molina, K. Riley
In the setting of a global pandemic, it is vastly important now more than ever that patients have agency and control over pain management when living with a debilitating chronic pain disease such as endometriosis. We present a review of the available literature on the most popular and easily accessible complementary pain management therapies for endometriosis including Transcutaneous Electrical Nerve stimulator (TENS) units, diets, Cannabidiol (CBD), turmeric, meditation, yoga, and acupuncture. These are worthwhile recommendations; however, the data for each is limited and more research is needed to further support each of its use.
{"title":"Complementary therapy for endometriosis related pelvic pain","authors":"Linda Li, K. Lou, A. Chu, Emily O'Brien, Andrea Molina, K. Riley","doi":"10.1177/22840265231159704","DOIUrl":"https://doi.org/10.1177/22840265231159704","url":null,"abstract":"In the setting of a global pandemic, it is vastly important now more than ever that patients have agency and control over pain management when living with a debilitating chronic pain disease such as endometriosis. We present a review of the available literature on the most popular and easily accessible complementary pain management therapies for endometriosis including Transcutaneous Electrical Nerve stimulator (TENS) units, diets, Cannabidiol (CBD), turmeric, meditation, yoga, and acupuncture. These are worthwhile recommendations; however, the data for each is limited and more research is needed to further support each of its use.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"34 - 43"},"PeriodicalIF":0.5,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47531297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/22840265231158416
Abi Begho, F. Waterman
Background: Our study aimed to understand the illness experience of women living in St Kitts and Nevis who have been affected by fibroids by utilising Leventhal’s commonsense model of illness. Methods: Upon receiving ethics approval, females aged between 18 and 55 who were currently a resident in St Kitts and Nevis and who had an experience with fibroids within the last 5 years were recruited to consent and complete 1-hour interviews during which they described the different ways in which fibroids affects them. Results: The interview guide incorporated the common-sense model; all interviews were 1:1 and a thematic analysis was conducted. The final sample consisted of 11 women, 10 from St Kitts and 1 from Nevis. Their ages ranged from 23 to 49, and the average age of participants was 39 years. Participants described their fibroids in generally negative terms and noted several physical, emotional, social and professional consequences as a result of their fibroid symptoms. Conclusions: Our study revealed the need for a clear strategy for managing patients with symptomatic fibroids—a strategy that includes regular monitoring of patients, good communication between doctor and patient and clear guidance on management for patients.
{"title":"A significant burden: A qualitative exploration of the experience of women living with fibroids in St. Kitts and Nevis","authors":"Abi Begho, F. Waterman","doi":"10.1177/22840265231158416","DOIUrl":"https://doi.org/10.1177/22840265231158416","url":null,"abstract":"Background: Our study aimed to understand the illness experience of women living in St Kitts and Nevis who have been affected by fibroids by utilising Leventhal’s commonsense model of illness. Methods: Upon receiving ethics approval, females aged between 18 and 55 who were currently a resident in St Kitts and Nevis and who had an experience with fibroids within the last 5 years were recruited to consent and complete 1-hour interviews during which they described the different ways in which fibroids affects them. Results: The interview guide incorporated the common-sense model; all interviews were 1:1 and a thematic analysis was conducted. The final sample consisted of 11 women, 10 from St Kitts and 1 from Nevis. Their ages ranged from 23 to 49, and the average age of participants was 39 years. Participants described their fibroids in generally negative terms and noted several physical, emotional, social and professional consequences as a result of their fibroid symptoms. Conclusions: Our study revealed the need for a clear strategy for managing patients with symptomatic fibroids—a strategy that includes regular monitoring of patients, good communication between doctor and patient and clear guidance on management for patients.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"18 - 26"},"PeriodicalIF":0.5,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48890732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-01DOI: 10.1177/22840265231156036
Helen C McNamara, K. A. Michalak, Claudia Cheng
Endometriosis is a common benign gynaecological disorder, which has an increased prevalence amongst twins and first degree relatives of affected individuals. Here we describe a case of remarkable resemblance in the distribution of deep infiltrating endometriosis related to the bowel in a monozygotic twin pair. We provide a literature review of studies of endometriosis in twins. We propose that genetic factors influence the nature and distribution of the disease, while environmental factors may affect the severity.
{"title":"Monozygotic twins with endometriosis in matching locations at time of laparoscopy: A case report","authors":"Helen C McNamara, K. A. Michalak, Claudia Cheng","doi":"10.1177/22840265231156036","DOIUrl":"https://doi.org/10.1177/22840265231156036","url":null,"abstract":"Endometriosis is a common benign gynaecological disorder, which has an increased prevalence amongst twins and first degree relatives of affected individuals. Here we describe a case of remarkable resemblance in the distribution of deep infiltrating endometriosis related to the bowel in a monozygotic twin pair. We provide a literature review of studies of endometriosis in twins. We propose that genetic factors influence the nature and distribution of the disease, while environmental factors may affect the severity.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"44 - 48"},"PeriodicalIF":0.5,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46340359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-02-13DOI: 10.1177/22840265231153518
Rozemarijn de Koning, Gertjan Zwart, A. Dahan, F. Jansen, M. Blikkendaal, A. Twijnstra
Introduction: The pathophysiology of endometriosis-induced pain is complex and current pain management is often inadequate. As a consequence, the quality of life of endometriosis patients is reduced due to persistent and often recurrent severe pain, affecting emotional well-being. Case description: In this case report, we present a 28-year-old patient with deep endometriosis and severe pain resistant to conventional therapy, who experienced, after an 8-h infusion with esketamine, no pain symptoms for 8 weeks. Discussion: Current treatment options to suppress chronic pain symptoms in patients with (deep) endometriosis are often inadequate. Esketamine targets key components of the condition (inflammation, pain, depression), but the use of this drug in the treatment of chronic pain due to endometriosis has not been reported yet. Future trials are necessary to assess the effect of esketamine in the treatment of chronic pain due to endometriosis. Conclusion: This case report highlights the potential of esketamine infusion therapy in the treatment of endometriosis patients with persistent pain despite conventional therapy.
{"title":"Esketamine in the treatment of chronic endometriosis-induced pain: a case report","authors":"Rozemarijn de Koning, Gertjan Zwart, A. Dahan, F. Jansen, M. Blikkendaal, A. Twijnstra","doi":"10.1177/22840265231153518","DOIUrl":"https://doi.org/10.1177/22840265231153518","url":null,"abstract":"Introduction: The pathophysiology of endometriosis-induced pain is complex and current pain management is often inadequate. As a consequence, the quality of life of endometriosis patients is reduced due to persistent and often recurrent severe pain, affecting emotional well-being. Case description: In this case report, we present a 28-year-old patient with deep endometriosis and severe pain resistant to conventional therapy, who experienced, after an 8-h infusion with esketamine, no pain symptoms for 8 weeks. Discussion: Current treatment options to suppress chronic pain symptoms in patients with (deep) endometriosis are often inadequate. Esketamine targets key components of the condition (inflammation, pain, depression), but the use of this drug in the treatment of chronic pain due to endometriosis has not been reported yet. Future trials are necessary to assess the effect of esketamine in the treatment of chronic pain due to endometriosis. Conclusion: This case report highlights the potential of esketamine infusion therapy in the treatment of endometriosis patients with persistent pain despite conventional therapy.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"49 - 52"},"PeriodicalIF":0.5,"publicationDate":"2023-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43856724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-19DOI: 10.1177/22840265221148786
Rachael Bosma, Emeralda Burke, Nida Mustafa, T. Di Renna, Rosemary A Wilson
Background: Chronic pelvic pain (CPP) is a common disorder in women that includes complex interactions between biological, psychological, and social factors. Accessibility to interprofessional, biopsychosocial CPP care remains a challenge for many patients. There is a lack of knowledge regarding the experiences of women using health services for CPP care and the impact of waiting for interprofessional CPP care. This study explores the perceptions and experiences of Canadian women with CPP interacting with the health system while waiting for interprofessional CPP care. Methods: Our qualitative study included women with CPP waiting for interprofessional care in Ontario, Canada. Data were obtained through semi-structured interviews which were transcribed verbatim and analyzed inductively using established methods for thematic analysis. Results: Ten women (median age of 38.5 years, age range 28–57) participated in in-depth semi-structured interviews. Three main themes were identified: (1) feeling adrift in the health system, (2) feeling “On hold,” uncertain, and in need of guidance, and (3) feeling reliant on a system that does not understand. Within these themes, women with CPP describe tangible strategies and recommendations for improving health system navigation and care. Conclusion: Our study highlights the need for improved access to interprofessional CPP programs, enhanced and targeted training for health professionals in CPP management, and better health system navigation support. Specific recommendations were provided from the perspectives of women with CPP and included providing information on what to expect and prepare for their appointment and engaging patients in education resources while they wait.
{"title":"Fractured system, fractured care: The experiences of Canadian women with chronic pelvic pain waiting for interprofessional pain care","authors":"Rachael Bosma, Emeralda Burke, Nida Mustafa, T. Di Renna, Rosemary A Wilson","doi":"10.1177/22840265221148786","DOIUrl":"https://doi.org/10.1177/22840265221148786","url":null,"abstract":"Background: Chronic pelvic pain (CPP) is a common disorder in women that includes complex interactions between biological, psychological, and social factors. Accessibility to interprofessional, biopsychosocial CPP care remains a challenge for many patients. There is a lack of knowledge regarding the experiences of women using health services for CPP care and the impact of waiting for interprofessional CPP care. This study explores the perceptions and experiences of Canadian women with CPP interacting with the health system while waiting for interprofessional CPP care. Methods: Our qualitative study included women with CPP waiting for interprofessional care in Ontario, Canada. Data were obtained through semi-structured interviews which were transcribed verbatim and analyzed inductively using established methods for thematic analysis. Results: Ten women (median age of 38.5 years, age range 28–57) participated in in-depth semi-structured interviews. Three main themes were identified: (1) feeling adrift in the health system, (2) feeling “On hold,” uncertain, and in need of guidance, and (3) feeling reliant on a system that does not understand. Within these themes, women with CPP describe tangible strategies and recommendations for improving health system navigation and care. Conclusion: Our study highlights the need for improved access to interprofessional CPP programs, enhanced and targeted training for health professionals in CPP management, and better health system navigation support. Specific recommendations were provided from the perspectives of women with CPP and included providing information on what to expect and prepare for their appointment and engaging patients in education resources while they wait.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"15 1","pages":"27 - 33"},"PeriodicalIF":0.5,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47659458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/22840265221139909
Laura Falconer, E. Hendricks, D. Harcourt
Aim: To identify and review the success of non-pharmaceutical, non-surgical biopsychosocial interventions in individuals with endometriosis, in managing pain and improving body image. Methods: Cochrane, EBSCO, IBSS, NICE, Open Grey, OVID, Proquest, Scopus and Science Direct were searched in April 2021, using inclusion and exclusion criteria. Data collection and analysis: Five randomised control trials, and one controlled clinical trial resulted from the search. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Studies were synthesised by intervention type, into physical only, and physical and psychological. Results: Across the six papers, 323 participants were recruited, through medical records or self-referral, and treatments largely administered by specialist practitioners. From the EPHPP quality assessment,2 weak quality papers, and four moderate quality papers found improvements to pain, with large effect sizes in four papers. No studies used established body image measures to examine intervention effects on body image, and all lacked health psychology theoretical basis. There were common issues in selection bias, confounders and blinding. Conclusion: Without gold-standard methodology, evidence of effectiveness cannot be concluded. However, there is promising rationale if these issues are addressed.
{"title":"What is the evidence of effectiveness of non-pharmaceutical, non-surgical, biopsychosocial interventions for body image and pain management in individuals with endometriosis? A systematic review","authors":"Laura Falconer, E. Hendricks, D. Harcourt","doi":"10.1177/22840265221139909","DOIUrl":"https://doi.org/10.1177/22840265221139909","url":null,"abstract":"Aim: To identify and review the success of non-pharmaceutical, non-surgical biopsychosocial interventions in individuals with endometriosis, in managing pain and improving body image. Methods: Cochrane, EBSCO, IBSS, NICE, Open Grey, OVID, Proquest, Scopus and Science Direct were searched in April 2021, using inclusion and exclusion criteria. Data collection and analysis: Five randomised control trials, and one controlled clinical trial resulted from the search. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Studies were synthesised by intervention type, into physical only, and physical and psychological. Results: Across the six papers, 323 participants were recruited, through medical records or self-referral, and treatments largely administered by specialist practitioners. From the EPHPP quality assessment,2 weak quality papers, and four moderate quality papers found improvements to pain, with large effect sizes in four papers. No studies used established body image measures to examine intervention effects on body image, and all lacked health psychology theoretical basis. There were common issues in selection bias, confounders and blinding. Conclusion: Without gold-standard methodology, evidence of effectiveness cannot be concluded. However, there is promising rationale if these issues are addressed.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"14 1","pages":"206 - 216"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48937016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/22840265221146479
H. Reddy, G. Dellacerra, F. Malcher, K. Plewniak, M. Arabkhazaeli, A. Sankin, V. Lerner
Background: Excision of multi-compartment deep infiltrating endometriosis with visceral involvement is challenging. We illustrate an interdisciplinary approach to complete minimally invasive excision in a single surgery. Case: We present a case of deep infiltrating endometriosis with visceral involvement in the anterior, middle, and posterior compartments. A collaborative surgical approach was taken with gynecologic, colorectal, and urologic surgeons to perform a robot-assisted total laparoscopic hysterectomy, bilateral salpingectomy, ovarian cystectomy, and unilateral oophorectomy with concurrent segmental resection of rectosigmoid and excision of transmural bladder and vaginal nodules. Conclusion: Thorough preoperative evaluation and an interdisciplinary approach to surgical planning involving radiology, gynecology, colorectal surgery, and urology allowed for complete simultaneous resection of bladder, rectosigmoid, and pelvic deep infiltrating endometriosis without complications via a minimally invasive route.
{"title":"Excision of triple compartment deep infiltrating endometriosis with visceral involvement","authors":"H. Reddy, G. Dellacerra, F. Malcher, K. Plewniak, M. Arabkhazaeli, A. Sankin, V. Lerner","doi":"10.1177/22840265221146479","DOIUrl":"https://doi.org/10.1177/22840265221146479","url":null,"abstract":"Background: Excision of multi-compartment deep infiltrating endometriosis with visceral involvement is challenging. We illustrate an interdisciplinary approach to complete minimally invasive excision in a single surgery. Case: We present a case of deep infiltrating endometriosis with visceral involvement in the anterior, middle, and posterior compartments. A collaborative surgical approach was taken with gynecologic, colorectal, and urologic surgeons to perform a robot-assisted total laparoscopic hysterectomy, bilateral salpingectomy, ovarian cystectomy, and unilateral oophorectomy with concurrent segmental resection of rectosigmoid and excision of transmural bladder and vaginal nodules. Conclusion: Thorough preoperative evaluation and an interdisciplinary approach to surgical planning involving radiology, gynecology, colorectal surgery, and urology allowed for complete simultaneous resection of bladder, rectosigmoid, and pelvic deep infiltrating endometriosis without complications via a minimally invasive route.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"14 1","pages":"217 - 222"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47076111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/22840265221142656
A. Gubbels, M. Linder, T. Baran, Filip Koritysskiy, A. Rahman
Purpose: The aim was to determine the impact of steroid dose on effectiveness of CT-guided pudendal nerve blocks. Secondary aim was to assess predictors for response. Materials and methods: A retrospective cohort study was performed. Two-hundred-and-seventeen patients with pudendal neuralgia were identified. Of these, 189 patients had data on response and 511 pudendal nerve blocks were analyzed. Demographics, social history, initial pain data, treatment data including steroid dosing, and follow-up data were collected. Non-responders to treatment were compared to responders. Results: The majority of patients were female (92.1%) and most common areas of pain involved the vulva/labia/ perineum/vagina (scrotum) (44.2%). Treatment response rates increased with number of blocks with maximum response rate of 92.2% after fourth injection. Responders underwent more blocks within the first year (3.1 ± 1.5 vs 2.6 ± 1.6, p = 0.026). Steroid dose did not have a significant effect on response rate nor did site of injection. Non-responders were more commonly on disability due to pain (p = 0.043). History of childhood/adolescent sexual abuse was more common in non-responders (p=0.046) and was a significant predictor of response (OR = 0.27 [0.08–0.94 95% confidence interval], p = 0.04). Conclusion: Steroid dose does not appear to have an impact on the short-term response rates to CT-guided pudendal nerve blocks in patients with clinically diagnosed pudendal neuralgia and our data may further support the discontinuation of steroids from CT block protocols. Current long-term disability leave status was a predictor of poor response along with history of childhood/adolescent sexual abuse. Adverse childhood events are easily assessed and may represent a clinical predictor of lack of response in this patient population. Clinical relevance: Approaches to managing pudendal neuralgia are varied. Steroid dose may not impact response to pudendal nerve blocks. Current disability status and history of childhood/adolescent sexual abuse may be clinical predictors of poor response to treatment.
目的:目的是确定类固醇剂量对ct引导下阴部神经阻滞效果的影响。次要目的是评估反应的预测因素。材料和方法:进行回顾性队列研究。217例阴部神经痛患者被确认。其中189例患者有反应数据，511例患者进行了阴部神经阻滞分析。收集了人口统计、社会历史、初始疼痛数据、治疗数据(包括类固醇剂量)和随访数据。对治疗无反应者与反应者进行比较。结果:患者以女性居多(92.1%)，最常见的疼痛部位为外阴/阴唇/会阴/阴道(阴囊)(44.2%)。治疗有效率随药物块数的增加而增加，第四次注射后的最高有效率为92.2%。应答者在第一年内经历了更多的阻滞(3.1±1.5 vs 2.6±1.6,p = 0.026)。类固醇剂量对有效率无显著影响，注射部位也无显著影响。无应答者更常因疼痛致残(p = 0.043)。儿童期/青少年性虐待史在无应答者中更为常见(p=0.046)，并且是应答的显著预测因子(OR = 0.27[0.08-0.94 95%置信区间]，p=0.04)。结论:在临床诊断为阴部神经痛的患者中，类固醇剂量似乎对CT引导的阴部神经阻滞的短期反应率没有影响，我们的数据可能进一步支持从CT阻滞方案中停止使用类固醇。目前的长期伤残休假状态是儿童/青少年性虐待史的不良反应的预测因子。儿童期不良事件很容易评估，并且可能代表该患者群体缺乏反应的临床预测因子。临床相关性:治疗阴部神经痛的方法多种多样。类固醇剂量可能不会影响对阴部神经阻滞的反应。目前的残疾状况和儿童期/青少年性虐待史可能是治疗不良反应的临床预测因素。
{"title":"Effect of steroid dose on efficacy of CT-guided pudendal nerve blocks for pudendal neuralgia","authors":"A. Gubbels, M. Linder, T. Baran, Filip Koritysskiy, A. Rahman","doi":"10.1177/22840265221142656","DOIUrl":"https://doi.org/10.1177/22840265221142656","url":null,"abstract":"Purpose: The aim was to determine the impact of steroid dose on effectiveness of CT-guided pudendal nerve blocks. Secondary aim was to assess predictors for response. Materials and methods: A retrospective cohort study was performed. Two-hundred-and-seventeen patients with pudendal neuralgia were identified. Of these, 189 patients had data on response and 511 pudendal nerve blocks were analyzed. Demographics, social history, initial pain data, treatment data including steroid dosing, and follow-up data were collected. Non-responders to treatment were compared to responders. Results: The majority of patients were female (92.1%) and most common areas of pain involved the vulva/labia/ perineum/vagina (scrotum) (44.2%). Treatment response rates increased with number of blocks with maximum response rate of 92.2% after fourth injection. Responders underwent more blocks within the first year (3.1 ± 1.5 vs 2.6 ± 1.6, p = 0.026). Steroid dose did not have a significant effect on response rate nor did site of injection. Non-responders were more commonly on disability due to pain (p = 0.043). History of childhood/adolescent sexual abuse was more common in non-responders (p=0.046) and was a significant predictor of response (OR = 0.27 [0.08–0.94 95% confidence interval], p = 0.04). Conclusion: Steroid dose does not appear to have an impact on the short-term response rates to CT-guided pudendal nerve blocks in patients with clinically diagnosed pudendal neuralgia and our data may further support the discontinuation of steroids from CT block protocols. Current long-term disability leave status was a predictor of poor response along with history of childhood/adolescent sexual abuse. Adverse childhood events are easily assessed and may represent a clinical predictor of lack of response in this patient population. Clinical relevance: Approaches to managing pudendal neuralgia are varied. Steroid dose may not impact response to pudendal nerve blocks. Current disability status and history of childhood/adolescent sexual abuse may be clinical predictors of poor response to treatment.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"14 1","pages":"192 - 198"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45306538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-01DOI: 10.1177/22840265221141527
T. Beaumont, Kate Phillips, M. L. Hull, R. Green
Introduction: This study aimed to test group Physiotherapy sessions – pain education and supervised exercise − in addition to individual consultations, for women referred with persistent pelvic pain (with/without endometriosis), with the primary outcomes being pain scores and pain impact. Methods: Parallel study design with three treatment arms: (1) usual care: a suite of individual Physiotherapy consultations; (2) introductory group pain education session followed by usual care and (3) introductory group pain education session followed by usual care and an 8-week supervised group exercise programme. Results: Ninety women were recruited (30/treatment arm), with 66 women (73%) completing their allocated treatment. Participants were aged between 16 and 51 years; endometriosis was confirmed in 41% (n = 27/66) of the study population. Data was analysed using descriptive and inferential statistics. Statistically significant gains (p < 0.05) in pain scores and pelvic pain impact scores were observed in all arms. Between groups, there was statistically significant improvement (p < 0.05) in pelvic pain impact score for those who attended the group pain education session followed by usual care (arm 2), compared to usual care (arm 1) alone. There was no significant added improvement with the weekly supervised group exercise programme (arm 3), when compared to those who received the group pain education programme and usual care (arm 2). Conclusion: This study has demonstrated positive benefits of a group pain education session on pain scores and pelvic pain impact for women referred with persistent pelvic pain, when added as a precursor to individual Physiotherapy consultations.
{"title":"Does group physiotherapy improve pain scores and reduce the impact of pelvic pain for women referred with persistent pelvic pain? A clinical trial","authors":"T. Beaumont, Kate Phillips, M. L. Hull, R. Green","doi":"10.1177/22840265221141527","DOIUrl":"https://doi.org/10.1177/22840265221141527","url":null,"abstract":"Introduction: This study aimed to test group Physiotherapy sessions – pain education and supervised exercise − in addition to individual consultations, for women referred with persistent pelvic pain (with/without endometriosis), with the primary outcomes being pain scores and pain impact. Methods: Parallel study design with three treatment arms: (1) usual care: a suite of individual Physiotherapy consultations; (2) introductory group pain education session followed by usual care and (3) introductory group pain education session followed by usual care and an 8-week supervised group exercise programme. Results: Ninety women were recruited (30/treatment arm), with 66 women (73%) completing their allocated treatment. Participants were aged between 16 and 51 years; endometriosis was confirmed in 41% (n = 27/66) of the study population. Data was analysed using descriptive and inferential statistics. Statistically significant gains (p < 0.05) in pain scores and pelvic pain impact scores were observed in all arms. Between groups, there was statistically significant improvement (p < 0.05) in pelvic pain impact score for those who attended the group pain education session followed by usual care (arm 2), compared to usual care (arm 1) alone. There was no significant added improvement with the weekly supervised group exercise programme (arm 3), when compared to those who received the group pain education programme and usual care (arm 2). Conclusion: This study has demonstrated positive benefits of a group pain education session on pain scores and pelvic pain impact for women referred with persistent pelvic pain, when added as a precursor to individual Physiotherapy consultations.","PeriodicalId":15725,"journal":{"name":"Journal of endometriosis and pelvic pain disorders","volume":"14 1","pages":"169 - 177"},"PeriodicalIF":0.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48361262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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