Psychological, social and gynecologic characteristics of chronic pelvic pain
DOI:
https://doi.org/10.18597/rcog.600Keywords:
chronic pelvic pain, depression, anxietyAbstract
Chronic pelvic pain (CPP) is one of the chronic pain syndromes where controversy exists in its definition, accompanying pelvic pathology, psychosocial and cultural associated factors, diagnosis, and therapeutic approaches.
Objective: To describe the socio-demographic profile of women with CPP, pelvic pathology by laparoscopy, and the association with anxiety or depressive symptoms in the woman.
Methods: A descriptive study was performed in thirty women with CPP and diagnostic laparoscopy.
Results: The mean age was of 34,2 + 6,2 years old. Long duration of the CPP (range 1-10 years) was observed. The most of the women 40% were of middle socioeconomic status (level 3, range 1-6), mixed ethnic backgrounds 53%, university education 50%, and stable marital state (married 53%, common marriage in law 23%. All women had pelvic pathology by laparoscopy. The most frequent were adherences 36,6%, adenomyosis 20%, endometriosis 10%, polycystic ovary (10%), and the remaining 43.4% were mixed pelvic pathologies. A high proportion of dense adherences with the intestine 30% was observed. Anxiety, characterized by Hospital Anxiety Depression Scale (HADS), was observed in high proportion (30%) as well, in contrast with a low proportion of depression 3,3%.
Conclusion: The studied women had a high frequency of anxiety and low frequency of depression. All cases were associated with pelvic pathology with a high proportion (30%) of dense adherences with the intestine. This gynecologic and psychosocial characteristics were different in relation to others populations.
Author Biographies
Claudia Patricia Criollo
Nora Myriam Romero
Olga Liliana Salazar
Freddy Briceño
Hernando Navarro
Julián Alberto Herrera
References
Reitter R. Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol 1998;41:422-35.
Zondervan K, Yudkin PL, Vessey M, Dawes MG, Barlow DH, Kennedy SH. The prevalence of chronic pelvic pain in women in the United Kingdom: a systematic review. Br J Obstet Gynaecol 1998;105:93-9.
Rosenfeld JA. Chronic pelvic pain: an integrated approach. Am Fam Physician 1996;54:2187-8.
Toth P, Jothivijayarani A. Gynecology chronic pelvic pain. Chapter 7. University of Iowa Family Practice Handbook, 3rd edition. Iowa; 2000.
American College of Obstetricians and Gynecologists. Chronic pelvic pain. ACOG Technical Bulletin No. 223. Washington, DC: ACOG; 1996.
Steege JF. Dolor pélvico crónico. Primera Edición. México, DF: McGraw-Hill Companies; 2000.
Farquhar C. Extracts from the "clinical evidence". Endometriosis. BMJ 2000;320:1449-52.
Ballweg M. Blaming the victim. The psychologizing of endometriosis. Obstet Gynecol Clin North Am 1997;24:441-53.
Miller D. Keep a low threshold in diagnosing PID. Patient Care 2000:75-90.
Wellbery C. Diagnosis and treatment of endometriosis. Am Fam Physician 1999;60:1753-68.
Valencia P. EPI y otras causas de dolor pélvico crónico. Hosp Pract 2000;4:63-6. 12.
Clemons JL, Arya LA, Myers DL. Diagnosing interstitial cystitis in women with chronic pelvic pain. Obstet Gynecol 2002;100:337-41.
Sullivan M. DSM-IV Pain disorder: a case against the diagnosis. Int Rev Psychiatry 2000;12:91-8.
Elliott ML. Chronic pelvic pain: What are the psychological considerations? APS Bulletin 1996;6:12-5.
Reed BD, Punch MR, Roth RS, Gorenflo DW, Gillespie BW. Psychosocial and sexual functioning in women with vulvodynia and chronic pelvic pain, a comparative evaluation. J Reprod Med 2000;45:624-32.
Bodden-Heidrich R, Kuppers V, Beckmann MW, Ozornek MH, Rechenberger I, Bender HG. Psychosomatic aspects of vulvodynia. Comparison with the chronic pelvic pain syndrome. J Reprod Med 1999;44:411-6.
Edwards L, Mason M, Phillips M, Norton J, Boyle M. Childhood sexual and physical abuse. Incidence in patients with vulvodynia. J Reprod Med 1997;42:135-9.
Jamieson D, Steege J. The association of sexual abuse with pelvic pain complaints in a primary care population. Am J Obstet Gynecol 1997;177:1408-12.
Rose V. ACOG releases a statement an identification and treatment of adolescent victims of sexual assault. Am Fam Physician 1999;59:1688.
Savidge CJ, Slade P. Psychological aspects of chronic pelvic pain. J Psychosom Res 1997;42:433-4.
Stones RW, Mountfield J. Interventions for treating chronic pelvic pain in women. The Cochrane Library; 2002.
Doyle DF, Li TC, Richmond MN. The prevalence of continuing chronic pelvic pain following a negative laparoscopy. J Obstet Gynaecol 1998;18:252-5.
Arguello RA. Dolor pélvico crónico indicador de laparoscopia. Controversias en Ginecología y Obstetricia 2000;6:17-25.
Elcombe S, Gath D, Day H. The psychological effects of laparoscopy on women with chronic pelvic pain. Psychol Med 1997;27:1041-50.
Miller BA, et al. Five reasons to consider a hysterectomy. Patient Care 1999;33:34-50.
Carter JE. Surgical treatment for chronic pelvic pain. JSLS 1998;2:129-39.
Toro RJ, Yepes LE. Trastornos depresivos. Psiquiatría, Fundamentos de Medicina. 3a edición. Medellín: CIB; 1997. p. 132-3.
Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983;67:361-70.
Herrmann C. International experiences with the Hospital Anxiety and Depression Scale-- a review of validation data and clinical results. J Psychosom Res 1997;42:17-41.
Heim LT. Evaluation and differential diagnosis of dyspareunia. Am Fam Physyician 2001;63:1535-43.
Gómez G. Varicocelectomía por laparoscopia: descripción de una nueva técnica y su acción sobre el dolor pélvico crónico. Med Reprod 1998;1:14-7.
Navarro H. Dolor pélvico crónico. En: Cifuentes R. (ed). Ginecología y obstetricia basadas en las evidencias. Bogotá: Editorial Distribuna; 2002. p.659-70.
Soysal M. A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Hum Reprod 2001;16:931-9.
Profamilia. Salud sexual y reproductiva en Colombia. Encuesta nacional de demografía y salud. 2000.
Kaplan H, Sadock B. Comprehensive textbook of Psychiatry. VI. Baltimore: William & Wilkins; 1995.
How to Cite
Downloads
Downloads
Published
Issue
Section
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
