- The effectiveness of non-steroidal anti-inflammatory drugs in the treatment of chronic pelvic pain syndrome
The effectiveness of non-steroidal anti-inflammatory drugs in the treatment of chronic pelvic pain syndrome
HEALTH OF WOMAN. 2018.7(133):111–115; doi 10.15574/HW.2018.133.111
Romanenko T. G. , Sulimenko O. M.
Shupyk National Medical Academy of Postgraduate Education MH of Ukraine, Kiev
Evidence-based medicine is an approach to medical practice in which the decision on the appointment of therapeutic, diagnostic or preventive measures is based on the evidence of their effectiveness and safety.
The objective: assessment of the effectiveness and safety of the use of NSAIDs in the treatment of chronic pelvic pain in women of reproductive age.
Materials and methods. Under our supervision, there were 101 women of reproductive age with chronic pelvic pain syndrome (CPPS) on the background of chronic inflammatory processes of the pelvic organs. Patients, depending on the received treatment, were randomly divided into two groups: Group I (n=54) – complex antibiotic (AB) therapy was conducted in combination with antiplatelet agents, antihypoxants, analgesics; Group II (n=47) – complex antibiotic (AB) therapy was performed in combination with antiplatelet agents, antihypoxants and NSAIDs (DICLOSAFE, diclofenac sodium 100 mg). The exclusion criterion was the presence of an endometriosis in a patient.
When patients were included in the study and 6 months after the completion of the treatment, a questionnaire was conducted to determine the severity of the pain syndrome, psychological status and quality of life.
Results. Positive dynamics of quantitative and qualitative characteristics of the pain syndrome, as well as dynamics of its intensity as a result of conservative treatment for 6 months in group ІІ, was noted. Also, in group ІІ, statistically significant data on the reduction of depression and personal anxiety are noted, in contrast to the indicators of group I.
The results of the questionnaire of patients in group II after treatment indicated improvement of all components of physical health. Statistically significant differences with the indicators of Group I were obtained on the scale of the effect of pain on daily activity (BP). In addition, after treatment in the II group, the patients showed statistically significant changes in mental health and all its components: vital activity (VT), social activity (SF), limitation of daily activity due to emotional problems (RE) and mental health I (MH).
Conclusion. Pathogenetically grounded use of NSAIDs (DICLOSAFE suppositories) in the complex treatment of patients with CPPS allows to achieve a significant improvement in quality of life indicators due to the correction of pain syndrome.
Key words: chronic pelvic pain syndrome, treatment, nonsteroidal anti-inflammatory drugs.
1. Ananeva L. 2005. Ratsionalna terapiia boliu – kombinatsiia analhetykiv. Liky Ukrainy 2(91):81–82.
2. Ryibalka AN, Miklin OP, Kamilova IK, Kosolapova NV, Prochan EN, Gudz OV. (2015). Varikoznaya bolezn ven malogo taza kak prichina hronicheskoy tazovoy boli. Tavricheskiy mediko-biologicheskiy
3. Korennaya VV. (2015). NPVP v lechenii patsientok s pervichnoy dismenoreey. Ginekologiya 01:55–58.
4. Sinchihin SP, Mamiev OB, Stepanyan LV, Elderova KS, Magakyan OG. (2015). Nekotoryie sovremennyie aspektyi vospalitelnyih zabolevaniy organov malogo taza. Consilium Medicum. 06:73–76.
5. Engeler DS, Baranowski AP, Dinis-Oliveira P et al. (2013). The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10-years of development. Eur. Urol. 64:431–439. https://doi.org/10.1016/j.eururo.2013.04.035; PMid:23684447
6. Royal College of Obstetricians and Gynaecologists. (2012, May). The initial management of chronic pelvic pain (Green-top Guideline 41). London: Royal College of Obstetricians and Gynecologists.
7. Williams AC, Eccleston C, Morley S. (2012). Psychological therapies for the management of chronic pain (excluding headache) in adults (review). Cochrane Database Syst Rev 2:CD007407. https://doi.org/10.1002/14651858.CD007407.pub3
8. Hannah Twiddy, Natalie Lane, Rajiv Chawla, Selina Johnson, Alison Bradshaw, Shaireen Aleem, Lucinda Mawdsley. (2015). The development and delivery of a female chronic pelvic pain management programme: a specialised interdisciplinary approach. British Journal of Pain 9(4):233–240. https://doi.org/10.1177/2049463715584408; PMid:26526186 PMCid:PMC4616979
9. Maria Beatriz Ferreira Gurian, Omero Benedicto Poli Neto, Julio Cesar Rosa e Silva, Antonio Alberto Nogueira and Francisco Jose, Candido dos Reis. (2015, May). Reduction of Pain Sensitivity is Associated with the Response to Treatment in Women with Chronic Pelvic Pain. Pain Medicine 16:849–854. https://doi.org/10.1111/pme.12625; PMid:25530460
10. Andrews J, Yunker A, Reynolds W et al. (2012). Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Publication 11(12)-EHC088-EF.
11. Maria T. Chao, Priscilla D. Abercrombie, Sanae Nakagawa, Lee A. Learman, Miriam Kuppermann. (2015). Prevalece and Use of Complementary Health Approaches among Women with Chronic Pelvic Pain in a Prospective Cohort Study. Pain Medicine 16:328–340. https://doi.org/10.1111/pme.12585; PMid:25279935 PMCid:PMC4329048