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Asencio FDA, Fins RJP, Mitie CK, Ussia A, Wattiez A, Ribeiro HS, Ribeiro PA, Koninckx PR. Segmental Rectum Resection for Deep Endometriosis and Excision Similarly Improve Sexual Function and Pain. Clin Pract 2023; 13:780-790. [PMID: 37489420 PMCID: PMC10366930 DOI: 10.3390/clinpract13040071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/08/2023] [Accepted: 06/30/2023] [Indexed: 07/26/2023] Open
Abstract
Segmental rectum resections for indications other than endometriosis were reported to result in up to 40% sexual dysfunctions. We, therefore, evaluated sexual function after low bowel resection (n = 33) for deep endometriosis in comparison with conservative excision (n = 23). Sexual function was evaluated with the FSFI-19 (Female Sexuality Functioning Index) and EHP 30 (Endometriosis Health Profile). The pain was evaluated with visual analogue scales. Linear excision and bowel resections improved FSFI, EHP 30, and postoperative pain comparably. By univariate analysis, a decreased sexual function was strongly associated with pain both before (p < 0.0001) and after surgery (p = 0.0012), age (p = 0.05), and duration of surgery (p = 0.023). By multivariate analysis (proc logistic), the FSFI after surgery was predicted only by FSFI before or EHP after surgery. No differences were found between low bowel segmental resection and a more conservative excision. In conclusion, improving pain after surgery can explain the improvement in sexual function. A deleterious effect of a bowel resection on sexual function was not observed for endometriosis. Sexual function in women with endometriosis can be evaluated using a simplified questionnaire such as FSFI-6.
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Affiliation(s)
| | | | - Carolina Kami Mitie
- Medicine College, University of Santa Casa de São Paulo, São Paulo 01224-001, Brazil
| | - Anastasia Ussia
- Gemelli Hospital, Universtità Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Arnauld Wattiez
- Department of Obstetrics and Gynaecology, University of Strasbourg, 67081 Strasbourg, France
- Latifa Hospital, Dubai P.O. Box 9115, United Arab Emirates
| | | | - Paulo Ayrosa Ribeiro
- Department of Gynaecology Endoscopy, Santa Casa de São Paulo Hospital, São Paulo 01221-010, Brazil
| | - Philippe Robert Koninckx
- Latifa Hospital, Dubai P.O. Box 9115, United Arab Emirates
- Department of Obstetrics and Gynecology, University Hospital Gasthuisberg, Catholic University Leuven, 3000 Leuven, Belgium
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Reichmann G, Parlier-Ahmad AB, Beck L, Thakkar B, Alappattu M, Boissoneault J, Martin CE. Chronic Pelvic Pain and Sexual Dysfunction Among Females and Males Receiving Treatment for Opioid Use Disorder. FRONTIERS IN PAIN RESEARCH 2022; 2:787559. [PMID: 35295502 PMCID: PMC8915557 DOI: 10.3389/fpain.2021.787559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Chronic pain brings complexity to opioid use disorder (OUD). Psychosocial and neurobiological risks for Chronic Pelvic Pain (CPP) and OUD overlap. The primary objective of this exploratory study is to compare sex-specific prevalence of CPP and sexual dysfunction between individuals receiving buprenorphine for OUD and a comparison group receiving treatment for other chronic medical conditions (CMC).Methods: Participants from an OUD treatment (n = 154) and primary care clinic (n = 109) completed a survey between July 2019 and February 2020 assessing reproductive and sexual health. Sex-stratified CPP and pain interference measures were adapted from the Brief Pain Inventory for females, and for males, the Brief Male Sexual Function Inventory and NIH Chronic Prostatitis Symptom Index. The Male and Female Sexual Function Index assessed sexual dysfunction. Prevalence of CPP and sexual dysfunction between groups were compared using Pearson χ2 and Fisher's Exact tests.Results: Participants were 54.4% female and 75.0% Black with almost half having a psychiatric diagnosis. Among OUD females, the highest pain severity reported was for menstrual-related pain, and for OUD males, testicular pain. CPP most interfered with mood in OUD females vs. sleep and enjoyment of life in OUD males. There were no differences in prevalence for global sexual dysfunction with 91.6% of females and 84.2% of males screening positive across groups.Discussion/Implications: CPP and sexual dysfunction are important components of wellness and may play a role in OUD recovery trajectories. The value of addressing CPP and sexual dysfunction in tailored comprehensive, sex-informed OUD treatment approaches should be further investigated.
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Affiliation(s)
- Geetika Reichmann
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | | | - Lori Beck
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Bhushan Thakkar
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, United States
| | - Meryl Alappattu
- Department of Physical Therapy, University of Florida, Gainesville, FL, United States
| | - Jeff Boissoneault
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Caitlin E. Martin
- School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, United States
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, United States
- *Correspondence: Caitlin E. Martin
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Mocquard C, Pluvy I, Chaput B, Hoogbergen MM, Watier E, Gandolfi S, Bertheuil N. Medial Thighplasty Improves Patient's Quality of Life After Massive Weight Loss: a Prospective Multicentric Study. Obes Surg 2021; 31:4985-4992. [PMID: 34378158 DOI: 10.1007/s11695-021-05654-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The aim of this study was to assess the impact of medial thighplasty following massive weight loss on the quality of life of patients and on their sexual life. METHODS We performed a multicentric, prospective study on the quality of life after massive weight loss using the Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of life questionnaire. Forty-nine patients who underwent medial thighplasty were included in three centers and evaluation was made pre- and post-operatively. RESULTS The mean age of the patients was 44 ± 12.5 years. The average pre-medial thighplasty body mass index was 27 ± 3.8 kg/m2. All the categories of the SF36 questionnaire scored higher after surgery apart from "health change" but only the "role limitations due to emotional problems" category was significantly improved (p = 0.0081). Similarly, the Moorehead-Ardelt questionnaire showed a positive impact of the surgery on the quality of life in general (mean total score 1.04 ± 1.37) and on self-esteem, physical activity, social relationships, and work performance. Interestingly, sexual activity was not improved by the surgery and this result is in line with the FSFI, which showed no effect of medial thighplasty on sexual life. CONCLUSIONS Medial thighplasty improves the quality of life of patients after massive weight loss but does not seem to modify the sexual quality of life. These results clearly indicate that this surgery should be widely offered to patients seeking reconstruction of massive weight sequelae.
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Affiliation(s)
- Camille Mocquard
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 16 Boulevard de Bulgarie, 35200, Rennes, France.
- INSERM U1236, University of Rennes 1, 35000, Rennes, France.
- SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, 35000, Rennes, France.
| | - Isabelle Pluvy
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU of Besancon, 25000, Besançon, France
| | - Benoit Chaput
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU of Toulouse, 31000, Toulouse, France
| | - Maarten M Hoogbergen
- Department of Plastic, Reconstructive and Hand Surgery, Catharina Hospital Eindhoven, 5623 EJ, Eindhoven, The Netherlands
| | - Eric Watier
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 16 Boulevard de Bulgarie, 35200, Rennes, France
| | - Silvia Gandolfi
- Department of Plastic, Reconstructive and Aesthetic Surgery, CHU of Rouen, 76000, Rouen, France
| | - Nicolas Bertheuil
- Department of Plastic, Reconstructive and Aesthetic Surgery, Hospital Sud, University of Rennes 1, 16 Boulevard de Bulgarie, 35200, Rennes, France
- INSERM U1236, University of Rennes 1, 35000, Rennes, France
- SITI Laboratory, Etablissement Français du Sang Bretagne, Rennes University Hospital, 35000, Rennes, France
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Centemero A, Rigatti L, Giraudo D, Mantica G, De Marchi D, Chiarulli EF, Gaboardi F. The role of the multi-disciplinary team and multi-disciplinary therapeutic protocol in the management of the chronic pelvic pain: There is strenght in numbers! Arch Ital Urol Androl 2021; 93:211-214. [PMID: 34286558 DOI: 10.4081/aiua.2021.2.211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 02/15/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The aim of the study is to evaluate the effectiveness of a Multi-disciplinary team (MDT) and multi-disciplinary approach in the treatment of Chronic Pelvic Pain (CPP). METHODS The data of all consecutive patients referred for a CPP from 11/2016 to 2/2019 has been prospectively collected. The sample was divided in two groups: Group A, made by patients managed after the institution of our MDT, and Group B, made of patients managed before this date. The MDT is composed by three urogynecologists, a psychologist and a physiotherapist. All Group A patients underwent a weekly bladder instillation with dimethyl sulfoxide (DMSO), kinesiotherapy for trigger points and Percutaneous Tibial Nerve Stimulation for 10 consecutive weeks. Patients were asked to perform a self-treatment following the Stanford Protocol and to adhere to a specific diet. All Group B patients were managed only with DMSO instillations and a strict diet. RESULTS The Group A was made of 41 females and 6 males while the Group B was made of 38 females and 5 males. The Group A patients showed a statistically significant improvement in the Pelvic Pain Urgency Frequency, in the frequency times reported at the 6 months voiding diary, and a better Patient Global Impression of Improvement. CONCLUSIONS Our data support the efficacy of the MDT in the management of CPP. The multimodal approach might represent an effective and reproducible non-invasive option to manage successfully CPP.
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Affiliation(s)
| | | | | | - Guglielmo Mantica
- Department of Urology, Policlinico San Martino Hospital, University of Genoa.
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