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Billis E, Kontogiannis S, Tsounakos S, Konstantinidou E, Giannitsas K. Hard Flaccid Syndrome: A Biopsychosocial Management Approach with Emphasis on Pain Management, Exercise Therapy and Education. Healthcare (Basel) 2023; 11:2793. [PMID: 37893867 PMCID: PMC10606578 DOI: 10.3390/healthcare11202793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Hard flaccid syndrome (HFS) is a rather rare, acquired clinical entity affecting young men's well-being, sexual and social life. HFS presents with a cluster of symptoms including penile-specific somatosensory disturbances, a semi-rigid penis at the flaccid state without any stimulation or desire, erectile dysfunction, perineal and/or penile pain, associated urinary symptoms, emotional distress as well as other psychosocial and stress-related manifestations. Although its pathophysiology is still not well understood, initial penile trauma causing minor nerve and vascular disturbances to the penis and associated pelvic floor musculature is suggested to trigger the syndrome. Despite the scarcity of research on HFS, the present report describes a case of a young male clinically diagnosed with HFS, who benefited from a biopsychosocial management strategy, focusing on pain management, therapeutic exercise approaches, such as pelvic floor exercise re-education, graded exposure to activity as well as education on lifestyle and stress-related modifications. This holistic management approach has been clinically reasoned in this case report, and the need for more evidence-based studies developing diagnosing criteria, elaborating pathophysiological mechanisms and testing the efficiency of different therapeutic options is highlighted.
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Affiliation(s)
- Evdokia Billis
- Laboratory of Clinical Physiotherapy and Research, Department of Physiotherapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Rio, Greece
| | | | - Spyridon Tsounakos
- Department of Psychiatry, University Hospital of Patras, 26504 Rio, Greece
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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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Edwards S, Mandeville A, Petersen K, Cambitzi J, Williams ACDC, Herron K. 'ReConnect': a model for working with persistent pain patients on improving sexual relationships. Br J Pain 2020; 14:82-91. [PMID: 32537146 PMCID: PMC7265594 DOI: 10.1177/2049463719854972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION Many individuals with persistent pain experience difficulties with sexual function which are exacerbated by avoidance and anxiety. Due to embarrassment or shame, sexual activity may not be identified as a goal for pain management programmes (PMPs). In addition, clinicians can feel that they lack skills and confidence in addressing these issues. METHODS We sought to develop a biopsychosocial model for helping patients return to sexual activity and manage relationships in the context of pain management, known as 'ReConnect'. The model amalgamates well-established methods from pain management and sex therapy to guide multidisciplinary team members. ReConnect comprises three components: (1) 'cognitive and myth-busting', (2) 'sensations and feelings' and (3) 'action-experimentation'. We collected self-report data from 281 women and 92 men from our specialist PMP for chronic abdomino-pelvic. pain, including questions measuring interference with and avoidance of sex due to pain, and the Multi-dimensional Sexuality Questionnaire (MSQ) to measure anxiety about sexual activity. RESULTS The results show statistically significant improvements for anxiety, avoidance of sex and sexual interference. Using the ReConnect model to structure clinical work, pain management clinicians reported increased confidence in addressing sexual activity goals. CONCLUSION By using the ReConnect model is a framework for clinicians to use to support sexual activity goals. It has demonstrated improvements in clinical outcomes such as anxiety around sex and interference of pain in sexual activity. We encourage its application in pain management services in both one-to-one and group sessions, as a method for encouraging pain patients to address this important area of life which can be adversely affected by pain.
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Affiliation(s)
- Sarah Edwards
- Pain Management Centre, National Hospital for Neurology and Neurosurgery at Cleveland Street, London, UK
| | - Anna Mandeville
- Pain Management Centre, National Hospital for Neurology and Neurosurgery at Cleveland Street, London, UK
| | - Katrine Petersen
- Pain Management Centre, National Hospital for Neurology and Neurosurgery at Cleveland Street, London, UK
| | - Julia Cambitzi
- Pain Management Centre, National Hospital for Neurology and Neurosurgery at Cleveland Street, London, UK
| | - Amanda C de C Williams
- Pain Management Centre, National Hospital for Neurology and Neurosurgery at Cleveland Street, London, UK
| | - Katherine Herron
- Pain Management Centre, National Hospital for Neurology and Neurosurgery at Cleveland Street, London, UK
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Min KJ, Choi H, Tae BS, Lee MG, Lee SJ, Hong KD. Short-term benefits of balneotherapy for patients with chronic pelvic pain: a pilot study in Korea. J OBSTET GYNAECOL 2019; 40:520-525. [PMID: 31455176 DOI: 10.1080/01443615.2019.1631771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to evaluate whether balneotherapy might be effective in patients with chronic pelvic pain (CPP) in the short term. This was an open and prospective pilot study. The balneotherapy programme was performed in a spa resort located in Wando Island, Republic of Korea from August 26 2018 to September 1 2018. It consisted of 10 heated seawater baths (38 °C, 20 minutes) and 10 mud-pack applications (40 °C, 10 minutes) for five days. Sixteen patients were enrolled. Upon analysing responses from a patient questionnaire, we found improvement in parameters such as pain, bladder irrigation symptoms and quality of life after balneotherapy. Inflammatory marker IL-1 and TNF-α was significantly decreased after treatment compared to baseline. There were no adverse events during treatment. Our data suggest that five-day balneotherapy can be beneficial for patients with CPP in the short term.Impact statementWhat is already known on this subject? The majority of articles in the field of balneotherapy discuss the treatment of rheumatic or dermatological disease. However, data on the effectiveness of balneotherapy for chronic pelvic pain are very limited.What the results of this study add? Our study suggests that balneotherapy can be beneficial for patients with CPP in the short-term. The duration of balneotherapy was five days, which is shorter than that of the European studies. Intuitively, it may be doubtful whether short-term therapy has any practical effect. As most people living in Korea have a vacation period of about one week each in summer and winter, the choice of a five-day programme in our study reflects the reality of vacation schedules.What the implications are of these findings for clinical practice and/or further research? Further studies are necessary to demonstrate the persistence of these benefits on the long term, as well as their existence in appropriate control group and different duration of treatment.
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Affiliation(s)
- Kyung-Jin Min
- Department of Obstetrics and Gynecology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Hoon Choi
- Department of Urology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Bum Sik Tae
- Department of Urology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Min-Goo Lee
- Department of Physiology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung-Jae Lee
- Center for Integrative Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kwang Dae Hong
- Department of Colorectal Surgery, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
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[Physiotherapeutic assessment of chronic pelvic pain syndrome : Development of a standardized physiotherapeutic assessment instrument for interprofessional cooperation in patients with chronic pelvic pain syndrome]. Schmerz 2019; 32:188-194. [PMID: 29693198 DOI: 10.1007/s00482-018-0293-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The chronic pelvic pain syndrome (CPPS) can be associated with physiotherapeutic findings. An interprofessional approach is recommended for patients with CPPS; however, no standardized physiotherapeutic assessment and documentation instrument for specific physiotherapeutic assessments exist, which is not only the foundation for physiotherapy but also for interprofessional communication. OBJECTIVE The aim was the development of a physiotherapeutic assessment instrument for patients with CPPS and therefore, to create a tool for clinical use, research and interprofessional communication. MATERIAL AND METHODS Based on an explorative literature search and an expert consensus, the first version of the instrument was developed as part of a specialized outpatient clinic. This version was applied clinically for 13 months, edited and finalized after another expert consensus. RESULTS The developed instrument Physical Therapy Assessment for Chronic Pelvic Pain Syndrome (PTA-CPPS) lists external and internal groups of muscles for a systematic assessment of myofascial findings. Functional capacity, breathing movements as well as scars and regions of pain are recorded. A manual for the assessment protocol was developed as accompanying material. CONCLUSION The developed instrument provides for the first time a physiotherapeutic assessment tool for patients with CPPS for interprofessional clinical and scientific use.
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Klotz SGR, Ketels G, Richardsen B, Löwe B, Brünahl CA. Physiotherapeutische Befunderhebung bei „chronic pelvic pain syndrome“. MANUELLE MEDIZIN 2019. [DOI: 10.1007/s00337-019-0537-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Wang J, Liang K, Sun H, Li L, Wang H, Cao J. Psychotherapy combined with drug therapy in patients with category III chronic prostatitis/chronic pelvic pain syndrome: A randomized controlled trial. Int J Urol 2018; 25:710-715. [PMID: 29862568 DOI: 10.1111/iju.13706] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 04/24/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Jianxin Wang
- Department of Urology; Taizhou First People's Hospital; Taizhou China
- Department of Urology; Binzhou Medical University Hospital; Binzhou China
| | - Kuixiang Liang
- Department of Obstetrics; Binzhou Medical University Hospital; Binzhou China
| | - Huijing Sun
- Department of Nursing; Binzhou Polytechnical College; Binzhou China
| | - Lianpeng Li
- Department of Urology; Binzhou Central Hospital; Binzhou China
| | - Hongcai Wang
- Department of Neurology; Binzhou Medical University Hospital; Binzhou China
| | - Jingyuan Cao
- Department of Urology; Taizhou First People's Hospital; Taizhou China
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Klotz SGR, Schön M, Ketels G, Löwe B, Brünahl CA. Physiotherapy management of patients with chronic pelvic pain (CPP): A systematic review. Physiother Theory Pract 2018; 35:516-532. [PMID: 29589778 DOI: 10.1080/09593985.2018.1455251] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Chronic pelvic pain (CPP) is a common pain condition. However, treatment remains challenging. Musculoskeletal findings are frequent; therefore physiotherapy might be helpful. The purpose of this review was to evaluate the current evidence on physiotherapy in patients with CPP (PROSPERO registration number CRD42016037516). METHODS Six databases were searched and additional hand searches were performed. Two reviewers independently conducted the database search and selected studies using a two-step approach. The methodological quality was assessed applying the Critical Review Form - Quantitative Studies. RESULTS A total of eight studies were included. Trigger point therapy was examined in four studies; two of which were randomized controlled trials. All studies indicate a significant change in pain measurement. The other four studies evaluated the effect of biofeedback, Thiele massage, Mensendieck somatocognitive therapy and aerobic exercises, whereas the last two were tested in controlled trials. All studies showed significant improvements in pain assessment. CONCLUSIONS The evidence currently available is sparse with methodological flaws, making it difficult to recommend a specific physiotherapy option. There is an urgent need for high-quality randomized controlled trials to identify the most effective physiotherapy management strategy for patients with CPP.
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Affiliation(s)
- Susanne G R Klotz
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Centre Hamburg-Eppendorf, Hamburg, Germany and Schön Klinik Hamburg Eilbek , Hamburg , Germany.,b Department of Physiotherapy , University Medical Centre Hamburg-Eppendorf , Hamburg , Germany
| | - Mila Schön
- b Department of Physiotherapy , University Medical Centre Hamburg-Eppendorf , Hamburg , Germany
| | - Gesche Ketels
- b Department of Physiotherapy , University Medical Centre Hamburg-Eppendorf , Hamburg , Germany
| | - Bernd Löwe
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Centre Hamburg-Eppendorf, Hamburg, Germany and Schön Klinik Hamburg Eilbek , Hamburg , Germany
| | - Christian A Brünahl
- a Department of Psychosomatic Medicine and Psychotherapy , University Medical Centre Hamburg-Eppendorf, Hamburg, Germany and Schön Klinik Hamburg Eilbek , Hamburg , Germany
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Brünahl CA, Klotz SGR, Dybowski C, Riegel B, Gregorzik S, Tripp DA, Ketels G, Löwe B. Combined Cognitive-Behavioural and Physiotherapeutic Therapy for Patients with Chronic Pelvic Pain Syndrome (COMBI-CPPS): study protocol for a controlled feasibility trial. Trials 2018; 19:20. [PMID: 29316946 PMCID: PMC5759202 DOI: 10.1186/s13063-017-2387-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 11/29/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Chronic pelvic pain syndrome (CPPS) is a pain condition perceived in the pelvic area for at least 6 months. While evidence of the aetiology and maintenance of CPPS is still unclear and therapy options are rare, there is preliminary evidence for the efficacy of cognitive behavioural therapy and physiotherapy. However, an integrated treatment has not yet been studied. The primary aim of this study is therefore to test the feasibility of combined psychotherapy and physiotherapy for female and male patients with CPPS. The secondary aim is to explore changes in patient-relevant and economic outcomes compared to a control group. METHODS A feasibility study with a crossover design based on the principles of a 'cohort multiple randomized controlled trial' will be conducted to test a combined therapy for patients with CPPS. The study will consist of two consecutive treatment modules (cognitive behavioural group psychotherapy and physiotherapy as individual and group sessions), which will be applied in varying order. The modules will consist of nine weekly sessions with a 4-week break between the modules. The control group will undergo treatment as usual. Study subjects will be recruited from the interdisciplinary outpatient clinic for CPPS at the University Medical Center Hamburg-Eppendorf. Thirty-six patients will be assigned to the intervention, and 18 patients will be assigned to the control group. The treatment groups will be gender homogeneous. Feasibility as the primary outcome will be analysed in terms of the demand, acceptability, and practicality. Secondary study outcomes will be measured using validated self-rating-scales and physical examinations. DISCUSSION To the best of our knowledge, this study is the first to investigate the feasibility of combined psychotherapy and physiotherapy for patients with CPPS. In addition to testing feasibility, the results can be used for the preliminary estimation of therapeutic effects. The results from this study will be used to generate an enhanced therapeutic approach, which might be subject to further testing in a larger study. TRIAL REGISTRATION German Clinical Trials Register, DRKS00009976 . Registered on 15 March 2016. ISRCTN, ISRCTN43221600 . Registered on 10 May 2016.
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Affiliation(s)
- Christian A. Brünahl
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
| | - Susanne G. R. Klotz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Christoph Dybowski
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
| | - Björn Riegel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
| | - Sonja Gregorzik
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
| | - Dean A. Tripp
- Department of Psychology, Queen’s University, Kingston, Ontario K7L 3 N6 Canada
- Department of Anaesthesia, Queen’s University, Kingston, Ontario K7L 3 N6 Canada
- Department of Urology, Queen’s University, Kingston, Ontario K7L 3 N6 Canada
| | - Gesche Ketels
- Department of Physiotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Schön Klinik Hamburg Eilbek, Dehnhaide 120, 22081 Hamburg, Germany
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Twiddy H, Bradshaw A, Chawla R, Johnson S, Lane N. Female chronic pelvic pain: the journey to diagnosis and beyond. Pain Manag 2017; 7:155-159. [PMID: 28073312 DOI: 10.2217/pmt-2016-0052] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Hannah Twiddy
- The Pain Management Department, the Walton Centre NHS Trust, Liverpool, UK
| | - Alison Bradshaw
- The Pain Management Department, the Walton Centre NHS Trust, Liverpool, UK
| | - Rajiv Chawla
- The Pain Management Department, the Walton Centre NHS Trust, Liverpool, UK
| | - Selina Johnson
- The Pain Management Department, the Walton Centre NHS Trust, Liverpool, UK.,Institute of Translational Medicine, The University of Liverpool, Liverpool, UK
| | - Natalie Lane
- The Pain Management Department, the Walton Centre NHS Trust, Liverpool, UK
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Twiddy H, Lane N, Chawla R, Johnson S, Bradshaw A, Aleem S, Mawdsley L. The development and delivery of a female chronic pelvic pain management programme: a specialised interdisciplinary approach. Br J Pain 2015; 9:233-40. [PMID: 26526186 PMCID: PMC4616979 DOI: 10.1177/2049463715584408] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
CONTEXT/BACKGROUND Chronic pelvic pain (CPP) is a physically and psychologically debilitating condition. European Association of Urology (EAU) Guidelines (2013) and Royal College of Obstetricians and Gynaecologists (RCOG) guidelines (2012) place strong emphasis upon multi-speciality assessment and liaison, as well as interdisciplinary assessment and intervention in reference to the management of CPP. OBJECTIVES The aim was to introduce and describe the development and delivery of an interdisciplinary pain management programme (PMP), at a Specialised Pain Management Centre in Liverpool, United Kingdom, for women diagnosed with CPP. METHOD The format and content of the CPP PMP at The Walton Centre, Liverpool, is described and the preliminary results from the CPP PMP are presented. RESULTS Preliminary data suggest that outcomes on the specialised CPP PMP indicate that patients are able to make clinically important change across a range of outcome measures. Moreover, these results compare favourably to the established PMP for generalised chronic pain when comparing clinically significant outcomes with the Walton Centre's (a tertiary-level pain management centre) 2013 PMP Audit document. Patients attending the CPP PMP positively appraised the PMP and felt it was useful and supportive to be in a group dedicated to CPP. CONCLUSIONS This article presents some preliminary results that suggest there is value in delivering a specialised multidisciplinary PMP for this group. There is a clear need for further clinical research into the effectiveness of similar interventions for CPP, including the early identification of those CPP patients who may benefit from both multi-specialty and interdisciplinary management.
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Affiliation(s)
- Hannah Twiddy
- Pain Management Programme, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Natalie Lane
- Pain Management Programme, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Rajiv Chawla
- Pain Management Programme, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Selina Johnson
- Pain Management Programme, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Alison Bradshaw
- Pain Management Programme, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Shaireen Aleem
- Gynacology and Obstetrics, Southport and Ormskirk Hospital NHS Trust, Southport, UK
| | - Lucinda Mawdsley
- Pain Management Programme, The Walton Centre NHS Foundation Trust, Liverpool, UK
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[Psychosomatic aspects of chronic pelvic pain syndrome. Psychometric results from the pilot phase of an interdisciplinary outpatient clinic]. Schmerz 2015; 28:311-8. [PMID: 24728530 DOI: 10.1007/s00482-014-1422-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Chronic pelvic pain syndrome (CPPS) presents as a multicausal disorder. Complex interactions of psychological factors with somatic dysfunctions are crucial to the development and maintenance of CPPS. AIM This study characterized the patient cohort from a psychosomatic perspective. MATERIAL AND METHODS Subjects with CPPS were recruited from an interdisciplinary CPP outpatient clinic. Sociodemographic data, symptoms (National Institutes of Health Chronic Prostatitis Symptom Index, NIH-CPSI) and pain-related factors (Short Form of the McGill Pain Questionnaire, SF-MPQ) as well as depressive symptoms (Patient Health Questionnaire 9, PHQ-9), anxiety [Generalized Anxiety Disorder 7-item (GAD-7) Scale], the severity of somatic symptoms (PHQ-15) and quality of life (Short Form-12, SF-12) were measured. Additional socioeconomic data were obtained. RESULTS A total of 50 men and women with a mean disease duration of 5.8 years were included in the study. The disease-related symptom severity and healthcare utilization were high. All psychometric scales showed significantly lower values compared with the general population. A high symptom burden was associated with high psychopathological findings and reduced quality of life. CONCLUSION The psychopathological comorbidities in subjects with CPPS require specific evidence-based diagnostic and treatment methods to reduce psychopathology and improve quality of life.
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Assessing psychological factors, social aspects and psychiatric co-morbidity associated with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) in men -- a systematic review. J Psychosom Res 2014; 77:333-50. [PMID: 25300538 DOI: 10.1016/j.jpsychores.2014.09.012] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/17/2014] [Accepted: 09/21/2014] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a chronic pain disease with high prevalence rates and substantial health care costs. An interdisciplinary classification system is commonly used (UPOINT) which includes psychosocial factors. Nevertheless, psychosocial influences on CP/CPPS only recently became a research focus. Therefore, we aimed to synthesize the existing data and to identify further research topics. Then, based on our results, diagnosis and treatment can be improved. METHODS In a systematic review conducted according to the PRISMA reporting guidelines we searched different databases (MEDLINE, EMBASE, PsychINFO) using the broad search terms "chronic pelvic pain syndrome AND men". Two raters independently screened the literature and assessed the risk of bias. RESULTS We included 69 original research articles which considered psychosocial variables. We found studies investigating different psychosocial factors (pain catastrophizing, stress, personality factors, social aspects), co-morbid psychiatric disorders (depression, anxiety and trauma-related disorders, somatization disorder, substance abuse) and Quality of Life (QoL). In addition, there is a high risk of bias in most studies e.g. concerning the study design or the measures. CONCLUSIONS There is evidence suggesting that psychological factors are important in understanding CP/CPPS. However, research concentrated on a few aspects while the others were not covered adequately. We found evidence of a higher number of psychosocial factors and psychiatric co-morbidities than is currently included in the UPOINT system. More high quality research is needed to understand the interplay of psychosocial factors in CP/CPPS. Furthermore, these factors should be incorporated into treatment approaches.
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Understanding chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). World J Urol 2013; 31:709-10. [PMID: 23812415 DOI: 10.1007/s00345-013-1121-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Accepted: 06/21/2013] [Indexed: 12/14/2022] Open
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