1
|
Sánchez-Prieto M, Pingarrón C, Bergamaschi L, Bermúdez JC, Subiris González J, Sánchez Sánchez R, Poyo Torcal S, Gómez M, Ruiz Pérez ML, Castillo Martínez M, Peña Penedo ME, Sánchez-Borrego R. Prospective, multicenter, uncontrolled study on the effectiveness and safety of a hyaluronic acid water-based vaginal lubricant in alleviating vaginal dryness and dyspareunia. Gynecol Endocrinol 2024; 40:2317268. [PMID: 38468593 DOI: 10.1080/09513590.2024.2317268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/30/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Vaginal dryness (VD) represents a significant concern affecting women across diverse life stages, encompassing both pre- and postmenopausal women at any age. Dyspareunia, defined by genital pain that can be experienced before, during, or after intercourse, is often associated with vaginal dryness. AIM This study aimed to evaluate the effectiveness and safety of a water-based vaginal lubricant with hyaluronic acid to reduce sexual discomfort associated with vaginal dryness. METHODS A prospective, multicenter, uncontrolled clinical investigation was conducted over a three-month period in women aged 18 years or older experiencing pain or difficulty during sexual intercourse for whom the use of a vaginal lubricant was recommended. RESULTS Significant improvements were observed in the FSFI scores, indicating enhanced sexual function (p < .001). Vaginal dryness symptoms, including irritation, dryness, itching, and dyspareunia, significantly decreased after product use (p < .001). CLINICAL IMPLICATIONS This study contributes to the limited scientific knowledge on the application of lubricants in the context of symptoms associated with VD. STRENGTHS & LIMITATIONS In addition to the short study period, inherent limitations of the study design, and lack of placebo control, it is pertinent to acknowledge that some of the pros used in this study were not based on validated questionnaires. However, as far as we know, this study is the only one that analyzes well-being and sexual pleasure as results using a lubricant formulated with hyaluronic acid. CONCLUSION This tested vaginal lubricant with hyaluronic acid has demonstrated efficacy in improving vaginal dryness and female sexual function, particularly in reducing pain and improving lubrication during sexual intercourse, and showed a favorable safety profile, with minimal and transient adverse events.
Collapse
|
2
|
Thorpe S, Dogan-Dixon J, Malone N, Palomino KA. 'Just be strong and keep going': the influence of Superwoman Schema on Black women's perceived expectations of coping with sexual pain. CULTURE, HEALTH & SEXUALITY 2024; 26:346-361. [PMID: 37226881 PMCID: PMC11214806 DOI: 10.1080/13691058.2023.2210199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 05/01/2023] [Indexed: 05/26/2023]
Abstract
Superwoman Schema, a conceptual framework that reflects Black women's ability to overcome gendered racism and stress, affects the way Black women choose to cope with health-related issues. The purpose of this study was to investigate how Black women perceive they should cope with sexual pain using the Superwoman Schema as an analytic and interpretative guide. Data were derived from participants who completed an individual interview on sexual pain and pleasure. Deductive thematic analysis was conducted. Results indicated whereas some Black women endorsed all five components of Superwoman Schema as coping strategies for sexual pain, other Black women resisted SWS completely. Additionally, one participant was an outlier and did not endorse or resist SWS. Implications for generational sexual health interventions for Black women are discussed.
Collapse
Affiliation(s)
- Shemeka Thorpe
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| | - Jardin Dogan-Dixon
- Department of Educational, School & Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Natalie Malone
- Department of Educational, School & Counseling Psychology, University of Kentucky, Lexington, KY, USA
| | - Kaylee A. Palomino
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY, USA
| |
Collapse
|
3
|
Abdulai AF, Howard AF, Parmar G, Noga H, Abdul-Ghafoor AA, Lisonek M, Yong PJ. The quality, suitability, and readability of web-based resources on endometriosis-associated dyspareunia: A systematic review. Health Informatics J 2024; 30:14604582241231151. [PMID: 38308637 DOI: 10.1177/14604582241231151] [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] [Indexed: 02/05/2024]
Abstract
People commonly and increasingly rely on the internet to search for health information, including those related to endometriosis-associated dyspareunia. Yet the content of such websites may be of variable accuracy and quality. This review aims to evaluate the quality, readability, and suitability of web-based resources on endometriosis-associated dyspareunia for patients. We searched 3 databases - Google, Bing, and Yahoo - to identify websites related to endometriosis-associated dyspareunia. Two independent reviewers screened the search results against inclusion and exclusion criteria. Another set of two reviewers evaluated the selected websites using validated measurement instruments. Out of 450 websites, 21 met the inclusion criteria and were evaluated. More than half of the websites had information on content updates, reported on authorship, or disclosed sponsorship information. The mean quality and suitability scores were 47.5 (SD = 13.3) and 65.2 (SD = 13.6) respectively, thus suggesting generally adequate quality and suitability levels. However, the mean readability scores exceeded the recommended level for health-related websites. The poor readability of the websites might limit accessibility for a significant proportion of patients with low educational levels. The findings of this review have implications for designing high-quality, readable and up-to-date web interventions for people who rely on web platforms as an alternative or complementary source of health information on dyspareunia.
Collapse
Affiliation(s)
| | - A Fuchsia Howard
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Gurkiran Parmar
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Heather Noga
- Women Health Research Institute, British Columbia Women's Hospital & Health Center, Vancouver, BC, Canada
| | | | - Michelle Lisonek
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Paul J Yong
- Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
- Women Health Research Institute, British Columbia Women's Hospital & Health Center, Vancouver, BC, Canada
| |
Collapse
|
4
|
Howard AF, Noga H, Parmar G, Kennedy L, Aragones S, Bassra R, Gelfer L, Lopez de Arbina E, Sutherland J, Allaire C, Oliffe JL, Currie LM, Yager H, Yong PJ. Web-Based Digital Storytelling for Endometriosis and Pain: Qualitative Pilot Study. JMIR Form Res 2023; 7:e37549. [PMID: 36917164 PMCID: PMC10131752 DOI: 10.2196/37549] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Endometriosis is a complex chronic disease characterized by pain, including painful sex, that can contribute to considerable sexual function, self-esteem, and relationship challenges. Digital storytelling is an arts-based, participatory methodology wherein individuals create and share their illness experiences in detailing their lived experiences. OBJECTIVE The study objective was to pilot-test a web-based digital storytelling workshop focused on endometriosis to understand storytellers' experiences of workshop participation. We assessed the feasibility of story cocreation and sharing, including the emotional impact of workshop participation, the acceptability of the workshop for the subject matter, and the storytellers' willingness to share their stories with broader audiences as a method for knowledge translation. METHODS This study used a community-based participatory methodology supplemented with patient-oriented research and integrated knowledge translation. Study participants, referred to as storytellers, cocreated 3- to 5-minute individual digital stories about their lived experiences of endometriosis during a web-based workshop (comprising five 2-hour sessions over 6 weeks) facilitated by The Center for Digital Storytelling. Data were collected through participant observations at the workshop, storyteller weekly reflective journals, and an end-of-workshop focus group interview with storytellers. These data were analyzed using a qualitative interpretive description approach. RESULTS A total of 5 women and 1 nonbinary storyteller aged 19 to 39 years who had experienced endometriosis for 4 to 22 years participated in the study. We characterized storytelling workshop participation and the acceptability of story cocreation by describing participants' experiences of opportunity, commitment, and connection; complex emotions that were healing; and a desire to share. Feasibility was demonstrated through 100% engagement in the workshops. All 6 storytellers reported feeling empowered by publicly sharing their cocreated digital stories through social media and the Sex, Pain & Endometriosis website. CONCLUSIONS Despite the complexities of the story-building process, the workshop and the cocreation and sharing of digital stories were feasible. The storytellers found that this process allowed for emotional healing and personal empowerment by offering a unique way to talk about painful sex, which also facilitated a connection among those in the workshop. The use of digital storytelling as a knowledge translation tool shows promise, and this approach also has potential as a therapeutic intervention.
Collapse
Affiliation(s)
- A Fuchsia Howard
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada.,Women's Health Research Institute, British Columbia Women's Hospital & Health Centre, Vancouver, BC, Canada
| | - Heather Noga
- Women's Health Research Institute, British Columbia Women's Hospital & Health Centre, Vancouver, BC, Canada
| | - Gurkiran Parmar
- Department of Obstetrics and Gynecology, The University of British Columbia, Vancouver, BC, Canada
| | - Lan Kennedy
- Endometriosis Patient Advisory Board, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Sarah Aragones
- Endometriosis Patient Advisory Board, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Roop Bassra
- Endometriosis Patient Advisory Board, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Lauren Gelfer
- Endometriosis Patient Advisory Board, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Edurne Lopez de Arbina
- Endometriosis Patient Advisory Board, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Jessica Sutherland
- Endometriosis Patient Advisory Board, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - Catherine Allaire
- Department of Obstetrics and Gynecology, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Women's Centre for Pelvic Pain and Endometriosis, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| | - John L Oliffe
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada.,Department of Nursing, University of Melbourne, Parkville, Australia
| | - Leanne M Currie
- School of Nursing, The University of British Columbia, Vancouver, BC, Canada
| | - Holly Yager
- Reproductive Health and Fertility Counselling, Vancouver, BC, Canada
| | - Paul J Yong
- Women's Health Research Institute, British Columbia Women's Hospital & Health Centre, Vancouver, BC, Canada.,Department of Obstetrics and Gynecology, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Women's Centre for Pelvic Pain and Endometriosis, British Columbia Women's Hospital and Health Centre, Vancouver, BC, Canada
| |
Collapse
|
5
|
Mohammadzadeh Z, Khakbazan Z, Rad M, Farnam F. Comparison of pain catastrophizing and anxiety in patients with dyspareunia and healthy women: a cross-sectional study. J Med Life 2023; 16:220-226. [PMID: 36937475 PMCID: PMC10015566 DOI: 10.25122/jml-2022-0234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/09/2023] [Indexed: 03/21/2023] Open
Abstract
Despite the prominent role of cognitive-affective variables, such as pain catastrophizing and anxiety in chronic pain, little is known about their relationship with dyspareunia. This study compared pain-catastrophizing and anxiety in reproductive-aged women with and without dyspareunia. A controlled cross-sectional study was conducted on 398 married women in Iran selected by convenience sampling. Sampling was performed both online and in person. Data were collected using a checklist designed for the study, including background characteristics, self-reported dyspareunia, and two standard questionnaires: the Pain Catastrophizing Scale (PCS) and the Spielberger State-Trait Anxiety Inventory-6 (STAI-6). Results showed that 49.5% of the women reported dyspareunia in the previous six months, with a reduced figure of 42% and 31% when using more specific criteria for dyspareunia. Women with dyspareunia had significantly higher scores for pain catastrophizing and anxiety than the control group without dyspareunia. Pain-catastrophizing was associated with aversion to genital contact and body image dissatisfaction. Anxiety was correlated with age, marriage duration, and sexual abuse. Managing anxiety and catastrophizing thoughts may help dyspareunia patients better cope with pain.
Collapse
Affiliation(s)
- Zahra Mohammadzadeh
- Reproductive Health and Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran
- Social Security Organization, East Azerbaijan Treatment Management, Tabriz, Iran
| | - Zohreh Khakbazan
- Reproductive Health and Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rad
- Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Farnaz Farnam
- Reproductive Health and Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Farnaz Farnam, Reproductive Health and Midwifery Department, Tehran University of Medical Sciences, Tehran, Iran. E-mail: ;
| |
Collapse
|
6
|
Mosca L, Riemma G, Braga A, Frigerio M, Ruffolo AF, Dominoni M, Munno GM, Uccella S, Serati M, Raffone A, Salvatore S, Torella M. Female Sexual Dysfunctions and Urogynecological Complaints: A Narrative Review. Medicina (B Aires) 2022; 58:medicina58080981. [PMID: 35893096 PMCID: PMC9331312 DOI: 10.3390/medicina58080981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/05/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Female sexual dysfunctions represent a real widespread problem, usually faced from a psychological point of view; however, millions of women worldwide are impacted by pelvic floor dysfunction, personal shame and social taboos, however, continue to inhibit free conversation on the subject. Women’s quality of life is considerably improved by screening, diagnosing, and controlling urogenital and sexual issues. This review aims to provide a critical perspective of urogenital conditions and common disturbances in female sexual function associated with these issues. It also includes a discussion of postpartum pelvic dysfunction.
Collapse
Affiliation(s)
- Lavinia Mosca
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80128 Naples, Italy; (L.M.); (G.R.); (G.M.M.)
| | - Gaetano Riemma
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80128 Naples, Italy; (L.M.); (G.R.); (G.M.M.)
| | - Andrea Braga
- Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, 6850 Mendrisio, Switzerland;
| | - Matteo Frigerio
- Department of Obstetrics and Gynecology, ASST Monza, Ospedale San Gerardo, 20900 Monza, Italy;
| | - Alessandro Ferdinando Ruffolo
- Obstetrics and Gynecology Unit, Vita-Salute University and IRCCS San Raffaele Hospital, 20132 Milan, Italy; (A.F.R.); (S.S.)
| | - Mattia Dominoni
- Department of Obstetrics and Gynecology, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy;
- Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Gaetano Maria Munno
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80128 Naples, Italy; (L.M.); (G.R.); (G.M.M.)
| | - Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, 37100 Verona, Italy;
| | - Maurizio Serati
- Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, 21100 Varese, Italy;
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences, IRCCS Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy;
- Gynecology and Obstetrics Unit, Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80100 Naples, Italy
| | - Stefano Salvatore
- Obstetrics and Gynecology Unit, Vita-Salute University and IRCCS San Raffaele Hospital, 20132 Milan, Italy; (A.F.R.); (S.S.)
| | - Marco Torella
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80128 Naples, Italy; (L.M.); (G.R.); (G.M.M.)
- Correspondence:
| |
Collapse
|
7
|
Chemotherapy and Related Female Sexual Dysfunction: A Review of Literature. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2022. [DOI: 10.5812/ijcm-120549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Context: Cancer is a detrimental illness that affects patients’ quality of life and other aspects of a healthy life. Chemotherapy has been shown to have a direct and indirect effect on the sex organs of women. Evidence Acquisition: We searched in databases including PubMed, Scopus, and Google scholar. The keywords for our search were as follows: “Chemotherapy” OR “Cancer treatment” AND “Sexual dysfunction “OR “Sexuality” OR "libido” OR "dyspareunia" OR "orgasmic disorder" OR "sexual disorder". We evaluated the articles based on their abstract and 92 studies were selected and used in the present study. Results: Chemotherapeutic agents damage ovaries and could cause premature ovarian failure. Furthermore, chemotherapy disturbs the femininity aspects of patients and reduces their libido. In this review article, we aimed at a better understanding the effect of chemotherapy on the sexual function of female cancer survivals. Conclusions: In conclusion, chemotherapy is one of the most common cancer treatments affecting sexual health aspects, such as decreased libido, arousal and orgasm, dyspareunia, dysfunction of the sexual response cycle before puberty, and vulvovaginal atrophy. However, many patients are reluctant to discuss their sexual problems.
Collapse
|
8
|
Sexual Dysfunction in Women with Neuromyelitis Optica Spectrum Disorders and Multiple Sclerosis. SEXUALITY AND DISABILITY 2022. [DOI: 10.1007/s11195-022-09731-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
9
|
Leitch J, Webb A, Pudwell J, Chamberlain S, Henry R, Nitsch R. Magnesium-based trigger point infiltrations versus local anesthetic infiltrations in chronic pelvic myofascial pain: A randomized, double-blind control study. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2022; 44:877-885. [PMID: 35339694 DOI: 10.1016/j.jogc.2022.02.129] [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: 08/17/2021] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine if a novel, magnesium-based trigger point infiltration formulation is more effective in treating chronic myofascial pelvic pain than lidocaine-only infiltration. METHODS This was a single-centre, double-blind, randomized controlled trial of women diagnosed with chronic pelvic myofascial pain associated with trigger points. We compared a novel magnesium-based infiltration formulation with lidocaine infiltration of trigger points and with a control group of participants who were waitlisted for a chronic pain clinic. Treatment groups completed a 12-week program that included 8 trigger point injection treatments and nine visits during which pain scores were recorded and questionnaires administered. The primary outcome measure was change in mean pain score between baseline and the final visit. Secondary outcomes included pain with function scores, scores on the World Health Organization Quality of Life questionnaire, procedural pain, concomitant medication use, and complications. RESULTS We assigned 44 women diagnosed with chronic myofascial pelvic pain associated with trigger points to either the magnesium-based infiltrate (n = 15), lidocaine infiltrate (n = 17), or waitlist (n = 12) group. In the intent-to-treat analysis, a clinically relevant decrease in mean pain score out of 10 was observed in the magnesium-based (-2.6 ± 3.2) and lidocaine (-2.9 ± 3.1) infiltration groups, but not in the waitlist group (-0.5 ± 2.3). The per protocol analysis post-hoc tests, adjusted for multiple comparisons, found a significant difference in the average change in pain score between the magnesium-based infiltrate and the waitlist groups (P = 0.045), while differences between the lidocaine infiltrate and waitlist groups approached statistical significance (P = 0.052). Both treatment groups saw improvements in pain with function and quality of life scores. CONCLUSION While this study is underpowered, it does not support the use of a magnesium-based trigger point infiltrate in the treatment of chronic myofascial pelvic pain over lidocaine-only infiltration. Nonetheless, these results are consistent with current management recommendations and suggest improvements in pain, pain with function, and quality of life scores with either magnesium-based or lidocaine-only infiltration. We outline an approach to assessment and treatment that can be adopted by general gynaecologists.
Collapse
Affiliation(s)
- Jordan Leitch
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON
| | - Amanda Webb
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
| | - Jessica Pudwell
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
| | - Susan Chamberlain
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON
| | - Richard Henry
- Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON
| | - Romy Nitsch
- Department of Obstetrics and Gynecology, Queen's University, Kingston, ON.
| |
Collapse
|
10
|
Velayati A, Jahanian Sadatmahalleh S, Ziaei S, Kazemnejad A. The role of personal factors in quality of life among Iranian women with vaginismus: a path analysis. Health Qual Life Outcomes 2021; 19:166. [PMID: 34130696 PMCID: PMC8204437 DOI: 10.1186/s12955-021-01799-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/08/2021] [Indexed: 12/16/2022] Open
Abstract
Background The aim of this study was to provide a path model for assessing the direct and/or indirect effects of psychological/behavioral parameters on health-related quality of life among women with vaginismus. Methods A cross-sectional study was conducted on a sample of 236 women with vaginismus disorder attending to sex clinics in Tehran, Iran from April 2017 to March 2018. Data were collected using a demographic questionnaire, the marital satisfaction scale, the hospital anxiety and depression scale, the rosenberg self-esteem scale, the body image concern inventory, the short-form health survey (SF-12) and the female sexual quality of life questionnaire. In addition to descriptive statistical data, the fitness of the proposed model was investigated using path analysis. Results The results of path analysis demonstrated that the final model had a good fit to the data (Chi-Square/degrees of freedom (Normed Chi2) = 2.12, root mean square error of approximation = 0.069, goodness fit index = 0.99, both comparative fit index = 0.99 and Tucker–Lewis index = 0.96). In this model, anxiety and depression significantly predicted health-related quality of life as measured by the SF-12. Conclusions Anxiety and depression are important components in predicting health-related quality of life among those suffering from vaginismus. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01799-5.
Collapse
Affiliation(s)
- Atefeh Velayati
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | | | - Saeideh Ziaei
- Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Anoshirvan Kazemnejad
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Ale-Ahmad Highway, 14115-111, Tehran, Iran
| |
Collapse
|
11
|
Aoun F, Alkassis M, Tayeh GA, Chebel JA, Semaan A, Sarkis J, Mansour R, Mjaess G, Albisinni S, Absil F, Bollens R, Roumeguère T. Sexual dysfunction due to pudendal neuralgia: a systematic review. Transl Androl Urol 2021; 10:2500-2511. [PMID: 34295736 PMCID: PMC8261452 DOI: 10.21037/tau-21-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/26/2021] [Indexed: 01/16/2023] Open
Abstract
Background The pudendal nerve is considered as the main nerve of sexuality. Pudendal neuralgia is an underdiagnosed disease in clinical practice. The aim of this systematic review is to highlight the role of pudendal neuralgia on sexual dysfunction in both sexes. Methods A PubMed search was performed using the following keywords: “Pudendal” AND “Sexual dysfunction” or “Erectile dysfunction” or “Ejaculation” or “Persistent sexual arousal” or “Dyspareunia” or “Vulvodynia”. The search involved patients having sexual dysfunction due to pudendal neuralgia. Treatment received was also reported. Results Five case series, seven cohort studies, two pilot studies, and three randomized clinical trials were included in this systematic review. Pudendal nerve and/or artery entrapment, or pudendal neuralgia, is a reversible cause of multiple sexual dysfunctions. Interventions such as anesthetic injections, neurolysis, and decompression are reported as potential treatment modalities. There are no studies describing the role of pudendal canal syndrome in the pathophysiology or treatment of delayed ejaculation or penile shortening. Discussion Pudendal neuralgia is an underestimated yet important cause of persistent genital arousal, erectile dysfunction (ED), premature ejaculation (PE), ejaculation pain, and vulvodynia. Physicians should be aware of this entity and examine the pudendal canal in such patients before concluding an idiopathic cause of sexual dysfunction.
Collapse
Affiliation(s)
- Fouad Aoun
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon.,Urology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Marwan Alkassis
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Georges Abi Tayeh
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Josselin Abi Chebel
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Albert Semaan
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Julien Sarkis
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Raymond Mansour
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon
| | - Georges Mjaess
- Urology Department, Hôtel Dieu de France, Université Saint Joseph, Beirut, Lebanon.,Urology Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Simone Albisinni
- Urology Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Fabienne Absil
- Urology department, Centre Hospitalier EpiCURA, Site de Ath, Ath, Belgium
| | - Renaud Bollens
- Urology department, Centre Hospitalier de Wallonie Picarde, Tournai, Belgium
| | - Thierry Roumeguère
- Urology Department, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.,Urology Department, Cliniques Universitaires de Bruxelles, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
12
|
Miles K, Miles S. Low Dose, High Frequency Movement Based Dilator Therapy for Dyspareunia: Retrospective Analysis of 26 Cases. Sex Med 2021; 9:100344. [PMID: 33992935 PMCID: PMC8240346 DOI: 10.1016/j.esxm.2021.100344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION While two-thirds of women will experience dyspareunia and vaginal dilators are often used to treat dyspareunia, outside of a single case report, no study has investigated the potential of low-dose, high frequency movement-based dilator therapy for dyspareunia in premenopausal female patients. AIM To determine the utility of low-dose, high frequency movement-based dilator use for dyspareunia in premenopausal female patients. METHODS Retrospective study of women presenting to outpatient hospital-based pelvic floor physical therapy office in a tertiary care center. All adult premenopausal female patients who were referred to pelvic floor physical therapy for dyspareunia and completed movement-based dilator therapy (MBDT) and met study criteria (n = 26) were included for analysis. MAIN OUTCOME MEASURE Patient change in pain level status using Numeric Pain Rating Scale with intercourse was compared between initial evaluation and time of discharge from pelvic floor physical therapy. RESULTS Among the 26 women who met criteria for this study, the average pain score decreased from 8.3 (SD 2.2) before treatment to 1.3 (SD 2.0) after treatment and was statistically significant (P< .001). Complete resolution of dyspareunia was reported in 58% of patients. Patients completed between 2 and 6 total pelvic floor physical therapy visits (average 3.7, SD1.5), over 0-44 weeks (mean 9.6 weeks, SD 8.3). CONCLUSION Low-dose, high frequency, movement-based dilator therapy significantly reduced or resolved the experience of pain with penetrative vaginal intercourse with dyspareunia. Future prospective studies with larger samples and the inclusion of sexual functional status should be considered to explore the full potential of this modality in treatment of premenopausal patients with dyspareunia. Miles K, Miles S. Low Dose, High Frequency Movement Based Dilator Treatment for Dyspareunia: Retrospective Analysis of 26 Cases. Sex Med 2021;9:100344.
Collapse
Affiliation(s)
- Katherine Miles
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD, USA; Uniformed Services University, Bethesda, MD, USA
| | - Shana Miles
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, PA, USA; Uniformed Services University, Bethesda, MD, USA.
| |
Collapse
|
13
|
Soltan MR, Raheem TAA, Soliman SS, Saleh NM, Khatery BH. Depression and anxiety as risk factors for female sexual pain. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00061-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Abstract
Background
Female sexual pain is a complex multifactorial condition. Most of researches have focused on underlying biomedical factors. Although psychological, psychiatric, and relational factors have been studied as possible correlates, limited research has been made in this area about the Egyptian population. The present study aimed to evaluate prevalence of female sexual pain among a sample of Egyptian females and detect its correlation with depression and anxiety. Female sexual function index (FSFI) was used to evaluate sexual pain in 450 women calculating their pain domain scores. Their scores were correlated to demographic data, genital health complaints, depression, and anxiety symptoms.
Results
The prevalence of marked severe sexual pain was 31.6% and that of trivial pain was 68.4% in the studied group. In the study group, 75 (16.7%) females had depressive symptoms, and 40 (8.9%) females had anxiety symptoms. Patients with severe depression had significantly marked severe pain than patients with minimal depression (p < 0.001 respectively). Patients with severe anxiety had significantly lower pain score than patients without (p < 0.001). Pain score had significant negative correlation with each of the depression score (r − 0.524, p < 0.001) and the anxiety score (r − 0.305, p < 0.001). Patients with gynecological causes especially fungal infection had significantly severe marked pain than patients without any other physical causes (< 0.001).
Conclusions
Anxiety, depression, and the presence of gynecological causes especially fungal infection were significantly independent risk factors for more sexual pain.
Collapse
|
14
|
Webber V, Miller ME, Gustafson DL, Bajzak K. Vulvodynia Viewed From a Disease Prevention Framework: Insights From Patient Perspectives. Sex Med 2020; 8:757-766. [PMID: 32773263 PMCID: PMC7691876 DOI: 10.1016/j.esxm.2020.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Persons with vulvodynia (a chronic vulvar pain condition) suffer many barriers to diagnosis and treatment, several of which may be exacerbated by the sociocultural and geographical context in which they live. AIM We drew on the experiences of patients with vulvodynia who were living in small urban and rural communities to learn what they perceived as the major barriers to diagnosis and treatment as well as to probe for possible solutions. METHODS For this qualitative case study, we conducted 3 focus groups with a total of 10 participants, drawn from patients seen at our academic tertiary referral center, with a goal of understanding their lived experience with vulvodynia. MAIN OUTCOME MEASURES The patient dialogue was coded into themes and temporally grouped to illustrate struggles and victories in diagnosis and treatment. RESULTS Participants confirmed that healthcare provider knowledge and attitudes as well as system challenges (specialist and allied healthcare provider availability) are major barriers to timely diagnosis. Of novel interest are other factors that exacerbate distress and delay diagnosis such as patients' inadequate knowledge of sexual functioning and sociocultural messages regarding "normal" sexual activity. Our work suggests that a disease prevention framework that includes comprehensive sexual education before or at the onset of sexual activity may be of benefit in reducing the burden of vulvodynia when added to strategies to increase healthcare provider knowledge and improve access to effective treatments. CONCLUSION While healthcare provider knowledge and attitudes are often at the forefront of barriers to diagnosis, our study suggests that to minimize patient distress and expedite diagnosis, resources must also be directed to promoting comprehensive sexual health education. Webber V, Miller ME, Gustafson DL, et al. Vulvodynia Viewed From a Disease Prevention Framework: Insights From Patient Perspectives. Sex Med 2020;8:757-766.
Collapse
Affiliation(s)
- Valerie Webber
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Michelle E Miller
- Discipline of Obstetrics and Gynecology, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Diana L Gustafson
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada
| | - Krisztina Bajzak
- Discipline of Obstetrics and Gynecology, Memorial University, St. John's, Newfoundland & Labrador, Canada.
| |
Collapse
|
15
|
Ghizzani A, Luisi S, Cartocci A, Cevenini G. Genitopelvic pain: retrospective evaluation of a multimodal treatment efficacy. ACTA ACUST UNITED AC 2020; 72:123-131. [PMID: 33000613 DOI: 10.23736/s0026-4784.20.04555-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Genitopelvic and sexual pain penetration disorder (GPPD) recognizes a multifaceted etiology. As with syndromes of chronic pain, it responds poorly to medications and its management is difficult. Clinicians consequently favor a multimodal comprehensive approach to tackle the different aspects of the disorder. To treat GPPD women, we chose a multimodal regimen including topical and systemic medications associated with physical interventions and behavioral couple therapy. Our aim was to evaluate the regimen efficacy and the influence that demographic, clinical, and pain characteristics may have on the outcome. METHODS Sixty self -referred women requesting medical care for GPPD, who were free of debilitating illness, in stable heterosexual relationships and with healthy and sexually functional partners, were treated according with the multimodal regimen we tailored on the specific needs of these women. As said, it associated topical and systemic medications combined with physical exercises used in behavioral sex therapy, and behavioral couple therapy. Past sexual history, characteristics of pain, vestibular hyperreactivity, pelvic floor hypertonicity, general health, and couple harmony were evaluated and statistically analyzed to determine which characteristics were associated with therapy outcome. RESULTS The statistical analysis of an association between demographic, reproductive, pain and medical conditions on one hand and therapy outcome on the other did not find any significance. CONCLUSIONS The lack of association between the investigated characteristics and treatment outcome is disappointing; on the other hand, the statistically significant impact of couple harmony (evaluated as partner presence and participation) on the treatment results may be the answer to our search for factors predicting outcome.
Collapse
Affiliation(s)
- Anna Ghizzani
- Department of Molecular and Developmental Medicine, Obstetrics and Ginecology, University of Siena, Siena, Italy
| | - Stefano Luisi
- Department of Molecular and Developmental Medicine, Obstetrics and Ginecology, University of Siena, Siena, Italy -
| | | | - Gabriele Cevenini
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| |
Collapse
|
16
|
Alaniz G, Dods M, Dackovic H, Mascola M, Moreira K, Dufour S. Pre-Licensure Inter-Professional Perspectives: Pelvic Health Physiotherapy. Physiother Can 2020; 72:298-304. [PMID: 35110798 DOI: 10.3138/ptc-2018-0112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: In this study, we examined knowledge and perspectives pertaining to pelvic health physiotherapy among medical, midwifery, nursing, and physician assistant students at McMaster University. Moreover, we identified opportunities to improve knowledge translation to facilitate inter-professional education in urogynecological care. Method: A cross-sectional design was created to distribute an online survey to participants using a modified Dillman approach. The survey assessed areas of clinical interest in, knowledge of the scope of practice of, and regulations governing pelvic health physiotherapy in specific, in addition to clinical applications. Fisher's exact and Kruskal-Wallis tests were used to assess statistical significance. Results: A total of 90% of the participants incorrectly indicated that internal digital exams could be delegated to physiotherapy assistants, and 50% believed that Kegel exercises were appropriate for all presentations of pelvic floor dysfunction. Moreover, when prompted to select conditions that could be treated by pelvic health physiotherapists, only 2% of the participants selected the correct conditions. Conclusions: Knowledge in all four programmes about the scope of practice, authorized activities, and application of pelvic health physiotherapy is inadequate. To foster the optimal integration of urogynecology into the relevant health science curriculums, enhanced inter-professional education, inclusive of pelvic health physiotherapy knowledge, appears to be needed.
Collapse
Affiliation(s)
- Grecia Alaniz
- Faculty of Health Science, McMaster University, Hamilton.,Radius Health Clinic, Chatham
| | - Margot Dods
- Faculty of Health Science, McMaster University, Hamilton
| | | | | | - Karen Moreira
- Faculty of Health Science, McMaster University, Hamilton
| | - Sinéad Dufour
- Faculty of Health Science, McMaster University, Hamilton.,The World of My Baby, Burlington, Ont
| |
Collapse
|
17
|
Witzeman K, Antunez Flores O, Renzelli-Cain RI, Worly B, Moulder JK, Carrillo JF, Schneider B. Patient-Physician Interactions Regarding Dyspareunia with Endometriosis: Online Survey Results. J Pain Res 2020; 13:1579-1589. [PMID: 32636669 PMCID: PMC7334010 DOI: 10.2147/jpr.s248887] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/28/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Dyspareunia can be a debilitating symptom of endometriosis. We performed this study to examine women's experiences with painful sexual intercourse, the impact of dyspareunia on patients' lives, and perceptions of interactions with healthcare practitioners. METHODS An anonymous 24-question online survey was provided through the social media network MyEndometriosisTeam.com and was available internationally to women aged 19-55 years who were self-identified as having endometriosis and had painful sexual intercourse within the past 2 years. RESULTS From June 13 to August 20, 2018, 860 women responded and 638 women completed the survey (United States, n = 361; other countries, n = 277; 74% survey completion rate). Respondents reported high pain levels (mean score, 7.4 ± 1.86; severity scale of 0 [no pain] to 10 [worst imaginable pain]), with 50% reporting severe pain [score of 8 to 10]). Nearly half (47%) reported pain lasting ≥24 hours after intercourse with the pain often leading to avoiding (34%) or stopping (29%) intercourse. Pain impacted patients' lives, causing depression (61%), anxiety (61%), low self-esteem (55%), and relationship strain. Many women feared to seek help (10%). Of those women who approached practitioners, many (36%) did not receive effective treatments. DISCUSSION Women with dyspareunia related to endometriosis experience severe pain that can negatively impact patients' lives. Dyspareunia may be a challenging topic for discussion for both patient and practitioner, leading to a suboptimal treatment approach and management. Results suggest that practitioners need improved education and training regarding dyspareunia to evaluate and treat patients' sexual pain caused by endometriosis.
Collapse
Affiliation(s)
- Kathryn Witzeman
- Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO, USA
| | | | | | - Brett Worly
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA
| | - Janelle K Moulder
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jorge F Carrillo
- Department of Obstetrics and Gynecology, University of Central Florida, Orlando, FL, USA
| | | |
Collapse
|
18
|
Pessoa de Farias Rodrigues M, Lima Vilarino F, de Souza Barbeiro Munhoz A, da Silva Paiva L, de Alcantara Sousa LV, Zaia V, Parente Barbosa C. Clinical aspects and the quality of life among women with endometriosis and infertility: a cross-sectional study. BMC WOMENS HEALTH 2020; 20:124. [PMID: 32532273 PMCID: PMC7291762 DOI: 10.1186/s12905-020-00987-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/05/2020] [Indexed: 12/24/2022]
Abstract
Background The quality of life (QoL) of patients with endometriosis and infertility was assessed in different stages and correlated with the clinical features of the cases. Methods The present study was a cross-sectional study; 106 women were included, divided in two endometriosis groups (Grade I/II, 26 women, and Grade II/IV, 74 women). All participants attended the Endometriosis and Infertility Outpatient Clinic of the Instituto Ideia Fértil de Saúde Reprodutiva, Faculdade de Medicina do ABC, São Paulo, Brazil, were and responded to the Short Form (SF) Health Survey-36. Convenience sampling was used due to the authors’ access to the study population; however, the sample number was calculated to be sufficient for 95% power in both groups. Results Homogeneity was observed between Grade I/II and Grade III/IV staging, with similar mean ages (35.27, ±3.64 years and 34.04, ±3.39 years, respectively, p = 0.133); types of infertility (p = 0.535); infertility time (p = 0.654); degrees of pain (p = 0.849); and symptoms common to endometriosis, namely, dysmenorrhea (p = 0.841), dyspareunia (0.466), chronic pelvic pain (p = 0.295), and intestinal (p = 0.573) or urinary (p = 0.809) diseases. Comparisons of median scores in the QoL domains demonstrated that the distributions of QoL and clinical symptoms were significantly related between the types of dyspareunia and the following domains: physical functioning (p = 0.017), role- emotional (p = 0.013), and general health (p = 0.001). Regarding pain outside of menstruation, there was significance in the pain domain (p = 0.017), and degree of pain was significance in physical functioning (p = 0.005) and role-physical (p = 0.011) domains. Conclusions The present study pointed out that it is not the stage of endometriosis that interferes in the quality of life of women with endometriosis and infertility but rather the clinical manifestations, such as dyspareunia and pain. Thus, we can conclude that the patient’s perception of the disease should be considered in health care and that the losses are independent of the degree of endometriosis in this population with the aggravating factor of infertility.
Collapse
Affiliation(s)
- Marina Pessoa de Farias Rodrigues
- Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Avenida Lauro Gomes, 2000, Vila Sacadura Cabral, Santo André, SP, 09060-870, Brazil.,Centro Universitário Vale do Salgado, Icó, Ceará, Brazil
| | | | | | - Laércio da Silva Paiva
- Centro Universitário Vale do Salgado, Icó, Ceará, Brazil.,Laboratório de Epidemiologia e Análises de Dados da Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Santo André, SP, Brazil
| | - Luiz Vinicius de Alcantara Sousa
- Centro Universitário Vale do Salgado, Icó, Ceará, Brazil.,Laboratório de Epidemiologia e Análises de Dados da Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Santo André, SP, Brazil
| | - Victor Zaia
- Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Avenida Lauro Gomes, 2000, Vila Sacadura Cabral, Santo André, SP, 09060-870, Brazil. .,Instituto Ideia Fértil de Saúde Reprodutiva, Santo André, SP, Brazil. .,Disciplina de Saúde Sexual, Reprodutiva e Genética e Pós-Graduação em Ciências da Saúde da Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Santo André, SP, Brazil.
| | - Caio Parente Barbosa
- Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Avenida Lauro Gomes, 2000, Vila Sacadura Cabral, Santo André, SP, 09060-870, Brazil.,Instituto Ideia Fértil de Saúde Reprodutiva, Santo André, SP, Brazil.,Disciplina de Saúde Sexual, Reprodutiva e Genética e Pós-Graduação em Ciências da Saúde da Faculdade de Medicina do ABC / Centro Universitário Saúde ABC, Santo André, SP, Brazil
| |
Collapse
|
19
|
Chen CL, Meng E. Can Botulinum Toxin A Play A Role In Treatment Of Chronic Pelvic Pain Syndrome In Female Patients?-Clinical and Animal Evidence. Toxins (Basel) 2020; 12:toxins12020110. [PMID: 32050685 PMCID: PMC7076794 DOI: 10.3390/toxins12020110] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/05/2020] [Accepted: 02/07/2020] [Indexed: 11/16/2022] Open
Abstract
Chronic pelvic pain (CPP) is defined as chronic pain and inflammation in the pelvic organs for more than six months. There are wide ranges of clinical presentations, including pelvic pain, painful intercourse, irritable bowel syndrome, and pain during urinating. Chronic pelvic pain syndrome (CPPS) is a subdivision of CPP, and the pain syndrome may be focused within a single organ or more than one pelvic organ. As there is uncertain pathogenesis, no standard treatment is currently available for CPPS. Botulinum toxin A (BoNT-A) is a potent neurotoxin that blocks acetylcholine release to paralyze muscles. Intravesical BoNT-A injection can reduce bladder pain in patients with interstitial cystitis/bladder pain syndrome. BoNT-A injected into the pelvic floor muscles of women has also been reported to improve chronic pain syndrome. Due to the reversible effect of BoNT-A, repeated injection appears to be necessary and effective in reducing symptoms. Adverse effects of BoNT-A may worsen the preexisting conditions, including constipation, stress urinary incontinence, and fecal incontinence. This review summarizes the evidence of BoNT-A treatment for CPPS in animal studies and clinical studies regarding the therapeutic effects of BoNT-A for CPPS in female patients.
Collapse
Affiliation(s)
| | - En Meng
- Correspondence: ; Tel.: +886-2-87927169
| |
Collapse
|
20
|
Abstract
Gastrointestinal (GI) pain - a form of visceral pain - is common in some disorders, such as irritable bowel syndrome, Crohn's disease and pancreatitis. However, identifying the cause of GI pain frequently represents a diagnostic challenge as the clinical presentation is often blurred by concomitant autonomic and somatic symptoms. In addition, GI pain can be nociceptive, neuropathic and associated with cancer, but in many cases multiple aetiologies coexist in an individual patient. Mechanisms of GI pain are complex and include both peripheral and central sensitization and the involvement of the autonomic nervous system, which has a role in generating the symptoms that frequently accompany pain. Treatment of GI pain depends on the precise type of pain and the primary disorder in the patient but can include, for example, pharmacological therapy, cognitive behavioural therapies, invasive surgical procedures, endoscopic procedures and lifestyle alterations. Owing to the major differences between organ involvement, disease mechanisms and individual factors, treatment always needs to be personalized and some data suggest that phenotyping and subsequent individual management of GI pain might be options in the future.
Collapse
|
21
|
Arthur B, Chung MK, Brobyn T, LaRiccia PJ. Successful Treatment of Dyspareunia with an Integrative Medicine Approach: A Case Report. Integr Med (Encinitas) 2019; 18:38-41. [PMID: 32549855 PMCID: PMC7238908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A 50-year-old woman with a five-and-a-half-year history of dyspareunia was successfully treated with an integrative medicine approach, including Neural Therapy, osteopathic therapy, acupuncture, and trigger point therapy, resulting in complete resolution which has been maintained to the present day, nineteen years later. Further research is justified and recommended.
Collapse
Affiliation(s)
- Brenda Arthur
- Medical student at Cooper Medical School of Rowan University located in Camden, NJ
| | - Myung Kyu Chung
- Clinical professor of family medicine at Rowan University School of Osteopathic Medicine and Chung Institute of Integrative Medicine located in Camden, NJ
| | - Tracy Brobyn
- Clinical assistant professor of family medicine at Cooper Medical School of Rowan University and Chung Institute of Integrative Medicine located in Camden, NJ
| | - Patrick J LaRiccia
- Research director at the Won Sook Chung Foundation and adjunct scholar center for clinical epidemiology and biostatistics at the Perlman School of Medicine of the University of Pennsylvania located in Camden, NJ
| |
Collapse
|
22
|
Abouzeid B, El Hasbani G, Mufarrij I. Observational analysis of mesh related complications in urogynecologic procedures. J Robot Surg 2019; 14:377-382. [PMID: 31493187 DOI: 10.1007/s11701-019-01020-2] [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: 07/13/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
Abstract
Since the 1990s, the use of mesh has expanded in gynecologic surgeries in the aim of correcting pelvic organ prolapse. Because there has been a lot of complications that were reported, the U.S. Food and Drug Administration has requested the withdrawal of many products from the market. Recently, many countries have called for the suspension of vaginal mesh products from the market. The objective of this review is to analyze the incidence of the complications that arise after vaginal mesh surgeries with an insight to the American College of Obstetricians and Gynecologists recommendations on the management of those complications.
Collapse
Affiliation(s)
| | | | - Imad Mufarrij
- The George Washington University Hospital, Washington, DC, USA
| |
Collapse
|