2020 News from the Research Team Articles

March 2020

Article Summary by IPPS Research Committee Member

Incidence and Risk Factors for Pelvic Pain After Mesh Implant Surgery for the Treatment of Pelvic Floor Disorders

Elizabeth J. Geller,* Emma Babb, Andrea G. Nackley, and Denniz Zolnoun
J Minim Invasive Gynecol. 2017 Jan 1; 24(1): 67–73.

Summary:  The aim of this study was to assess incidence and risk factors for pelvic pain after pelvic mesh implantation. This was a retrospective study of women who have undergone surgery with pelvic mesh implant for treatment of pelvic floor disorders including prolapse and incontinence.Pain was measured by the McGill Short-Form Pain Questionnaire for somatic pain, Neuropathic Pain Symptom Inventory for neuropathic pain, Pennebaker Inventory of Limbic Languidness for somatization, and Female Sexual Function Index (FSFI) for sexual health and dyspareunia. General health was assessed with the 12-item Short-Form Health Survey. Among 160 enrolled women, mean time since surgery was 20.8 ± 10.5 months, mean age was 62.1 ± 11.2 years, 93.8% were white, 86.3% were postmenopausal, and 3.1% were tobacco users. Types of mesh included midurethral sling for stress incontinence (78.8%), abdominal/robotic sacrocolpopexy (35.7%), transvaginal for prolapse (6.3%), and perirectal for fecal incontinence (1.9%), with 23.8% concomitant mesh implants for both prolapse and incontinence. Our main outcome, self-reported pelvic pain at least 1 year after surgery, was 15.6%. Women reporting pain were younger, with fibromyalgia, worse physical health, higher somatization, and lower surgery satisfaction (all p < .05). Current pelvic pain correlated with early postoperative pelvic pain (p < .001), fibromyalgia (p = .002), worse physical health (p = .003), and somatization (p = .003). Sexual function was suboptimal (mean FSFI, 16.2 ± 12.1). Only 54.0% were sexually active, with 19.0% of those reporting dyspareunia. The authors concluded that 1 in 6 women reported de novo pelvic pain after pelvic mesh implant surgery, with decreased sexual function. Risk factors for denovo pain included younger age, fibromyalgia, early postoperative pain, poorer physical health, and somatization.

Full article available HERE.

February 2020

Article Summary by IPPS Research Committee Member

Craniosacral therapy for chronic pain: a systematic review and meta-analysis of randomized controlled trials.

Haller H, Lauche R, Sundberg T, Dobos G, Cramer H.
BMC Musculoskeletal Disorders, 2020; 21:1

Summary: The objective of this systematic review and meta-analysis was to assess the evidence of Craniosacral Therapy (CST) for the treatment of chronic pain. The authors identified 10 RCTs of 681 patients with neck and back pain, migraine, headache, fibromyalgia, epicondylitis, and pelvic girdle pain. CST showed greater post intervention effects on: pain intensity (SMD = -0.32, 95%CI = [- 0.61,-0.02]) and disability (SMD = -0.58, 95%CI = [- 0.92,-0.24]) compared to treatment as usual; on pain intensity (SMD = -0.63, 95%CI = [- 0.90,-0.37]) and disability (SMD = -0.54, 95%CI = [- 0.81,-0.28]) compared to manual/non-manual sham; and on pain intensity (SMD = -0.53, 95%CI = [- 0.89,-0.16]) and disability (SMD = -0.58, 95%CI = [- 0.95,-0.21]) compared to active manual treatments. At six months, CST showed greater effects on pain intensity (SMD = -0.59, 95%CI = [- 0.99,-0.19]) and disability (SMD = -0.53, 95%CI = [- 0.87,-0.19]) versus sham. Secondary outcomes were all significantly more improved in CST patients than in other groups, except for six-month mental quality of life versus sham. The authors concluded that in patients with chronic pain, CST significantly improves pain and function lasting up to six months. . 

Full article available HERE.

January 2020

Article Summary by IPPS Research Committee Member

Pharmacological Interventions for Treating Chronic Prostatitis/Chronic Pelvic Pain Syndrome.

Franco JV1, Turk T, Jung JH, Xiao YT, Iakhno S, Tirapegui FI, Garrote V, Vietto V.
Cochrane Database Syst Rev. 2019

Summary: Chronic prostatitis / chronic pelvic pain syndrome (CP/CPPS) is characterized as pelvic pain and lower urinary tract symptoms. This systematic review aimed to assess the efficacy of pharmacological therapies for CP/CPPS, which is considered a complex and multifactorial disorder. In the review, the authors included randomized controlled trials conducted in men a diagnosis of CP/CPPS. They evaluated all available pharmacological interventions compared to placebo or in head-to-head comparisons. The authors identified 99 unique studies assessing 16 types of pharmacological therapies. Overall, they found low- to very low-quality evidence that alpha blockers, antibiotics, 5-ARI, anti-inflammatories, phytotherapy, intraprostatic BTA injection, and traditional Chinese medicine may cause a reduction in prostatitis symptoms without an increased incidence of adverse events in the short term, except for alpha blockers which may be associated with an increase in mild adverse events. There were few trials with active comparators and little evidence of the effects of these drugs on sexual dysfunction, quality of life or anxiety and depression. 

Full article available HERE.

2019 Archived Research News

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April 2019 

May 2019

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July 2019 

August 2019