Effective treatment of pelvic pain: A Synthesis of Findings from 42 Studies

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Original Abstract of the Article

Key research findings

Various studies have explored effective treatments for pelvic pain. 18 found that pregabalin was not superior to placebo in treating men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). Pregabalin has been proven effective in other chronic pain syndromes. 29 showed that onabotulinumtoxin A injections were not more effective than saline injections in reducing muscle pain on palpation in women with myofascial pelvic pain. However, those who received onabotulinumtoxin A were more likely to report improvement in their overall pelvic floor pain. 5 suggests that terazosin is an effective treatment for CPPS patients. 37 suggests that low-intensity shockwave therapy (LiST) may be effective for managing pain in patients with CP/CPPS. 8 suggests that physical therapy is effective in preventing and treating pregnancy-related back and pelvic pain. 41 found that therapeutic ultrasound was more effective than local anesthetic injections for women with chronic pelvic pain due to abdominal myofascial syndrome. 30 showed that gabapentin can be effective in reducing pain in women with chronic pelvic pain. These studies suggest that there are a variety of approaches to treating chronic pelvic pain.

Treatment summary

18 found that pregabalin was not superior to placebo in treating men with CP/CPPS. 29 showed that onabotulinumtoxin A injections were not more effective than saline injections in reducing muscle pain on palpation in women with myofascial pelvic pain. 5 suggests that terazosin is an effective treatment for CPPS patients. 37 suggests that LiST may be effective for managing pain in patients with CP/CPPS. 8 suggests that physical therapy is effective in preventing and treating pregnancy-related back and pelvic pain. 41 found that therapeutic ultrasound was more effective than local anesthetic injections for women with chronic pelvic pain due to abdominal myofascial syndrome. Lastly, 30 showed that gabapentin can be effective in reducing pain in women with chronic pelvic pain. These studies present a variety of possibilities for treating chronic pelvic pain.

Benefits and risks

Benefits summary

Various treatments for chronic pelvic pain have the potential to provide benefits such as pain reduction, improved quality of life, improved sexual function, improved bladder function, and improved bowel function. For example, 16 found that extracorporeal shock wave therapy (ESWT) is effective in improving pain, quality of life, and voiding conditions in men with CPPS. 29 found that women who received onabotulinumtoxin A injections were more likely to report improvement in their overall pelvic floor pain compared to women who received placebo. 37 suggests that LiST is effective for managing pain in CP/CPPS patients. Furthermore, 34 showed that gabapentin may reduce pain in women with chronic pelvic pain.

Risk summary

Treatments for chronic pelvic pain may come with side effects. For example, 30 showed that gabapentin has a higher risk of side effects, such as dizziness. Also, 23 found that 20% of patients stopped the study due to adverse effects of duloxetine. Other treatments, such as onabotulinumtoxin A injections, may cause side effects such as constipation, urinary incontinence, and urinary tract infection. 29 It is important to carefully consider the potential risks and benefits when selecting a treatment option.

Comparison between studies

Commonalities between studies

Many studies are evaluating the effectiveness and safety of various treatments for chronic pelvic pain. For example, studies such as 18 , 29 , 16 , 30 , 34 are using placebo-controlled trials to assess the effectiveness of certain treatments. These studies employ standard methodologies for assessing the effectiveness of treatment options.

Differences between studies

Studies differ in terms of the population studied, the treatments used, and the outcomes evaluated. For example, 18 focused on men with CP/CPPS, while 29 focused on women with myofascial pelvic pain. 16 investigated ESWT, while 30 investigated gabapentin. These differences could make interpreting the results challenging. Furthermore, 14 employed traditional Chinese medicine (TCM) to treat chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). This study used a blinded controlled trial method to evaluate the effectiveness of TCM treatment principles. The TCM treatment principles are a feature not found in other studies.

Consistency and contradictions in the results

There is no consistent evidence regarding the effectiveness of treatments for chronic pelvic pain. Some studies show that certain treatments are effective, while others do not show effectiveness or require further investigation. For example, 18 found that pregabalin was not superior to placebo in treating men with CP/CPPS. On the other hand, 30 showed that gabapentin may reduce pain in women with chronic pelvic pain. These conflicting results may reflect the complex nature of chronic pelvic pain and the diversity among patients.

Considerations for applying the results to real-life scenarios

There are a variety of options for treating chronic pelvic pain, but the best treatment option varies depending on the individual patient. When selecting a treatment, it is important to consider the potential risks and benefits, the patient’s medical history, and the severity of the symptoms. Collaboration with a healthcare professional is essential to maximize the effectiveness of the treatment. Avoid self-treating or stopping treatment without consulting a healthcare professional.

Limitations of the current research

Research on treatments for chronic pelvic pain has several limitations. For example, many studies have limited patient populations, making it difficult to generalize the findings to other populations. Some studies also have small sample sizes, which may lead to a lack of statistical significance. Furthermore, research on the long-term effects of treatments for chronic pelvic pain is lacking. These limitations highlight the need for further research on treatments for chronic pelvic pain.

Future research directions

Further research on treatments for chronic pelvic pain should focus on the following areas:

  • Identifying the optimal treatments for various subtypes of chronic pelvic pain.
  • Conducting large-scale clinical trials with diverse patient populations.
  • Conducting studies evaluating long-term effects.
  • Developing new treatment methods and technologies to improve the effectiveness of treatment options.

Conclusion

Chronic pelvic pain is a debilitating symptom for many women. While a variety of treatments are available, the best treatment option for each individual will vary. Working closely with a healthcare professional to select the appropriate treatment is essential. Further research on chronic pelvic pain is crucial to improve the quality of life of patients. We look forward to advances in this field.

List of treatments

Pregabalin, onabotulinumtoxin A injections, terazosin, low-intensity shockwave therapy (LiST), physical therapy, therapeutic ultrasound, gabapentin, traditional Chinese medicine (TCM), extracorporeal shock wave therapy (ESWT), duloxetine, mindfulness-based cognitive therapy, cognitive behavioral therapy, pelvic floor physical therapy, corticosteroid injection, acupuncture, medroxy-progesterone acetate, counselling, multidisciplinary approach, lysis of deep adhesions, hysterectomy, distension of painful structures, digital therapeutics (DTx), tamsulosin, osteopathic treatment, exercise programs, cognitive and behavioral medicine, dietary modification, massage

Keywords
Benefit Keywords
Integrated approach effective
Reduced pelvic pain
1
Prostate volume reduction
Symptom improvement
2
Improved chronic pelvic pain treatment
3
Improved understanding of pelvic pain
4
Effective treatment of CPPS
5
CPP management
6
Reduced back pain
8
Pelvic pain treatment
9
Treatment of pelvic musculoskeletal pain
10
Improved motor function
Reduced pelvic pain
11
Improved quality of life
Pain relief
12
Improves quality of life
13
CP/CPPS treatment
14
CPP management
15
Pain reduction
QoL improvement
Safe treatment
Voiding improvement
16
Improved symptoms (short term)
17
Reduced CP/CPPS symptoms
18
Treatment of chronic pelvic pain
19
CP/CPPS treatment
20
Pain management
21
Pregnancy-related pain treatment
22
CP/CPPS treatment
Improved quality of life
23
Chronic pain treatment
25
Improved CPP treatment
26
Improved CP and/or CPPS treatment
27
Improved sexual well-being
Reduced pelvic pain
28
Pelvic pain improvement
29
Reduced chronic pelvic pain
30
Improved CPP
31
Chronic pelvic pain treatment
Pain reduction
32
AMPS treatment
33
Improved quality of life
Pain reduction
35
Female MFP treatment
36
LUTS treatment
Pain relief
37
Pain reduction
39
CPP treatment
40
CPP treatment
41
DTx for chronic pelvic pain
42
Risk Keywords
Laparoscopy ineffective
1
Unsatisfactory treatment
4
No obvious etiology
Not curable
6
Pelvic pain
7
Chronic pelvic pain
10
Adverse reactions
14
Pain worsening
15
Side effects
23
Chronic pelvic pain syndrome
Chronic prostatitis
24
Constipation
Urinary incontinence
Urinary tract infection
29
Dizziness
30
Chronic pelvic pain
32
Gabapentin ineffective
Gabapentin side effects
34
Insufficient evidence
35
Poor quality CPGs
38
Side effects
39
Literature analysis of 42 papers
Positive Content
35
Neutral Content
3
Negative Content
4
Article Type
24
6
17
15
41
1.

A randomized clinical trial to compare two different approaches in women with chronic pelvic pain.

Author: PetersA A, van DorstE, JellisB, van ZuurenE, HermansJ, TrimbosJ B

Integrated approach effective
Reduced pelvic pain
Laparoscopy ineffective

A study of 106 patients with chronic pelvic pain compared a standard approach, focusing on organic causes, with an integrated approach addressing multiple factors. The integrated approach led to greater improvement in pain compared to the standard approach. Laparoscopy did not significantly impact treatment outcomes.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Effects of finasteride in patients with inflammatory chronic pelvic pain syndrome: a double-blind, placebo-controlled, pilot study.

Author: LeskinenM, LukkarinenO, MarttilaT

Prostate volume reduction
Symptom improvement

Finasteride improved symptoms associated with inflammatory chronic pelvic pain syndrome, but its mechanism is unclear.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Use of terazosine in patients with chronic pelvic pain syndrome and evaluation by prostatitis symptom score index.

Author: GülO, EroğluM, OzokU

Effective treatment of CPPS

Chronic pelvic pain syndrome (CPPS) affects a significant number of men seen by urologists. There is no standard approach to treating CPPS. This study investigates the effectiveness of terazosine in treating men with CPPS.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Focus on primary care: chronic pelvic pain in women.

Author: GelbayaT A, El-HalwagyH E

CPP management
No obvious etiology
Not curable

Chronic pelvic pain (CPP) is a significant health issue, accounting for a large portion of gynecological visits and surgeries. Often, the cause of CPP is unclear, even after a surgical exam. While CPP may not be curable, it can be managed to improve function. This review of research from 1980 to 2000 examines methods used to diagnose and treat chronic pelvic pain in women.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

7.

Chronic prostatitis and chronic pelvic pain in men: aetiology, diagnosis and management.

Author: LuzziG A

Pelvic pain

Chronic prostatitis/pelvic pain syndrome (CPPS) is a common condition that causes genital or pelvic pain lasting more than 3 months. The exact cause of CPPS is unknown, but it is not typically caused by infection. While antibiotics are often used to treat CPPS, there is no reliable treatment for this condition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Physical therapy for pregnancy-related low back and pelvic pain: a systematic review.

Author: StugeBritt, HildeGunvor, VøllestadNina

Reduced back pain

A systematic review of prospective controlled clinical trials found limited evidence to support the effectiveness of physical therapy interventions for preventing and treating pregnancy-related back and pelvic pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

9.

A prospective, randomized, placebo controlled, double-blind study of pelvic electromagnetic therapy for the treatment of chronic pelvic pain syndrome with 1 year of followup.

Author: RoweE, SmithC, LaverickL, ElkabirJ, WitherowR O'N, PatelA

Pelvic pain treatment

The study investigated the potential neuromodulating effect of electromagnetic therapy on pelvic floor spasm and neural hypersensitivity in men with chronic pelvic pain syndrome.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Musculoskeletal causes of chronic pelvic pain: a systematic review of existing therapies: part II.

Author: TuFrank F, As-SanieSawsan, SteegeJohn F

Treatment of pelvic musculoskeletal pain
Chronic pelvic pain

Chronic pelvic pain is a common problem with many possible causes, including musculoskeletal issues in the pelvis. This review found limited research on musculoskeletal pelvic pain and its treatment. Most studies were observational, not controlled trials, and those with control groups were too small to draw firm conclusions. More rigorous research is needed to determine the effectiveness of treatments for musculoskeletal pelvic pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Mensendieck somatocognitive therapy as treatment approach to chronic pelvic pain: results of a randomized controlled intervention study.

Author: HaugstadGro K, HaugstadTor S, KirsteUnni M, LegangerSiv, KlemmetsenInger, MaltUlrik F

Improved motor function
Reduced pelvic pain

Mensendieck somatocognitive therapy combined with standard gynecological care improved pain experience and motor functions in women with chronic pelvic pain better than gynecological treatment alone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

Distension of painful structures in the treatment for chronic pelvic pain in women.

Author: HeymanJ, OhrvikJ, LeppertJ

Improved quality of life
Pain relief

Distension of painful pelvic structures was effective in relieving pain and improving quality of life in women with chronic pelvic pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

13.

Physical activity of men with chronic prostatitis/chronic pelvic pain syndrome not satisfied with conventional treatments--could it represent a valid option? The physical activity and male pelvic pain trial: a double-blind, randomized study.

Author: GiubileiGianluca, MondainiNicola, MinerviniAndrea, SaievaCalogero, LapiniAlberto, SerniSergio, BartolettiRiccardo, CariniMarco

Improves quality of life

This study investigates the potential role of physical activity in treating chronic prostatitis/chronic pelvic pain syndrome, a condition associated with poor quality of life and limited effective treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

[Clinical study on treatment of chronic prostatitis/chronic pelvic pain syndrome by three different TCM principles].

Author: ZhangMin-jian, ChuKe-dan, ShiYa-lei

CP/CPPS treatment
Adverse reactions

TCM therapy for smoothing Gan-qi showed good efficacy with quick initiating and high safety for the treatment of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : Chinese

15.

Medical, surgical and alternative treatments for chronic pelvic pain in women: a descriptive review.

Author: VercelliniPaolo, ViganòPaola, SomiglianaEdgardo, AbbiatiAnnalisa, BarbaraGiussy, FedeleLuigi

CPP management
Pain worsening

Chronic pelvic pain (CPP) is common, but the cause is often unknown. Limited research has been done on treating CPP, with only a few treatments showing benefit. Treatment may focus on pain relief, addressing the underlying cause, or both. Combining medications with different mechanisms may help. Nerve blocks are indicated in specific cases. Alternative non-invasive treatments include exercise, therapy, dietary changes, and massage. Hysterectomy may be considered in women who are done having children, especially if pelvic varicose veins are present. However, only 60-70% experience significant pain relief with surgery, and some experience worsening pain or new symptoms. Treating CPP often involves managing symptoms rather than curing them.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

16.

Extracorporeal shock wave therapy for the treatment of chronic pelvic pain syndrome in males: a randomised, double-blind, placebo-controlled study.

Author: ZimmermannReinhold, CumpanasAlin, MicleaFlorin, JanetschekGünter

Pain reduction
QoL improvement
Safe treatment
Voiding improvement

Perineal extracorporeal shock wave therapy (ESWT) showed statistically significant improvement in pain, quality of life, and voiding conditions compared to placebo in patients with chronic pelvic pain syndrome (CPPS).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

17.

Effects of a 6-month course of tamsulosin for chronic prostatitis/chronic pelvic pain syndrome: a multicenter, randomized trial.

Author: ChenYong, WuXiaohou, LiuJia, TangWei, ZhaoTao, ZhangJianhua

Improved symptoms (short term)

This randomized controlled trial examined the efficacy and long-term benefits of tamsulosin in treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in 100 men. Tamsulosin showed modest improvement in symptoms during treatment, but these effects gradually decreased after cessation of therapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

18.

Pregabalin for the treatment of men with chronic prostatitis/chronic pelvic pain syndrome: a randomized controlled trial.

Author: PontariMichel A, KriegerJohn N, LitwinMark S, WhitePaige C, AndersonRodney U, McNaughton-CollinsMary, NickelJ Curtis, ShoskesDaniel A, AlexanderRichard B, O'LearyMichael, ZeitlinScott, ChuaiShannon, LandisJ Richard, CenLiyi, PropertKathleen J, KusekJohn W, NybergLeroy M, SchaefferAnthony J,

Reduced CP/CPPS symptoms

Pregabalin, a medication effective for other chronic pain syndromes, was not superior to placebo in treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) symptoms in a randomized, double-blind, placebo-controlled trial of 324 men. While pregabalin was associated with improvements in symptom scores and a higher Global Response Assessment response rate, the primary outcome of a 6-point decrease in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score was not met.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

19.

Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options.

Author: ChiarioniGiuseppe, AsteriaCorrado, WhiteheadWilliam E

Treatment of chronic pelvic pain

Chronic pain in the anus, rectum, and other pelvic organs affects a significant portion of the population, causing significant quality of life issues and healthcare costs. While these conditions are not well understood, research is increasing. A recent study showed that biofeedback was highly effective (85% success rate) in treating chronic anal pain when used with patients who showed tenderness in specific pelvic muscles. This suggests that similar approaches to diagnosis and treatment might be helpful for other pelvic pain conditions.

EditorialAn article in which the editor or publisher expresses their opinion or perspective on a particular topic or issue. Its purpose is to convey a specific message or idea to the reader.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

20.

[Long-term effects of osteopathic treatment of chronic prostatitis with chronic pelvic pain syndrome: a 5-year follow-up of a randomized controlled trial and considerations on the pathophysiological context].

Author: MarxS, CimniakU, RützM, ReschK L

CP/CPPS treatment

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a condition with unknown causes, and diagnosis often relies on ruling out other conditions. This study examined the long-term (5-year) effects of osteopathic treatment, which addresses musculoskeletal and organ dysfunction, for CP/CPPS. The study aimed to show that this approach, which uses gentle manual techniques, is a sustainable and cost-effective treatment option.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

21.

The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development.

Author: EngelerDaniel S, BaranowskiAndrew P, Dinis-OliveiraPaulo, ElneilSuzy, HughesJohn, MesselinkEmbert J, van OphovenArndt, WilliamsAmanda C,

Pain management

Pain specialists are moving away from focusing solely on the physical source of pelvic pain and are now considering the overall mechanisms of pain, including psychological, social, and sexual factors. This shift affects how pain is classified and treated. Determining the appropriate tests to rule out treatable conditions before adopting this approach requires expertise in both pain management and traditional medical knowledge.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Practice GuidelineGuidelines and recommendations for the diagnosis and treatment of specific medical conditions in medical practice.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

Improved function in women with persistent pregnancy-related pelvic pain after a single corticosteroid injection to the ischiadic spine: a randomized double-blind controlled trial.

Author: TorstenssonThomas, LindgrenAnne, KristianssonPer

Pregnancy-related pain treatment

Back and pelvic pain during pregnancy is a common problem that can continue after childbirth. This study will investigate the source of pain and effective treatments for pregnancy-related back and pelvic pain.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Surgical treatment of adhesion-related chronic abdominal and pelvic pain after gynaecological and general surgery: a systematic review and meta-analysis.

Author: van den BeukelBarend A, de ReeRoy, van LeuvenSuzanne, BakkumErica A, StrikChema, van GoorHarry, Ten BroekRichard P G

Chronic pain treatment

This study discussed the challenges of managing chronic post-operative pain, particularly related to adhesions, following surgery of the female genital or alimentary tract.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

26.

Physiotherapy management of patients with chronic pelvic pain (CPP): A systematic review.

Author: KlotzSusanne G R, SchönMila, KetelsGesche, LöweBernd, BrünahlChristian A

Improved CPP treatment

Physiotherapy may be a valuable treatment option for chronic pelvic pain (CPP) due to the frequent presence of musculoskeletal findings.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Chronic Prostatitis and/or Chronic Pelvic Pain as a Psychoneuromuscular Disorder-A Meta-analysis.

Author: AndersonRodney U, WiseDavid, NathansonBrian H

Improved CP and/or CPPS treatment

This study evaluated the effectiveness of physical therapy, biofeedback, and cognitive behavioral therapy for chronic prostatitis/chronic pelvic pain syndrome (CP and/or CPPS), highlighting the potential of a psychoneuromuscular approach to treating this condition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

28.

A Comparison of Mindfulness-Based Cognitive Therapy Vs Cognitive Behavioral Therapy for the Treatment of Provoked Vestibulodynia in a Hospital Clinic Setting.

Author: BrottoLori A, BergeronSophie, ZdaniukBozena, DriscollMiriam, GrabovacAndrea, SadownikLeslie A, SmithKelly B, BassonRosemary

Improved sexual well-being
Reduced pelvic pain

This abstract explores the effectiveness of cognitive behavioral therapy (CBT) and mindfulness-based approaches for treating provoked vestibulodynia (PVD), a condition characterized by chronic genital pain associated with vaginal penetration. It suggests that both CBT and mindfulness-based interventions can significantly reduce pain intensity and improve psychological and sexual well-being.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

29.

A randomized, double-blind, placebo-controlled trial of onabotulinumtoxin A trigger point injections for myofascial pelvic pain.

Author: DessieSybil G, Von BargenEmily, HackerMichele R, HavilandMiriam J, ElkadryEman

Pelvic pain improvement
Constipation
Urinary incontinence
Urinary tract infection

A double-blind, randomized, placebo-controlled trial comparing onabotulinumtoxinA to saline injections for myofascial pelvic pain found no significant difference in muscle pain on palpation at 2 weeks. However, participants receiving onabotulinumtoxinA reported greater improvement in overall pelvic pain at 4 and 12 weeks.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

30.

Gabapentin for the management of chronic pelvic pain in women.

Author: AbdelHafeezM A, RedaA, ElnaggarA, El-ZeneinyH, MokhlesJ M

Reduced chronic pelvic pain
Dizziness

Oral gabapentin effectively reduced chronic pelvic pain (CPP) in women compared to placebo. A significantly higher proportion of patients in the gabapentin group experienced a 30% or more reduction in pain scores at 24 weeks. The most common adverse effect of gabapentin was dizziness.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

31.

Group-based multimodal physical therapy in women with chronic pelvic pain: A randomized controlled trial.

Author: NygaardAne Sigrid, RydningenMona Birgitte, StedenfeldtMona, WojniuszSlawomir, LarsenMarthe, LindsetmoRolv-Ole, HaugstadGro Killi, ØianPål

Improved CPP

The study compares structured group-based multimodal physical therapy in a hospital setting with primary-care physical therapy for women with chronic pelvic pain. The study aimed to evaluate the effectiveness of different physical therapy approaches in managing this complex condition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

32.

Baseline pain characteristics predict pain reduction after physical therapy in women with chronic pelvic pain. Secondary analysis of data from a randomized controlled trial.

Author: NygaardAne S, HaugstadGro K, WilsgaardTom, ØianPål, StedenfeldtMona

Chronic pelvic pain treatment
Pain reduction
Chronic pelvic pain

Background and aims Women with chronic pelvic pain represent a heterogeneous group, and it is suggested that the existence of sub-groups can explain varying results and inconclusiveness in clinical trials. Some predictors of treatment outcome are suggested, but the evidence is limited. The primary aim of this study was to explore if selected pre-treatment characteristics of the participants in a recently conducted randomized controlled trial were associated with treatment outcome. Methods In this study secondary analysis of data collected in a randomized trial were conducted. The participants were women with chronic pelvic pain randomized to two different physical therapy treatments. Analyses in this study were performed for the whole group as a cohort. The primary outcome measure was change in pain intensity from baseline to 12 months, measured with the numeric rating scale (0-10). The women were asked to rate their mean pelvic pain intensity during the last 7 days. Based on previous research and on available variables from the randomized controlled trial four potential predictive factors were derived from the baseline data and assessed one by one in a linear regression model, adjusted for age and treatment group. The variables with strongest association (p < 0.10) with the primary outcome were further included in a multivariable linear regression model with backward selection, adjusted for age and treatment group. Results Fifty women (mean age 38.1, SD = 12.2) were included in the analysis. For these women the mean change in pain intensity was -1.2 points (95% CI -1.8 to -0.7) from baseline to 12 months. The multivariable regression model showed that pelvic pain duration of 6 years or more was associated with less decrease in pain intensity with a regression coefficient of 1.3 (95% CI 0.3-2.4). Baseline pain intensity was associated with higher pain reduction after PT treatment with a regression coefficient per SD increase in baseline pain of -0.6 (95% CI -1.1 to -0.1). None of the women with main pain site other places than in the pelvis reported any pain reduction after physical therapy treatment, but due to the small numbers the predictor was not included in the regression analysis. Conclusions We identified that pelvic pain duration of 6 years or more was associated with less pain reduction, and that higher baseline pain intensity was associated with higher pain reduction after physical therapy treatment in this sample of women with chronic pelvic pain. For the variable main pain site other places than the pelvis the results are unsure due to small numbers. Implications Based on our finding of long pain duration as a negative predictor for pain reduction, we emphasize that early intervention is important. Many of the participants in our RCT reported pelvic surgeries or other treatments prior to referral for PT, and we suggest that referral to a non-invasive intervention such as PT should be considered at an earlier stage. In order to tailor interventions to the individual women's needs, thorough baseline assessments, preferably in a multidisciplinary setting, should be performed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

33.

Ashi Acupuncture Versus Local Anesthetic Trigger Point Injections in the Treatment of Abdominal Myofascial Pain Syndrome: A Randomized Clinical Trial.

Author: MitidieriAndreia Moreira de Souza, BaltazarMaria Carolina Dalla Vecchia, da SilvaAna Paula Moreira, GurianMaria Beatriz Ferreira, Poli-NetoOmero Benedicto, Candido-Dos-ReisFrancisco Jose, NogueiraAntonio Alberto, Rosa-E-SilvaJulio Cesar

AMPS treatment

This study emphasized the importance of considering abdominal myofascial syndrome (AMPS) in the management of chronic pelvic pain (CPP), highlighting the potential role of musculoskeletal dysfunction.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

34.

Gabapentin for chronic pelvic pain in women (GaPP2): a multicentre, randomised, double-blind, placebo-controlled trial.

Author: HorneAndrew W, VincentKaty, HewittCatherine A, MiddletonLee J, KoscielniakMagda, SzubertWojciech, DoustAnn M, DanielsJane P,

Gabapentin ineffective
Gabapentin side effects

A multicentre, randomised, double-blind, placebo-controlled trial was conducted to measure the efficacy and safety of gabapentin in women with chronic pelvic pain and no obvious pelvic pathology. 306 women were randomly assigned to receive either gabapentin or matching placebo for 16 weeks. The study found that treatment with gabapentin did not result in significantly lower pain scores and was associated with higher rates of side-effects than placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

35.

The Benefits and Harms of Botulinum Toxin-A in the Treatment of Chronic Pelvic Pain Syndromes: A Systematic Review by the European Association of Urology Chronic Pelvic Pain Panel.

Author: ParsonsBrian A, GoonewardeneSanchia, DabestaniSaeed, Pacheco-FigueiredoLuis, YuanYuhong, ZumsteinValentin, CottrellAngela M, BorovickaJan, Dinis-OliveiraPaulo, BerghmansBary, ElneilSohier, HughesJohn, MesselinkBert E J, de C WilliamsAmanda C, BaranowskiAndrew P, EngelerDaniel S

Improved quality of life
Pain reduction
Insufficient evidence

This systematic review evaluated the benefits and harms of botulinum toxin A (BTX-A) injections in the treatment of chronic pelvic pain syndrome (CPPS). While some studies showed beneficial effects on pain, quality of life, and functional symptoms in certain CPPS subtypes, the current evidence is too weak to recommend BTX-A for treating CPPS. Further research is needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

36.

Interventional treatment for myofascial pelvic floor pain in women: systematic review with meta-analysis.

Author: FredericeClaudia Pignatti, BritoLuiz Gustavo Oliveira, PereiraGlaucia Miranda Varella, LunardiAnna Lygia Barbosa, JuliatoCássia Raquel Teatin

Female MFP treatment

This study explores different treatments for pain in the pelvic floor muscles (PFM) in women, a type of chronic pelvic pain that can cause urinary, bowel, and sexual problems. The study aims to determine if different treatments are more effective than placebos or no treatment for this condition.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

37.

The Effect of Low-intensity Shockwave Therapy on Non-neurogenic Lower Urinary Tract Symptoms: A Systematic Review and Meta-analysis of Preclinical and Clinical Studies.

Author: SokolakisIoannis, PyrgidisNikolaos, NeisiusAndreas, GierthMichael, KnollThomas, RassweilerJens, HatzichristodoulouGeorgios,

LUTS treatment
Pain relief

Low-intensity shockwave therapy may be effective for managing pain associated with lower urinary tract symptoms, particularly in patients with chronic prostatitis/chronic pelvic pain syndrome or interstitial cystitis/bladder pain syndrome. Further research is needed to clarify its role in other LUTS disorders.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

38.

Treatment recommendations for the management of persistent pelvic pain: a systematic review of international clinical practice guidelines.

Author: MardonAmelia K, LeakeHayley B, SzetoKimberley, AstillThomas, HiltonSandra, MoseleyGraham Lorimer, ChalmersKatherine Jane

Poor quality CPGs

This review analyzed 20 clinical practice guidelines (CPGs) for the management of persistent pelvic pain (PPP) in adult females. While the CPGs were generally poor in quality, they endorsed considering biopsychosocial elements of PPP. However, most recommended pharmaceutical, surgical, and other biomedical interventions rather than psychological, physiotherapy, or conservative interventions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

39.

Is gabapentin effective and safe in the treatment of chronic pelvic pain in women: a systematic review and meta-analysis.

Author: HeYuewen, ZhuangXuhui, MaWuhua

Pain reduction
Side effects

This systematic review and meta-analysis of four randomized controlled trials found that gabapentin was significantly different from placebo in average pain scores at 3 and 6 months in women with chronic pelvic pain (CPP). However, the two drugs did not differ in the reduction in pain scores from baseline. Gabapentin was also associated with a higher incidence of side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

40.

Pelvic floor physical therapy and mindfulness: approaches for chronic pelvic pain in women-a systematic review and meta-analysis.

Author: BittelbrunnCleima Coltri, de FragaRogerio, MartinsCamilli, RomanoRicardo, MassaneiroThomaz, MelloGlauco Vinicius Pauka, CanciglieriMatheus

CPP treatment

Chronic pelvic pain (CPP) in women is a complex problem affecting many women and leading to significant costs. This study examines the use of mindfulness and pelvic floor physical therapy (PFPT) for managing CPP, highlighting the need for effective treatments for this often-overlooked condition.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

41.

Therapeutic ultrasound versus injection of local anesthetic in the treatment of women with chronic pelvic pain secondary to abdominal myofascial syndrome: a randomized clinical trial.

Author: BaltazarMaria Carolina Dalla Vecchia, RussoJéssica Aparecida de Oliveira, De LuccaVictória, MitidieriAndréia Moreira de Souza, da SilvaAna Paula Moreira, GurianMaria Beatriz Ferreira, Poli-NetoOmero Benedicto, Rosa-E-SilvaJúlio César

CPP treatment

This study focuses on abdominal myofascial pain syndrome (AMPS), a type of chronic pelvic pain (CPP) that is often overlooked. While many women with CPP have muscle and tissue issues, this study highlights the need for more research on AMPS, which is characterized by deep pain in the abdomen caused by sensitive trigger points in muscles and surrounding tissues.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

42.

Pain Reduction With an Immersive Digital Therapeutic Tool in Women Living With Endometriosis-Related Pelvic Pain: Randomized Controlled Trial.

Author: MerlotBenjamin, DispersynGarance, HussonZoé, Chanavaz-LacherayIsabella, DennisThomas, Greco-VuilloudJuliette, FougèreMaxime, PotvinStéphane, Cotty-EslousMaryne, RomanHorace, MarchandSerge

DTx for chronic pelvic pain

This study explores the use of digital therapeutics (DTx) for managing chronic pelvic pain in women with endometriosis. While traditional treatments like medication and surgery have limitations, DTx presents a non-pharmacological alternative.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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