Complementary and Alternative Approach to Chronic Pelvic Pain

Abstract

Chronic pelvic pain (CPP) is defined as pain of at least 6 months' duration that occurs in the lower abdomen or below the umbilicus and has resulted in functional or psychological disability, and required intervention and treatment. Therapeutic interventions center around the treatment of CPP as a diagnosis in and of itself, and treatment of specific disorders that may be related to CPP. A multidisciplinary approach for diagnosis and treatment seems to be most effective for symptomatic relief. The evidence for such interventions as psychological treatments including the use of complementary and alternative medicine techniques for CPP treatment is reviewed in this study. Unfortunately, finding the best evidence in this setting is difficult as very few randomized controlled trials are available. A combination of treatments is usually required over time for the treatment of refractory CPP. The multifactorial nature of CPP needs to be discussed with the patient and a good rapport as well as a partnership needs to be developed to plan a management program with regular follow up. Promotion of a multidisciplinary approach which includes complementary and alternative medicine techniques in managing CPP in women seems to yield the best results.

Keywords

• Chronic pelvic pain,acupuncture,Chinese herbal medicine,psychotherapy

Kronik Pelvik Ağrıya Tamamlayıcı ve Alternatif Yaklaşım

Abstract

Kronik pelvik ağrı (KPA) en az 6 ay süren, alt karın bölgesinde veya umbilikusun altında yerleşen fonksiyonel veya psikolojik hastalığa neden olabilen, değerlendirme ve tedavi gerektiren bir ağrıdır. Tedaviye yönelik girişimler, bir tanı olarak KPA tedavisi ve KPA ile ilişkili belli başlı hastalıkların tedavisi etrafında yoğunlaşır. Semptomatik rahatlama için tanı ve tedavide multidisipliner bir yaklaşımın en etkilisi olduğu görülmektedir. Bu çalışmada KPA tedavisinde, tamamlayıcı ve alternatif tıp tekniklerinin de kullanıldığı psikolojik tedavi gibi girişimlerin kanıtları gözden geçirilmiştir. Maalesef bu konuda yapılmış çok az randomize kontrollü çalışma olduğundan en iyi kanıtı bulmak çok zordur. Refrakter KPA tedavisi için zaman geçtikçe bir tedavi kombinasyonuna ihtiyaç duyulmaktadır. KPA’nın multifaktöriyel doğası hastayla tartışmayı, onunla iyi bir uyum içinde bir partner kadar yakın olmayı ve düzenli takip edilecek bir yönetim planı geliştirmeyi gerektirir. Kadınlarda KPA yönetiminde tamamlayıcı ve alternatif tıp tekniklerinin de dahil olduğu multidisipliner bir yaklaşımı teşvik etmek en iyi sonuçları doğuracak gibi görünmektedir.

Keywords

• Kronik pelvik ağrı,akupunktur,Çin bitkisel tıbbı,psikoterapi

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