ENDOMETRİOZİS AĞRI YÖNETİMİNDE GÜNCEL TEDAVİ YAKLAŞIMLARI VE HEMŞİRENİN ROLÜ

Year 2021, , 221 - 225, 15.09.2021

Dilek Bingöl , Nuriye Büyükkayacı Duman

https://doi.org/10.34108/eujhs.681860

Abstract

Endometriozis, endometrial benzeri dokunun uterus boşluğu dışında bulunması şeklinde tanımlanan ve en çok üreme çağındaki kadınları etkileyen jinekolojik bir hastalıktır. Endometriozisin hastanın yaşam kalitesini ve hastalığın tedavisine ilişkin uyumunu olumsuz etkileyebilen klinik belirtileri arasında; kronik pelvik ağrı, disparoni, dismenore ve infertilite bulunmaktadır. Tanı konulmasında jinekolojik öykü, laparoskopi ve fiziksel değerlendirme yapılmaktadır. Endometriozis ile ilişkili ağrının tedavisinde kullanılan alternatif yöntemler arasında medikal ve cerrahi yöntemler de olup belirtilerin azaltılması amaçlanmaktadır. Ancak her iki yöntemde de ağrının tekrarlama sıklığı devam edebilmektedir. Endometriozis de ağrı yönetiminde, hastalığın progresyonunun önlenmesi,  bireyin sağlığının iyileştirilmesi ve yaşam kalitesinin arttırılmasına dayalı multidisipliner bir yaklaşım gerekir. Hastalığın ilerlemesinin önlenmesinde ve kadınların yaşam kalitesini iyileştirilmesinde hemşireler büyük rol oynamaktadırlar. Bu derlemede, endometrioziste ağrı yönetiminde etkin ve güvenilir güncel yaklaşımlara ışık tutmak ve hemşirenin rolünün tartışılması amaçlanmıştır.

Keywords

ağrı yönetimi, Endometriozis, hemşirelinin rolü

CURRENT TREATMENT APPROACHES AND THE ROLE OF THE NURSE IN ENDOMETRIOSIS PAIN MANAGEMENT

Abstract

Endometriosis is a gynecological disease that is defined as the presence of endometrium-like tissue outside of the uterine cavity and most often affects women of reproductive age. Among the clinical symptoms of endometriosis that can negatively affect the patient's quality of life and compliance with the treatment of the disease are chronic pelvic pain, dyspareunia, dysmenorrhea and infertility. Gynecological history, laparoscopy and physical evaluation are used for diagnosis. Medical and surgical methods are among the alternative methods used in the treatment of pain associated with endometriosis, and it is aimed to reduce the symptoms. However, the frequency of recurrence of pain can continue in both methods. In the management of endometriosis-related pain, a multidisciplinary approach based on preventing disease progression, improving the health of the individual and increasing the quality of life is required. Nurses play a major role in preventing disease progression and improving women's quality of life. In this review, it is aimed to shed light on effective and reliable current approaches in pain management in endometriosis and to discuss the role of the nurse.

Keywords

Endometriosis, nurse, pain management.

References

• 1. Moura APC, Ribeiro HSAA, Bernardo WM, et al. Accuracy of transvaginal sonography versus magnetic resonance imaging in the diagnosis of rectosigmoid endometriosis: Systematic review and meta-analysis. PLoS ONE 2019; 14(4): e0214842. https://doi.org/10.1371/journal. pone.0214842 2. Vercellini P, Viganò P, Somigliana E, et al. Endometriosis: pathogenesis and treatment. Nature Reviews Endocrinology 2014; 10(5):261. 3. Baştu E, Mutlu MF, Serdaroğlu H. Endometriozis tedavisinde güncel yaklaşım. İstanbul Tıp Fakültesi Dergisi 2012; 75(4):60-70. 4. Alimi Y, Iwanaga J, Loukas M, et al. The Clinical Anatomy of Endometriosis: A Review. Cureus 2018; 10(9):e3361. DOI 10.7759/cureus.3361 5. Biberoğlu E, Biberoğlu K. Endometriozis ve Pelvik Ağrı (Kanıta Dayalı Tıp). Turkiye Klinikleri Journal of Gynecology Obstetrics-Special Topics 2010; 3(3):54-61. 6. Kocakoç E, Bhatt S, Dogra VS. Endometriosis. Ultrasound Clin 2008; 3(3):399-414. 7. Hwang H, Chung YJ, Lee SR, et al. Clinical evaluation and management of endometriosis: guideline for Korean patients from Korean Society of Endometriosis. Obstetrics & gynecology science 2018; 61(5):553-564. 8. Karadadaş N, Hurşitoğlu BS. Endometriozisli İnfertil Hastaya Yaklaşım. Turkiye Klinikleri Journal Of Gynecology Obstetrics-Special Topics 2012; 5(2):86-91. 9. Sinaii N, Plumb K, Cotton L, et al. Differences in characteristics among 1,000 women with endometriosis based on extent of disease. Fertil Steril 2008; 89(3):538-545. 10. Oral E, Api M, Ata B, ark. Türkiye endometriozis tanı ve yönetim kılavuzu. Turkiye Klinikleri Journal of Gynecology Obstetrics-Special Topics 2016; 9(2):80-112. 11. Çiçek MN, Mungan MT. Endometriozis, Klinikte Obstetrik ve Jinekoloji. İstanbul: Güneş Tıp Evleri; 2007. s. 587-596. 12. Practice Committee of the American Society for Reproductive Medicine. Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertility and sterility 2014; 101(4):927-935. 13. Unutkan A, Kukulu K. Endometriozis İlişkili Ağrının Yönetimi Ve Ağrının Yönetiminde Hemşirenin Rolü. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2014; 3(2):804-814. 14. As-Sanie S, Harris RE, Napadow V, et al. Changes in regional gray matter volume in women with chronic pelvic pain: a voxel-based morphometry study. Pain 2012; 153(5):1006-1014. 15. Collinet P, Fritel X, Revel-Delhom C, et al. Management of endometriosis: CNGOF/HAS clinical practice guidelines–Short version. Journal of Gynecology Obstetrics and Human Reproduction 2018; 47(7):265-274. 16. Biberoğlu E, Biberoğlu K. Endometriozis Yönetiminde Hormonal Tedavi. Turkiye Klinikleri Journal of Gynecology Obstetrics-Special Topics 2012; 5(3):44-51. 17. Hurt KJ. Pocket Obstetrics and Gynecology. 1nd Edition. Philadelphia, PA: Wolters Kluwer Health; 2014. p. 11-16. 18. Prescott J, Farland LV, Tobias DK, et al. A prospective cohort study of endometriosis and subsequent risk of infertility. Human reproduction, 2016; 31(7): 1475-1482. 19. Casper RF. Introduction: a focus on the medical management of endometriosis. Fertility and sterility 2017; 107(3):521-522. 20. Marjoribanks J, Ayeleke RO, Farquhar C, et al. Nonsteroidal anti-inflammatory drugs for dysmenorrhea. Cochrane Database of Systematic Reviews. 2015; 30(7). 21. Brown J, Crawford TJ, Allen C, et al. Nonsteroidal anti‐inflammatory drugs for pain in women with endometriosis. Cochrane Database of Systematic Reviews 2017; (1). 22. Brown J, Kives S, Akhtar M. Progestagens and anti-progestagens for pain associated with endometriosis. Cochrane Database of Systematic Reviews. 2012; 3. 23. Taneja A, Kaur S, Soni RK. Evaluating the efficacy of levonorgestrel intrauterine system and danazol for relief of postoperative pain in endometriosis. Journal of clinical and diagnostic research: JCDR 2017; 11(7): QC10-QC12. 24. Bedaiwy MA, Allaire C, Alfaraj S. Long-term medical management of endometriosis with dienogest and with a gonadotropin-releasing hormone agonist and add-back hormone therapy. Fertility and sterility 2017; 107(3):537-548. 25. Prentice A, Deary AJ, Goldbeck-Wood S, et al. Gonadotrophin-secreting hormone analogs for pain associated with endometriosis. Cochrane Database Syst Rev. 2010; (12):CD008475. 26. Brown J, Pan A, Hart RJ. Pain analogs associated with gonadotrophin-releasing hormone endometriosis. Cochrane Database Syst Rev. 2010; (12):CD008475. 27. Pundir J, Omanwa K, Kovoor E, et al. Laparoscopic excision versus ablation for endometriosis-associated pain: an updated systematic review and meta-analysis. Journal of minimally invasive gynecology 2017; 24(5):747-756. 28. Vercellini P, Crosignani P, Somigliana E, et al. “Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis. Hum Reprod 2011; 26(1):3-13. 29. Smith CA, Zhu X, He L,et al. Acupuncture for primary dysmenorrhoea. Cochrane Database Syst Rev. 2011; 19(1):CD007854. 30. Suresh PK. Complementary And Alternative Medicine (Cam) Therapies For Management Of Pain Related To Endometriosis. İnternational Research Journal Of Pharmacy 2012; 3(3): 30-34. 31. Flower A, Liu JP, Chen S, et al. Chinese herbal medicine for endometriosis. Cochrane Database Syst Rev. 2009; 8(3):CD006568. 32. Schrager S, Falleroni J, Edgoose J. Evaluation and treatment of endometriosis. Am Fam Physician 2013; 87(2):107-113.