The relationship between chronic pelvic pain and myofascial pain in endometriosis: etiopathogenesis and current approaches in treatment

Öz

Abstract Sixty percent of patients with endometriosis experience chronic pelvic pain. Pain can be suppressed with hormonal treatments such as GnRH analogs, aromatase inhibitors, progestagens, and oral contraceptives. Non-hormonal treatments such as NSAIDs and opioids reduce inflammation and mask pain. Surgical removal of deep infiltrative lesions may reduce pain. Response to progestagen treatments varies from patient to patient. Pain in endometriosis arises from peripheral and central mechanisms and is associated with pelvic floor muscle dysfunction. Pelvic pain refractory to medical treatment is due to central sensitization and myofascial dysfunction. There is no linear correlation between the endometriosis staging system and pain. Personalized treatment planning is important. This review uses pubmed and google scholar to search for current studies on the topic.

Anahtar Kelimeler

• Endometriosis
• muscle hypeertonia
• pelvic floor
• trigger points

Endometrioziste kronik pelvik ağrı ve miyofasyal ağrı ilişkisi: etiyopatogenez ve tedavide güncel yaklaşımlar

Öz

Öz Endometriozisli hastaların %60 ı kronik pelvik ağrılıdır. Hormonal tedaviler olan GnrH analogları, aromataz inhibitörleri, progestagenler ve oral kontraseptifler ile ağrı baskılanabilmektedir. Non-hormonal tedaviler NSAID ve opiodler enflamasyonu azaltarak ağrıyı maskeleyici etki yaparlar. Cerrahi olarak derin infiltratif lezyonların alınması ağrıyı azaltabilir. Progestagen tedavilerinde hastadan hastaya yanıtlar farklıdır. Endometriozisde ağrı periferik ve santral mekanizmalar ile ortaya çıkmakta ve pelvik taban kaslarda disfonksiyonla birliktelik göstermektedir. Pelvik ağrının medikal tedaviye dirençli olmasının nedeni santral duyarlılık ve miyofasyal disfonksiyondur. Endometriozis evreleme sistemi ile ağrı arasında doğrusal korelasyon yoktur. Kişisel tedavi planlamaları önemlidir. Bu derlemede pubmed ve gooogle schoolar kullanılarak konu ile ilgili güncel çalışmalar taranmıştır.

Anahtar Kelimeler

• Endometriozis,
• kas hipertonisi, pelvik taban,
• tetikleyici noktalar,
• pelvik ağrı

Etik Beyan

Makale derleme formatındadır

Kaynakça

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