Kadınlarda kronik pelvik ağrı

Mert Küçük; Mustafa Oğurlu; Filiz Sekdur; Selda Demircan

doi:10.16948/zktb.18463

Chronic pelvic pain in women

Yıl 2010, Cilt: 41 Sayı: 2, 77 - 86, 01.03.2010

Mert Küçük Mustafa Oğurlu Filiz Sekdur Selda Demircan

Öz

Chronic pelvic pain is common in women and reduces quality of life ofpatients and is an important health care problem. Economic burden of chronic pelvic pain on the health system is quite high. When all of the direct and indirect costs were considered, a serious amount of money is spent on treatment of patients with chronic pelvic pain. Productivity of working women with chronic pelvic pain is negatively affected. Therefore significant work disability occurs in patients with chronic pelvic pain. Patients with chronic pelvic pain limit their routine daily activities and chronic pelvic pain lead to problems in their sexual life. Pathophysiology of chronic pelvic pain is poorly understood. Pain in the pelvic region can result from numerous organs. Chronic pelvic pain may result from the genital organs, urinary organs, pelvic floor muscles, gastrointestinal organs in this region, or from other systems as well as neuropsychiatric systems. Only less than half of patients with chronic pelvic pain seek medical care. Patients admitting to primary health care services for chronic pelvic pain are reported to be under evalûated and were found not to be correctly directed to appropriate health care clinics in studies. For correct diagnosis, a good evaluation of the symptoms including detailed questions on pain intensity, propagation, decreasing and increasing causes, the association of pain with sexual intercourse or menstruation, probable pregnancy, previous operations, menstrual cycle, depression symptoms, and a good physical examination is also very important. Treatment options vary from conservative medical treatment to surgical treatment. Multidisciplinary approach in the treatment of chronic pelvic pain is very important. In this review, we intended to provide update information on the definition and evaluation of chronic pelvic pain, and treatment options.

Anahtar Kelimeler

Kaynakça

1. ACOG Practice Bulletin No. 51. Chronic pelvic pain. Obstet Gynecol. 2004;103(3):589-605
2. Kennedy SH, Moore J. The initial management of chronic pelvic pain. Green top guidelines. London, Royal College of Obstetricians and Gynaecologists, 2005 3. Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, Kennedy SH. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract. 2001 Jul;51(468):541-7
4. Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 1996 Mar;87(3):321-7
5. Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol. 1999 Nov;106(11):1149-55
6. Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006 Jul 6;6:177
7. Grace VM, Zondervan KT. Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. AustNZ J Public Health. 2004 Aug;28(4):369-75
8. Howard FM. The role oflaparoscopy in chronic pelvic pain: Promise and pitfalls. Obstet Gynecol Surv. 1993 Jun;48(6):357-87
9. Stones RW, Mountfield J. Interventions for treating chronic pelvic pain in women. Cochrane Database Syst Rev. 2000;(4):CD000387 10. Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Patterns of diagnosis arid referral in women consultingfor chronic pelvic pain in UK primary care. Br J Obstet Gynaecol. 1999 Nov;106(11):1156-61
11. Gambone JC, Mittman BS, Munro MG, Scialli AR, Winkel CA; Chronic Pelvic Pain/Endometriosis Working Group. Consensus statement for the management of chronic pelvic pain and endometriosis: proceedings of an expert-panel consensus process. Fertil Steril. 2002;78(5):961-72
12. Jensen MP, Karoly P. Self-report scales and procedures for assessing pain in adults. In: Turk DC, MelzackR, eds. Handbook of pain assessment. 1st ed. New York: Guilford Press, 1992. p. 135-51
13. Di Spiezio Sardo A, Guida M, Bettocchi S, Nappi L, Sorrentino F, Bifulco G, Nappi C. Role of hysteroscopy in evaluating chronic pelvic pain. Fertil Steril. 2008 0ct;90(4): 1191-6
14. MettlerL, Alhujeily M. Role oflaparoscopy in identifying the clinical significance and cause of adhesions and chronic pelvic pain: a retrospective review at the Kiel School of Gynecological Endoscopy. JSLS. 2007 Jul-Sep;l1(3):303-8
15. Howard FM. The role of laparoscopy as a diagnostic tool in chronic pelvic pain. Best Pract Res Clin Obstet Gynecol 2000; 14:467-494 16. GaneshanA, UpponiS, HonLQ, Uthappa MC, Warakaulle DR, Uberoi R. Chronic pelvic pain due to pelvic congestion syndrome: the role of diagnostic and interventional radiology. Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6): 1105-11
17. Howard FM. Chronic pelvic pain. Obstet Gynecol. 2003 Mar;101 (3). 594-611
18. Thomson H, Francis DM. Abdominal-wall tenderness: A useful sign in the acute abdomen. Lancet. 1977 Nov 19;2(8047): 1053-4
19. Vercellini P, Vigand P, Somigliana E, Abbiati A, Barbara G, Fedele L. Medical, surgical and alternative treatments for chronic pelvic pain in women: a descriptive review. Gynecol Endocrinol. 2009 Apr;25(4):208-21
20. Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R, Lapensee L, Lea RH, Leyland NA, Martyn P, Shenassa H, Taenzer P, Abu-Rafea B; Chronic Pelvic Pain Working Group; Society of Obstetricians and Gynaecologists of Canada. Consensus guidelines for the management ofchronic pelvic pain. J Obstet Gynaecol Can. 2005 Sep;27(9):869-910
21. Miotto K, Compton P, Ling W, Conolly M. Diagnosing addictive disease in chronic pain patients. Psychosomatics. 1996 May-Jun;37(3) :223-35
22. Vercellini P, Daguati R, Abbiati A. Chronic pelvic pain. In: Arici A, Seli E, editors. Non-invasive management of gynecologic disorders. 1st ed. London: Informa Healthcare Publishing Group; 2008. p. 33-51 23. Onghena P, Van Houdenhove BV. Antidepressant-induced analgesia in chronic non-malignant pain: a metanalysis of 39 placebo controlled studies. Pain. 1993 Feb;52(2):247-9
24. Engel CC Jr, Walker EA, Engel AL, Bullis J, Armstrong A. A randomized, double-blind crossover trial of sertraline in women with chronic pelvic pain. JPsychosom Res. 1998 Feb;44(2):203-7
25. Stones RW, Bradbury L, Anderson D. Randomized placebo controlled trial of lofexidine hydrochloride for chronic pelvic pain in women. Hum Reprod. 2001 Aug; 16(8): 1719-21
26. Farquhar CM, Rogers V, Franks S, Pearce S, Wadsworth J, Beard RW. A randomized controlled trial of medroxyprogesterone acetate and psychotherapy for the treatment of pelvic congestion. BrJObstet Gynaecol. 1989 0ct;96(10):1153-62
27. Barbieri RL. Primary gonadotr opin-releasing hormone agonist therapy for suspected endometriosis: a nonsurgical approach to the diagnosis and treatment of chronic pelvic pain. Am JManag Care 1997;3:285-290
28. Soysal ME, Soysal S, Vicdan K, Özer S. A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Hum Reprod. 2001 May;16(5):931 -9
29.Sagsveen M, Farmer JE, Prentice A, et al. Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density. Cochrane Database of Systematic Reviews 2003(4): CD001297
30. Levy MH. Pharmacologic treatment of cancer pain. NEngl J Med. 1996 Oct 10;335(15):1124-32
31. Alexander-Williams J. Do adhesions cause pain? Br Med J (Clin Res Ed). 1987 Mar 14;294(6573):659-60
32. Saravelos HG, Li TC, Cooke ID. An analysis of the outcome of microsurgical and laparoscopic adhesiolysis for chronic pelvic pain. Hum Reprod. 1995 Nov;10(11):2895-901
33. Diamond MP, Daniell JF, Feste J, Surrey MW, McLaughlin DS, Friedman S, Vaughn WK, Martin DC. Adhesion reformation and de novo adhesion formation after reproductive pelvic surgery. Fertil Steril. 1987 May;47(5):864-6
34. Swank D J, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ, Jeekel J. Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet. 2003 Apr 12;361(9365):1247-51
35. Peters AA, van Dorst E, Jellis B, van Zuuren E, Hermans J, Trimbos JB. A randomized clinical trial to compare two different approaches in women with chronic pelvic pain. Obstet Gynecol. 1991 May; 77(5): 740-4
36. Sekiba K. Use of Interceed (TC7) absorbable adhesions barrier to reduce postoperative adhesion reformation in infertility and endometriosis surgery. Obstet Gynecol. 1992 Apr;79(4):518-22
37. HowardFM, El-MinawiA, SanchezR. Conscious laparoscopic pain mapping in women with chronic pelvic pain. Obstet Gynecol. 2000 Dec;96(6):934-9
38. Bonica JJ. General considerations of pain in the pelvis and perineum. In: Bonica JJ, Loeser JD, Chapman CR, Fordyce WE, editors. The management of pain, 2nd ed. Malvern, PA; Lea & Febiger; 1990. p. 1283-312
39. Rocker I. Pelvic pain in women. Diagnosis and management. London: Springer-Verlag; 1990 40. Vercellini P, Aimi G, Busacca M, Apolone G, UgliettiA, Crosignani PG. Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial. Fertil Steril. 2003 Aug;80(2):310-9
41. Latthe PM, Proctor ML, Farquhar CM, Johnson N, Khan KS. Surgical interruption of pelvic nerve pathways in dysmenorrhea: a systematic review of effectiveness. Acta Obstet Gynecol Scand. 2007;86(1):4-15
42. Sutton CJ, Ewen SP, Whitelaw N, Haines P. Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment ofpelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril. 1994 Oct;62(4):696-700
43. Palomba S, Zupi E, Falbo A, Russo T, Tolino A, Marconi D, Mattel A, Zullo F. Presacral neurectomy for surgical management ofpelvic pain associated with endometriosis: a descriptive review. J Minim Invasive Gynecol. 2006 Sep-Oct;13(5):377-85
44. Carlson KJ, Miller BA, Fowler FJ Jr. The Maine women s health study. I. Outcome of hysterectomy. Obstet Gynecol 1994 Apr;83(4):556-65
45. Reiter RC. Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol. 1998 Jun;41(2):422-35
46. LyallH, Campbell-Brown M, Walker JJ. GnRH analogue in everyday gynecology. Is it possible to rationalize its use? Acta Obstet Gynecol Scand. 1999 Apr; 78(4):340-5
47. Peng PW, Tumber PS. Ultrasound-guided interventional procedures for patients with chronic pelvic pain - a description of techniques and review of literature. Pain Physician. 2008 Mar-Apr; 11(2) :215-24
48. Chen F-P, Soong Y-K. The efficacy and complications of laparoscopic presacral neurectomy in pelvic pain. Obstet Gynecol. 1997Dec;90(6):974-7
49. Sinha D, Karri K, Arunkalaivanan AS. Applications of Botulinum toxin in urogynaecology.Eur J Obstet Gynecol Reprod Biol. 2007 Jul; 133(1): 4-11
50. Abbott J. Gynecological indications for the use of botulinum toxin in women with chronic pelvic pain. Toxicon. 2009 Oct;54(5):647-53
51.Abbott J A, Jarvis SK, Lyons SD, Thomson A, Vancaille TG. Botulinum toxin type A for chronic pain and pelvic floor spasm in women: a randomized controlled trial. Obstet Gynecol. 2006 Oct;108(4) :915-23
52. Jeffery S, Fynes M, Lee F, Wang K, Williams L, Morley R Efficacy and complications of intradetrusor injection with botulinum toxin A in patients with refractory idiopathic detrusor overactivity. BJU Int. 2007 Dec; 100(6):1302-6
53. Anpalagan A, Condous G. Is there a role for use of levonorgestrel intrauterine system in women with chronic pelvic pain? J Minim Invasive Gynecol. 2008 Nov-Dec; 15(6):663-6
54. Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol. 2001 Dec;166(6):2226-31
55. Heyman J, Ohrvik J, Leppert J. Distension of painful structures in the treatment for chronic pelvic pain in women. Acta Obstet Gynecol Scand. 2006;85(5):599-603
56. GulA, Zeteroglu Ş, Karayel M, Çelebi H, Şimşek Y. The efficacy of Transcutaneous Electrical Nevre Stimulation (TENS) for the Treatment of Chronic Pelvic Pain. T Klinikleri J Med Res 2000; 18:90-94 57. Chen R, Nickel JC. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003 Jun; 61(6): 1156-9 58. Renaer M, Vertommen H, Nijs P, Wagemans L, Van Hemelrijck T. Psychological aspects of chronic pelvic pain in women. Am J Obstet Gynecol. 1979 May l;134(l):75-80
59. Lifford KL, Barbieri RL. Diagnosis and management of chronic pelvic pain. Urol Clin North Am. 2002 Aug;29(3):637-47
60. Gunter J. Chronic pelvic pain: an integrated approach to diagnosis and treatment. Obstet Gynecol Surv. 2003 Sep;58(9):615-23
61. Reed BD, Haefner HK, Punch MR, Roth RS, Gorenflo DW, Gillespie BW. Psychosocial and sexual functioning in women with vulvodynia and chronic pelvic pain. A comparative evaluation. J Reprod Med. 2000 Aug;45(8):624-32
62. Talley NJ, Owen BK, Boyce P, Paterson K. Psychological treatments for irritable bowel syndrome: A critique of controlled treatment trials. Am J Gastroenterol. 1996 Feb;91(2):277-83

Kadınlarda kronik pelvik ağrı

Yıl 2010, Cilt: 41 Sayı: 2, 77 - 86, 01.03.2010

Mert Küçük Mustafa Oğurlu Filiz Sekdur Selda Demircan

Öz

Kadınlarda kronik pelvik ağrı sık karşılaşılan, hastanın yaşam kalitesini azaltan, önemli bir sağlık sorunudur. Kronik pelvik ağrının sağlık sistemi üzerine ekonomik yüküde oldukça fazladır. Direkt ve indirekt maliyetlerin tamamı göz önüne alınınca çok ciddi bir miktar kronik pelvik ağrılı hastaların tedavisine harcanmaktadır. Kronik pelvik ağrı çalışan kadınlarda iş verimini de olumsuz yönde etkilemektedir. Hastaların bu nedenle önemli iş gücü kayıpları meydana gelmektedir. Kronik pelvik ağrı hastaların aktivitelerini kısıtlamakta ve cinsel yaşamlarında sorunlara sebep olmaktadır. Kronik pelvik ağrının fizyopatolojisi tam olarak anlaşılamamıştır. Ağrı pelvik bölgede bulunan çok sayıda organdan kaynaklanabilmektedir. Kronik pelvik ağrı bu bölgede bulunan genital organlar, üriner organlar, pelvik taban kas yapısı, gastrointestinal organlardan kaynaklanabildiği gibi, nöropsikiyatrik sistem gibi başka sistemlerden de kaynaklanabilmektedir. Kronik pelvik ağrılı hastaların ancak yarısından az bir kısmı hekime başvurmaktadır. Birinci basmak sağlık hizmetlerine başvuran ve kronik pelvik ağrı tanısı konan hastaların yeterince değerlendirilip uygun kliniklerine doğru yönlendirme yapılmadığı çalışmalarda bildirilmiştir. Doğru tanı için ağrının şiddeti, yayılımı, ağrıyı arttıran ve azaltan nedenler, ağrının cinsel ilişki ve menstruasyonla ilişkisi, olası gebelik durumu, daha önce geçirdiği operasyonlar, adet düzeni, depresyon semptomları gibi ayrıntılı soruları içeren semptomların iyi bir şekilde değerlendirilmesi gereklidir ve iyi bir fizik muayene çok önemlidir. Hastalığın tedavi seçenekleri konservatifmedikal tedaviden cerrahi tedaviye kadar geniş bir yelpazede yer alır. Bu hastalığın tedavisinde multidisipliner yaklaşım çok önemlidir. Bu derlemede kronik pelvik ağrının tanımı, değerlendirilmesi ve tedavisi konusunda güncel bilgiler vermek amaçlanmıştır.

Anahtar Kelimeler

Kaynakça

1. ACOG Practice Bulletin No. 51. Chronic pelvic pain. Obstet Gynecol. 2004;103(3):589-605
2. Kennedy SH, Moore J. The initial management of chronic pelvic pain. Green top guidelines. London, Royal College of Obstetricians and Gynaecologists, 2005 3. Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, Kennedy SH. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract. 2001 Jul;51(468):541-7
4. Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 1996 Mar;87(3):321-7
5. Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol. 1999 Nov;106(11):1149-55
6. Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006 Jul 6;6:177
7. Grace VM, Zondervan KT. Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. AustNZ J Public Health. 2004 Aug;28(4):369-75
8. Howard FM. The role oflaparoscopy in chronic pelvic pain: Promise and pitfalls. Obstet Gynecol Surv. 1993 Jun;48(6):357-87
9. Stones RW, Mountfield J. Interventions for treating chronic pelvic pain in women. Cochrane Database Syst Rev. 2000;(4):CD000387 10. Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Patterns of diagnosis arid referral in women consultingfor chronic pelvic pain in UK primary care. Br J Obstet Gynaecol. 1999 Nov;106(11):1156-61
11. Gambone JC, Mittman BS, Munro MG, Scialli AR, Winkel CA; Chronic Pelvic Pain/Endometriosis Working Group. Consensus statement for the management of chronic pelvic pain and endometriosis: proceedings of an expert-panel consensus process. Fertil Steril. 2002;78(5):961-72
12. Jensen MP, Karoly P. Self-report scales and procedures for assessing pain in adults. In: Turk DC, MelzackR, eds. Handbook of pain assessment. 1st ed. New York: Guilford Press, 1992. p. 135-51
13. Di Spiezio Sardo A, Guida M, Bettocchi S, Nappi L, Sorrentino F, Bifulco G, Nappi C. Role of hysteroscopy in evaluating chronic pelvic pain. Fertil Steril. 2008 0ct;90(4): 1191-6
14. MettlerL, Alhujeily M. Role oflaparoscopy in identifying the clinical significance and cause of adhesions and chronic pelvic pain: a retrospective review at the Kiel School of Gynecological Endoscopy. JSLS. 2007 Jul-Sep;l1(3):303-8
15. Howard FM. The role of laparoscopy as a diagnostic tool in chronic pelvic pain. Best Pract Res Clin Obstet Gynecol 2000; 14:467-494 16. GaneshanA, UpponiS, HonLQ, Uthappa MC, Warakaulle DR, Uberoi R. Chronic pelvic pain due to pelvic congestion syndrome: the role of diagnostic and interventional radiology. Cardiovasc Intervent Radiol. 2007 Nov-Dec;30(6): 1105-11
17. Howard FM. Chronic pelvic pain. Obstet Gynecol. 2003 Mar;101 (3). 594-611
18. Thomson H, Francis DM. Abdominal-wall tenderness: A useful sign in the acute abdomen. Lancet. 1977 Nov 19;2(8047): 1053-4
19. Vercellini P, Vigand P, Somigliana E, Abbiati A, Barbara G, Fedele L. Medical, surgical and alternative treatments for chronic pelvic pain in women: a descriptive review. Gynecol Endocrinol. 2009 Apr;25(4):208-21
20. Jarrell JF, Vilos GA, Allaire C, Burgess S, Fortin C, Gerwin R, Lapensee L, Lea RH, Leyland NA, Martyn P, Shenassa H, Taenzer P, Abu-Rafea B; Chronic Pelvic Pain Working Group; Society of Obstetricians and Gynaecologists of Canada. Consensus guidelines for the management ofchronic pelvic pain. J Obstet Gynaecol Can. 2005 Sep;27(9):869-910
21. Miotto K, Compton P, Ling W, Conolly M. Diagnosing addictive disease in chronic pain patients. Psychosomatics. 1996 May-Jun;37(3) :223-35
22. Vercellini P, Daguati R, Abbiati A. Chronic pelvic pain. In: Arici A, Seli E, editors. Non-invasive management of gynecologic disorders. 1st ed. London: Informa Healthcare Publishing Group; 2008. p. 33-51 23. Onghena P, Van Houdenhove BV. Antidepressant-induced analgesia in chronic non-malignant pain: a metanalysis of 39 placebo controlled studies. Pain. 1993 Feb;52(2):247-9
24. Engel CC Jr, Walker EA, Engel AL, Bullis J, Armstrong A. A randomized, double-blind crossover trial of sertraline in women with chronic pelvic pain. JPsychosom Res. 1998 Feb;44(2):203-7
25. Stones RW, Bradbury L, Anderson D. Randomized placebo controlled trial of lofexidine hydrochloride for chronic pelvic pain in women. Hum Reprod. 2001 Aug; 16(8): 1719-21
26. Farquhar CM, Rogers V, Franks S, Pearce S, Wadsworth J, Beard RW. A randomized controlled trial of medroxyprogesterone acetate and psychotherapy for the treatment of pelvic congestion. BrJObstet Gynaecol. 1989 0ct;96(10):1153-62
27. Barbieri RL. Primary gonadotr opin-releasing hormone agonist therapy for suspected endometriosis: a nonsurgical approach to the diagnosis and treatment of chronic pelvic pain. Am JManag Care 1997;3:285-290
28. Soysal ME, Soysal S, Vicdan K, Özer S. A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Hum Reprod. 2001 May;16(5):931 -9
29.Sagsveen M, Farmer JE, Prentice A, et al. Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density. Cochrane Database of Systematic Reviews 2003(4): CD001297
30. Levy MH. Pharmacologic treatment of cancer pain. NEngl J Med. 1996 Oct 10;335(15):1124-32
31. Alexander-Williams J. Do adhesions cause pain? Br Med J (Clin Res Ed). 1987 Mar 14;294(6573):659-60
32. Saravelos HG, Li TC, Cooke ID. An analysis of the outcome of microsurgical and laparoscopic adhesiolysis for chronic pelvic pain. Hum Reprod. 1995 Nov;10(11):2895-901
33. Diamond MP, Daniell JF, Feste J, Surrey MW, McLaughlin DS, Friedman S, Vaughn WK, Martin DC. Adhesion reformation and de novo adhesion formation after reproductive pelvic surgery. Fertil Steril. 1987 May;47(5):864-6
34. Swank D J, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ, Jeekel J. Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomised controlled multi-centre trial. Lancet. 2003 Apr 12;361(9365):1247-51
35. Peters AA, van Dorst E, Jellis B, van Zuuren E, Hermans J, Trimbos JB. A randomized clinical trial to compare two different approaches in women with chronic pelvic pain. Obstet Gynecol. 1991 May; 77(5): 740-4
36. Sekiba K. Use of Interceed (TC7) absorbable adhesions barrier to reduce postoperative adhesion reformation in infertility and endometriosis surgery. Obstet Gynecol. 1992 Apr;79(4):518-22
37. HowardFM, El-MinawiA, SanchezR. Conscious laparoscopic pain mapping in women with chronic pelvic pain. Obstet Gynecol. 2000 Dec;96(6):934-9
38. Bonica JJ. General considerations of pain in the pelvis and perineum. In: Bonica JJ, Loeser JD, Chapman CR, Fordyce WE, editors. The management of pain, 2nd ed. Malvern, PA; Lea & Febiger; 1990. p. 1283-312
39. Rocker I. Pelvic pain in women. Diagnosis and management. London: Springer-Verlag; 1990 40. Vercellini P, Aimi G, Busacca M, Apolone G, UgliettiA, Crosignani PG. Laparoscopic uterosacral ligament resection for dysmenorrhea associated with endometriosis: results of a randomized, controlled trial. Fertil Steril. 2003 Aug;80(2):310-9
41. Latthe PM, Proctor ML, Farquhar CM, Johnson N, Khan KS. Surgical interruption of pelvic nerve pathways in dysmenorrhea: a systematic review of effectiveness. Acta Obstet Gynecol Scand. 2007;86(1):4-15
42. Sutton CJ, Ewen SP, Whitelaw N, Haines P. Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment ofpelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril. 1994 Oct;62(4):696-700
43. Palomba S, Zupi E, Falbo A, Russo T, Tolino A, Marconi D, Mattel A, Zullo F. Presacral neurectomy for surgical management ofpelvic pain associated with endometriosis: a descriptive review. J Minim Invasive Gynecol. 2006 Sep-Oct;13(5):377-85
44. Carlson KJ, Miller BA, Fowler FJ Jr. The Maine women s health study. I. Outcome of hysterectomy. Obstet Gynecol 1994 Apr;83(4):556-65
45. Reiter RC. Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol. 1998 Jun;41(2):422-35
46. LyallH, Campbell-Brown M, Walker JJ. GnRH analogue in everyday gynecology. Is it possible to rationalize its use? Acta Obstet Gynecol Scand. 1999 Apr; 78(4):340-5
47. Peng PW, Tumber PS. Ultrasound-guided interventional procedures for patients with chronic pelvic pain - a description of techniques and review of literature. Pain Physician. 2008 Mar-Apr; 11(2) :215-24
48. Chen F-P, Soong Y-K. The efficacy and complications of laparoscopic presacral neurectomy in pelvic pain. Obstet Gynecol. 1997Dec;90(6):974-7
49. Sinha D, Karri K, Arunkalaivanan AS. Applications of Botulinum toxin in urogynaecology.Eur J Obstet Gynecol Reprod Biol. 2007 Jul; 133(1): 4-11
50. Abbott J. Gynecological indications for the use of botulinum toxin in women with chronic pelvic pain. Toxicon. 2009 Oct;54(5):647-53
51.Abbott J A, Jarvis SK, Lyons SD, Thomson A, Vancaille TG. Botulinum toxin type A for chronic pain and pelvic floor spasm in women: a randomized controlled trial. Obstet Gynecol. 2006 Oct;108(4) :915-23
52. Jeffery S, Fynes M, Lee F, Wang K, Williams L, Morley R Efficacy and complications of intradetrusor injection with botulinum toxin A in patients with refractory idiopathic detrusor overactivity. BJU Int. 2007 Dec; 100(6):1302-6
53. Anpalagan A, Condous G. Is there a role for use of levonorgestrel intrauterine system in women with chronic pelvic pain? J Minim Invasive Gynecol. 2008 Nov-Dec; 15(6):663-6
54. Weiss JM. Pelvic floor myofascial trigger points: manual therapy for interstitial cystitis and the urgency-frequency syndrome. J Urol. 2001 Dec;166(6):2226-31
55. Heyman J, Ohrvik J, Leppert J. Distension of painful structures in the treatment for chronic pelvic pain in women. Acta Obstet Gynecol Scand. 2006;85(5):599-603
56. GulA, Zeteroglu Ş, Karayel M, Çelebi H, Şimşek Y. The efficacy of Transcutaneous Electrical Nevre Stimulation (TENS) for the Treatment of Chronic Pelvic Pain. T Klinikleri J Med Res 2000; 18:90-94 57. Chen R, Nickel JC. Acupuncture ameliorates symptoms in men with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003 Jun; 61(6): 1156-9 58. Renaer M, Vertommen H, Nijs P, Wagemans L, Van Hemelrijck T. Psychological aspects of chronic pelvic pain in women. Am J Obstet Gynecol. 1979 May l;134(l):75-80
59. Lifford KL, Barbieri RL. Diagnosis and management of chronic pelvic pain. Urol Clin North Am. 2002 Aug;29(3):637-47
60. Gunter J. Chronic pelvic pain: an integrated approach to diagnosis and treatment. Obstet Gynecol Surv. 2003 Sep;58(9):615-23
61. Reed BD, Haefner HK, Punch MR, Roth RS, Gorenflo DW, Gillespie BW. Psychosocial and sexual functioning in women with vulvodynia and chronic pelvic pain. A comparative evaluation. J Reprod Med. 2000 Aug;45(8):624-32
62. Talley NJ, Owen BK, Boyce P, Paterson K. Psychological treatments for irritable bowel syndrome: A critique of controlled treatment trials. Am J Gastroenterol. 1996 Feb;91(2):277-83

Toplam 55 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Bölüm	Makaleler
Yazarlar	Mert Küçük Bu kişi benim Mustafa Oğurlu Bu kişi benim Filiz Sekdur Bu kişi benim Selda Demircan Bu kişi benim
Yayımlanma Tarihi	1 Mart 2010
Yayımlandığı Sayı	Yıl 2010 Cilt: 41 Sayı: 2

Kaynak Göster

APA	Küçük, M., Oğurlu, M., Sekdur, F., Demircan, S. (2010). Kadınlarda kronik pelvik ağrı. Zeynep Kamil Tıp Bülteni, 41(2), 77-86. https://doi.org/10.16948/zktb.18463
AMA	Küçük M, Oğurlu M, Sekdur F, Demircan S. Kadınlarda kronik pelvik ağrı. Zeynep Kamil Tıp Bülteni. Mart 2010;41(2):77-86. doi:10.16948/zktb.18463
Chicago	Küçük, Mert, Mustafa Oğurlu, Filiz Sekdur, ve Selda Demircan. “Kadınlarda Kronik Pelvik ağrı”. Zeynep Kamil Tıp Bülteni 41, sy. 2 (Mart 2010): 77-86. https://doi.org/10.16948/zktb.18463.
EndNote	Küçük M, Oğurlu M, Sekdur F, Demircan S (01 Mart 2010) Kadınlarda kronik pelvik ağrı. Zeynep Kamil Tıp Bülteni 41 2 77–86.
IEEE	M. Küçük, M. Oğurlu, F. Sekdur, ve S. Demircan, “Kadınlarda kronik pelvik ağrı”, Zeynep Kamil Tıp Bülteni, c. 41, sy. 2, ss. 77–86, 2010, doi: 10.16948/zktb.18463.
ISNAD	Küçük, Mert vd. “Kadınlarda Kronik Pelvik ağrı”. Zeynep Kamil Tıp Bülteni 41/2 (Mart 2010), 77-86. https://doi.org/10.16948/zktb.18463.
JAMA	Küçük M, Oğurlu M, Sekdur F, Demircan S. Kadınlarda kronik pelvik ağrı. Zeynep Kamil Tıp Bülteni. 2010;41:77–86.
MLA	Küçük, Mert vd. “Kadınlarda Kronik Pelvik ağrı”. Zeynep Kamil Tıp Bülteni, c. 41, sy. 2, 2010, ss. 77-86, doi:10.16948/zktb.18463.
Vancouver	Küçük M, Oğurlu M, Sekdur F, Demircan S. Kadınlarda kronik pelvik ağrı. Zeynep Kamil Tıp Bülteni. 2010;41(2):77-86.

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