Chronic pelvic pain: from correct diagnosis to adequate therapy
https://doi.org/10.14412/2074-2711-2020-2-12-16
Abstract
Management of patients with chronic pelvic pain (CPP) is an actual interdisciplinary problem of modern clinical medicine. CPP is chronic or persistent pain lasting more than 6 months, which is located in the structures related to the male or female pelvis and is associated with negative cognitive, behavioral, and emotional consequences, as well as with lower urinary tract, bowel, and pelvic floor symptoms, and reproductive and sexual dysfunction. In accordance with the biopsychosocial model, CPP is the result of a dynamic interaction of biological, psychological and sociocultural factors. When diagnosing CPP, it is most acceptable to phenotype patients according to the UPOINTS classification.
To implement the treatment strategy, it is necessary to adhere to a multidisciplinary personalized approach to pain management with active patient participation. Cognitive behavioral therapy (CBT) occupies an important place in the treatment of CPP. There is clinical and neurophysiological evidence of the efficiency of CBT in patients with CPP, a protocol has been developed for the combined use of CBT and physical therapy. CBT is recommended to be included in a comprehensive treatment and rehabilitation program for patients with CPP.
To implement the treatment strategy, it is necessary to adhere to a multidisciplinary personalized approach to pain management with active patient participation. Cognitive behavioral therapy (CBT) occupies an important place in the treatment of CPP. There is clinical and neurophysiological evidence of the efficiency of CBT in patients with CPP, a protocol has been developed for the combined use of CBT and physical therapy. CBT is recommended to be included in a comprehensive treatment and rehabilitation program for patients with CPP.
About the Authors
S. A. Rachin
Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia
Russian Federation
6-8, Lev Tolstoy St., Saint Petersburg 197022, Russia
Russian Federation
6-8, Lev Tolstoy St., Saint Petersburg 197022, Russia
M. N. Sharov
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
20, Delegatskaya St., Build. 1, Moscow 127473, Russia
Russian Federation
20, Delegatskaya St., Build. 1, Moscow 127473, Russia
A. V. Zaitsev
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
20, Delegatskaya St., Build. 1, Moscow 127473, Russia
Russian Federation
20, Delegatskaya St., Build. 1, Moscow 127473, Russia
A. M. Tynterova
Immanuel Kant Baltic Federal University, Ministry of Education and Science of Russia
Russian Federation
14, A. Nevsky St., Kaliningrad 236041, Russia
Russian Federation
14, A. Nevsky St., Kaliningrad 236041, Russia
M. V. Nuvakhova
National Medical Research Center of Rehabilitation and Balneology, Ministry of Health of Russia
Russian Federation
32, Novyi Arbat St., Moscow 121099, Russia
Russian Federation
32, Novyi Arbat St., Moscow 121099, Russia
Yu. S. Prokofyeva
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
20, Delegatskaya St., Build. 1, Moscow 127473, Russia
Russian Federation
20, Delegatskaya St., Build. 1, Moscow 127473, Russia
R. R. Parsamyan
V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia
Russian Federation
112, Bolshaya Kazachiya St., Saratov 410012, Russia
Russian Federation
112, Bolshaya Kazachiya St., Saratov 410012, Russia
M. Yu. Maksimova
Research Center of Neurology, Ministry of Education and Science of Russia
Russian Federation
80, Volokolamskoe Shosse, Moscow 125367, Russia
Russian Federation
80, Volokolamskoe Shosse, Moscow 125367, Russia
A. P. Rachin
National Medical Research Center of Rehabilitation and Balneology, Ministry of Health of Russia
Russian Federation
32, Novyi Arbat St., Moscow 121099, Russia
Russian Federation
32, Novyi Arbat St., Moscow 121099, Russia
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Review
For citations:
Rachin S.A., Sharov M.N., Zaitsev A.V., Tynterova A.M., Nuvakhova M.V., Prokofyeva Yu.S., Parsamyan R.R., Maksimova M.Yu., Rachin A.P. Chronic pelvic pain: from correct diagnosis to adequate therapy. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(2):12-16. (In Russ.) https://doi.org/10.14412/2074-2711-2020-2-12-16
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