Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates

Mathias, Susan D.; Kuppermann, Miriam; Liberman, Rebecca F.; Lipschutz, Ruth C.; Steege, John F.

doi:10.1016/0029-7844(95)00458-0

Cited by 948 publications

(628 citation statements)

References 14 publications

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“…CPP affects 15% of both men and women, and commonly involves the pelvic cavity, as in irritable bowel syndrome (IBS) and interstitial cystitis (IC), and/or the pelvic floor (Berger et al 1998;Clemens et al 2005;Mathias et al 1996;Moldwin 2002;Wesselmann 2001;Zondervan et al 2001). Considering that the colorectum and urinary bladder, exclusive from other pelvic organs, function as an integral part of daily, physiological pelvic activity, it is not surprising that IBS and IC, analogous disorders of pelvic visceral pain and urgency, account for half of all cases of CPP (Zondervan et al 1999).…”

Section: Introductionmentioning

confidence: 99%

Convergence of bladder and colon sensory innervation occurs at the primary afferent level

Christianson¹,

Liang²,

Ustinova³

et al. 2007

Pain

177

155

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Dichotomizing afferents are individual dorsal root ganglion (DRG) neurons that innervate two distinct structures thereby providing a form of afferent convergence that may be involved in pelvic organ cross-sensitization. To determine the distribution of dichotomizing afferents supplying the distal colon and bladder of the Sprague-Dawley rat and the C57Bl/6 mouse, we performed concurrent retrograde labeling of urinary bladder and distal colon afferents using cholera toxin subunit B (CTB) fluorescent conjugates. Animals were perfused 4-5 days after sub-serosal organ injections, and the T10-S2 DRG were removed, sectioned, and analyzed using confocal microscopy. In the rat, CTBpositive afferents retrogradely labeled from the bladder were nearly 3 times more numerous than those labeled from the distal colon, while in the mouse, each organ was equally represented. In both species, the majority of colon and bladder afferents projected from lumbosacral (LS) ganglia and secondarily from thoracolumbar (TL) ganglia. In the rat, 17% of the total CTB-positive neurons were retrogradely labeled from both organs with 11% localized in TL, 6% in LS, and 0.8% in thoracic (TH) ganglia. In the mouse, 21% of the total CTB-positive neurons were dually-labeled with 12% localized in LS, 4% in TH, and 4% in TL ganglia. These findings support the existence of dichotomizing pelvic afferents, which provide a pre-existing neuronal substrate for possible immediate and maintained pelvic organ cross-sensitization and ultimately may play a role in the overlap of pelvic pain disorders.

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Section: Introductionmentioning

confidence: 99%

Convergence of bladder and colon sensory innervation occurs at the primary afferent level

Christianson¹,

Liang²,

Ustinova³

et al. 2007

Pain

177

155

View full text Add to dashboard Cite

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“…CPP is associated with symptoms of depression, anxiety, low quality of life, low productivity, decreased energy, sexual dysfunction and relationship problems [5,6]. Laparoscopy is considered the gold standard for the diagnosis of pelvic pain but in many cases either no pathology is found or the identified pathology may not be responsible for the symptoms described, particularly if minimal or mild endometriosis and pelvic adhesions are recognised.…”

Section: Introductionmentioning

confidence: 99%

Chronic pelvic pain and quality of life after laparoscopy

Cox

Ayers

Nala

et al. 2007

European Journal of Obstetrics & Gynecology and Reproductiv

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This is the unspecified version of the paper.This version of the publication may differ from the final published version. Permanent repository link AbstractObjectives: To examine the long-term relationship between chronic pelvic pain (CPP) and quality of life and see if this is affected by a negative laparoscopy result.Study design: A postal questionnaire survey of CPP and quality of life in 63 women who underwent a diagnostic laparoscopy 12-18 months previously.Results: Women with CPP still reported pain 12-18 months after laparoscopy and a significantly poorer quality of life than UK norms for women of a similar age. Factor analysis showed that reports of pain symptoms clustered into two dimensions: (1) pain associated with menstruation and (2) pain associated with sexual intercourse and bladder and bowel function. Most dimensions of quality of life were significantly associated with pain. However, 'role limitation due to emotional problems' and 'mental health' were only associated with pain due to sexual intercourse and bladder and bowel function. Pain and quality of life were not affected by laparoscopy result or follow-up appointment.Conclusions: Women with CPP continue to have pain and a low quality of life 12-18 months after laparoscopy. Laparoscopy results and follow-up appointments do not appear to affect either pain symptoms or quality of life in the long term, although this may be confounded by women obtaining treatment elsewhere.

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“…[11][12][13] It negatively affects all dimensions of health-related quality of life and has a crippling financial impact. [14][15][16] Between 35% and 50% of people living with chronic pain experience depression or anxiety, 17,18 and chronic pain is associated with increased risk of suicide. 19 Problematic use of substances is also a concern 19 ; Canada has the second highest per capita rate of opioid prescribing in the world, 20 and moderate quality evidence suggests that prescription of opioids for chronic non-cancer pain is associated with a 5.5% risk of opioid use disorder.…”

Section: Introductionmentioning

confidence: 99%

Researching what matters to improve chronic pain care in Canada: A priority-setting partnership process to support patient-oriented research

Poulin

Shergill

Romanow

et al. 2018

Canadian Journal of Pain

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Background Chronic pain affects more than 6 million Canadians. Patients need to be involved in setting research priorities to ensure a focus on areas important to those who will be most impacted by the results. Aims The aim of this study was to leverage patient experiences to identify chronic pain research priorities in Canada. Method The process was informed by the James Lind Alliance. After gathering an exhaustive list of questions using surveys, town hall meetings, interviews, and social media consultations, we used a computerized Delphi with four successive iterations to select the final list of research priorities. The final Delphi round was conducted by a panel of ten patients living with chronic pain and ten clinicians from different disciplines. Results We received more than 5000 suggestions from 1500 people. The Delphi process led to the identification of 14 questions fitting under the following 4 themes: (1) improving knowledge and competencies in chronic pain; (2) improving patient-centered chronic pain care; (3) preventing chronic pain and reducing associated symptoms; and (4) improving access to and coordination of patient-centered chronic pain care. Challenges included the issue of chronic pain being ubiquitous to many diseases, leading to many initial suggestions focusing on these diseases. We also identified the need for further engagement efforts with marginalized groups in order to validate the priorities identified or identify different sets of priorities specific to these groups. Conclusion The priorities identified can guide patient-oriented chronic pain research to ultimately improve the care offered to people living with chronic pain.

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Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates

Abstract: Frequently, the cause of chronic pain is undiagnosed, although it affects approximately one in seven U.S. women. Increased awareness of its cost and impact on quality of life should promote increased medical attention to this problem.

Cited by 948 publications

References 14 publications

Convergence of bladder and colon sensory innervation occurs at the primary afferent level

Convergence of bladder and colon sensory innervation occurs at the primary afferent level

Chronic pelvic pain and quality of life after laparoscopy

Researching what matters to improve chronic pain care in Canada: A priority-setting partnership process to support patient-oriented research

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