Diagnosis and treatment of the causes of chronic pelvic pain

Carter, JE

doi:10.1016/s1074-3804(96)80145-9

Cited by 6 publications

(6 citation statements)

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“…For these reasons, LUNA is currently a preferable process [2,6,11,12]. While in surgical procedures the nerves are either cut or excised to interrupt the neural input, in neurolysis their microscopic neural architecture is chemically destroyed to interrupt the neural input [7,14,15,29,30,31,32]. In gynecological practice generally, neurolytic blocks are used in cancer-related CPP and in the form of percutaneous neurolytic superior hypogastric plexus block [29].…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain

Naykı

Sönmez²,

Ulug³

et al. 2016

J Clin Exp Invest

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Objective: To investigate the efficacy of laparoscopic uterine nerve ethanol neurolysis (LUNEN) for pain management in patients with chronic pelvic pain (CPP).Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were compared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6 th month Visual Analogue Scale (VAS) scores were estimated and a subjective pain evaluation questioning patients' satisfaction about pain relief in the 6th month after surgery was also performed.Results: A total of 31 (73.8%) out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postoperative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02). In the LUNEN group, the number of patients who stated that their pain was relieved partially or completely was also significantly higher than in the control group (82% vs. 40%, p=0.019). Conclusion:LUNEN is a feasible, safe and effective surgical alternative to traditional surgical methods in patients suffering from CPP. J Clin Exp Invest 2016; 7 (1): 7-13

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Section: Discussionmentioning

confidence: 99%

“…In fact, CPP is the indication for 40% of all gynecological laparoscopies in the United States [6]. The laparoscopic approach makes not only the detection but also the treatment of the underlying pathology of the pelvic pain feasible [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain

Naykı

Sönmez²,

Ulug³

et al. 2016

J Clin Exp Invest

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“…29,30,51,52,54,55,56 Examples of cross-system effects would include: bladder inflammation, which reduces the rate of uterine contractions and the effects of drugs on the uterus; and colon inflammation, which produces signs of inflammation in an otherwise healthy bladder and reduces volume voiding thresholds of the bladder. 34,40,57,58,59,60 "The percentage of neurons in the spinal cord which receive convergent input from two or more pelvic organs appears to be higher than the proportion of DRG cells innervating multiple viscera. For example, 26 percent of all recorded neurons in the dorsal horn of lumbo-sacral segments of the spinal cord receive afferent inputs from both the colon and urinary bladder."…”

Section: Clinical Notementioning

confidence: 99%

2 General Concepts

Philip¹

2016

Pelvic Pain and Dysfunction

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This chapter discusses components of differential diagnostics with which the clinician may or may not be familiar; however, they are important in the formation of a functional diagnosis that allows clinicians to better be able to treat their patients. Some of the information will be a review for the reader, whereas other information will be novel. To those for whom the information is novel: enjoy and learn. To those who "know" the information provided in this chapter, take the time to review and reflect on it and apply the concepts to your current practice. S5 Co1 Co2 SCJ X X Pancreas X X Liver X Gall bladder X X X X X Stomach/duodenum X X X X Small intestine X X Epididymis X Colon: ascending X X X X Kidney X X X X Appendix X X X X Ureter X X X Bladder fundus X X X Uterine fundus X X X Bladder neck X X X Vagina/penis X X X Suprarenal gland X X X Ovary/testes X X X Colon; flexure X X X Colon; sigmoid X X X Prostate X X X X Urethra X X X X Rectum X X X Muscle Upper trapezius X X Iliopsoas X X X X X Guteus: med/min X X X Gluteus maximus X X Piriformis X X Obturator internus X X Quadratus femoris X X X X Semitendinosus X X X X X Semimembranosus X X X X X Adductor magnus X X X X Peroneus: longus, brevis & tertius X X X X Tibialis anterior X X X X Ext. hall. Long/brevis X X X X X Triceps surae X X X X X Peroneus tertius X X X X X S5 Co1 Co2 Levator ani X X X X Superficial transverse perineal X X X X Deep transverse perineal X X X X Bulbospongiosus X X X X Ischiocavernosus X X X X External anal sphincter X X X X Urethral sphincter X X X X Coccygeus X X X Test Passive scap. Apprx T1-2 Abdominal reflex X X X X X X X X Beevor's Sign X X X X DTR: quadriceps X X Cremaster reflex Prone knee flexion X(?) X X X X X X Clitorolabial reflex X X X X Bulbocavernosus reflex X X X Straight leg raise X X X X DTR: achilles X X Q-tip X Pin-prick X Nerve branch: Superior glutea nerve X X X X Inferior gluteal nerve X X Lateral cutaneous branch of subcostal X Lateral cutaneous branch of femoral nerve X X Genitofemoral nerve X X Ilioinguinal nerve X Obturator nerve, cutaneous branch X X X Medial clunial nerve X X X Superior clunial nerve X X X

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“…The laparoscopic approach makes not only the detection but also the treatment of the underlying pathology of the pelvic pain feasible [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain

Sönmez¹,

Naykı²,

Ulug³

et al. 2016

Journal of Clinical and Experimental Investigations

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ÖZETAmaç: Kronik pelvik ağrılı (KPA) hastalarda ağrı tedavisinde laparoskopik olarak uterin sinirin etanol ile nörolizi-sinin (LUNEN) etkinliğinin araştırılması Yöntemler: Kimyasal bir nörolizis prosedürü olan LU-NEN, 22 hastaya uygulandı ve bunlar sadece tanısalk laparoskopi yapılan 20 kontrol hastayla karşılaştırıldı. Tedavi öncesi ve tedavi sonrası altıncı ayda Vizüel Analog Skalası (VAS) değerlendirildi, Ayrıca, ağrı kontrolünde hasta memnuniyetini sorgulayan subjektif bir ağrı değer-lendirmesi yapıldı. Methods: LUNEN, as a chemical neurolysis procedure, was performed on 22 subjects, and these were compared with 20 controls that had a diagnostic laparoscopy alone. Pre-treatment and postoperative 6 th month Visual Analogue Scale (VAS) scores were estimated and a subjective pain evaluation questioning patients' satisfaction about pain relief in the 6th month after surgery was also performed.Results: A total of 31 (73.8%) out of 42 CPP patients had a laparoscopic pelvic pathology. Preoperative VAS scores were similar in the groups; however, the mean postoperative VAS score was significantly lower in the LUNEN group than in the control group (3.18 ± 2.88 vs. 5.35 ± 3.09; p=0.02). In the LUNEN group, the number of patients who stated that their pain was relieved partially or completely was also significantly higher than in the control group (82% vs. 40%, p=0.019). Conclusion:LUNEN is a feasible, safe and effective surgical alternative to traditional surgical methods in patients suffering from CPP. J Clin Exp Invest 2016; 7 (1): 7-13

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Diagnosis and treatment of the causes of chronic pelvic pain

Cited by 6 publications

References 0 publications

Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain

Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain

2 General Concepts

Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain

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