Nurses' role in the management of persons with chronic urogenital pelvic pain syndromes: A scoping review

Abstract

Background Pelvic pain has cognitive, behavioral, sexual, and emotional consequences. Nurses involved in pelvic floor rehabilitation clinics have contacts with patients reporting chronic pain and should know the most appropriate service for patient referral, to submit the problem to professionals capable of correctly assessing and managing the condition. Furthermore, in some countries nurses can use conservative methods to treat the painful symptoms inside a multidisciplinary team such as breathing retraining, biofeedback, and noninvasive neuromodulation. This paper aims to provide an overview of the literature regarding the role of rehabilitation nurses in dealing with patients suffering from chronic urogenital pelvic pain or urogenital painful syndromes, inside a multidisciplinary team. Methods Scoping review on Pubmed, CINAHL, Embase, Scopus, Web of Science including trials, reviews, case studies or series, and other descriptive studies regarding the role of nurses inside the multidisciplinary team in the management of males and females presenting chronic pelvic pain (CPP) or chronic pelvic pain syndrome (CPPS). Results The 36 papers included in this review allowed answering research questions in four areas of nursing: collecting basic information, referring the person to appropriate services, evidence‐based nursing interventions for CPP and CPPS, and proper documentation. Clinical history and assessment of breathing pattern, Muscular assessment and research of trigger points are the main points of data collection. Techniques for muscular relaxation and breathing retraining are important aspects of treatment, as well as biofeedback and noninvasive neuromodulation where the law allows nurses to practice such techniques. The McGill pain questionnaire and the pain inventory of the International Pain Society allow systematic data collection and handover. Conclusion Rehabilitation nurses work inside multidisciplinary teams when dealing with persons suffering from pelvic pain; further research is needed as our comprehension of the underlying pathophysiological mechanisms of CPP and CPPS evolve.

Transcutaneous electrical nerve stimulation for pelvic pain: A scoping review of treatment protocols, practical indications, and caveats

“…TENS should therefore be viewed as one of the components of the rehabilitation program in the frame of thorough and continuous patient assessment. 11…”

“…As the European Guidelines 42 pointed out, pelvic pain requires a multimodal approach, of which TENS is just a part. TENS should therefore be viewed as one of the components of the rehabilitation program in the frame of thorough and continuous patient assessment 11 …”

“…We excluded grey literature, but we used such sources to check for additional references, as done by other authors 11 and suggested by the Jonna Briggs method 9 …”

“…In contrast, blood flow increases with LF TENS at intensities above 25% of the motor threshold. 28 This last finding is important because one of the factors maintaining chronic pelvic pain and chronic pelvic pain syndromes is hypoxia 14 (also often related to pathological breathing patterns 11 ), which can be alleviated by increased blood flow. In most studies, the frequency varies from 1 to 100 Hz, depending on the levels of the painful response.…”

Cut‐off scores of the Depression Anxiety Stress Scale‐8: Implications for improving the management of chronic pain

“…and comorbid chronic pain is neuroinflammation, which is noted by glial activation (increased glial marker 18 kDa translocator protein) and changes in functional connectivity in the anterior middle and pregenual anterior cingulate cortices to the dorsolateral prefrontal cortex (Albrecht et al, 2021) sensitization (Terzoni et al, 2023). In fact, women with CPP account for lack of support and formal pain management activities by seeking information and making major lifestyle changes (e.g.…”