Quality of life associated to chronic pelvic pain is independent of endometriosis diagnosis-a cross-sectional survey

Abstract

BackgroundPain is strongly related to poor quality of life. We performed a cross-sectional study in a universitary hospital to investigate quality of life in women suffering from chronic pelvic pain (CPP) due to endometriosis and others conditions.MethodsFifty-seven patients aged between 25 and 48 years-old submitted to laparoscopy because of CPP were evaluated for quality of life and depressive symptoms. Quality of life was accessed by a quality of life instrument [World Health Organization Quality of Life Assessment-Bref (WHOQOL-bref)]. Causes of pelvic pain were determined and severity of CPP was measured with a visual analogue scale. According to the intensity of pelvic pain score, patients were classified in two groups (group Low CPP < 25th percentile visual analogue scale and group High CPP > 25th percentile). Four dimensions on quality of life were measured (physical, psychological, social and environmental). We stratified the analysis of quality of life according CPP causes (presence or not of endometriosis in laparoscopy).ResultsPatients with higher pain scores presented lower quality of life status in psychological and environmental dimensions. We found a negative correlation between pain scores and psychological dimension of quality of life (r = -0.310, P = .02). Quality of life scores were similar between groups with and without endometriosis (physical 54.2 ± 12.8 and 51.1 ± 13.8, P = 0.504; psychological 56.2 ± 14.4 and 62.8 ± 12.4, P = 0.182; social 55.6 ± 18.2 and 62.1 ± 19.1, P = 0.325; environmental 59.2 ± 11.7 61.2 ± 10.8, P = 0.608; respectively)ConclusionsHigher pain scores are correlated to lower quality of life; however the fact of having endometriosis in addition to CPP does not have an additional impact upon the quality of life.

Associations between chronic pelvic pain and psychiatric disorders and symptoms

“…Another investigation found equivalent rates of depression and anxiety in subjects with CPP and migraine 21 , and two others found no differences when comparing CPP groups with different etiologies 27,37 .…”

“…From these, five studies [24][25][26][27][28] used an observational descriptive design and the remaining 13 8,20,21,[29][30][31][32][33][34][35][36][37][38] used a case-control design. Most of the studies were conducted in the United States (n = 6) and Brazil (n = 5).…”

“…The most frequent inclusion criteria for the clinical groups were duration of pain symptoms 8,20,21,[24][25][26][27]29,[31][32][33][34][35][36] , which ranged from three to six months, and specificities related to the etiology of pain 21,27,[31][32][33][34]36,37 , for example, pain resulting from pelvic adhesions. It is noteworthy that not all studies strictly followed the international criteria for the diagnosis of CPP, which require a minimum duration of six months for pain symptoms [9][10][11][12][13] .…”

“…: uterine fibroids and cysts) and pregnancy. It should be noted that nine studies 24,[26][27][28]29,31,33,34,36 described no exclusion criteria.…”

Vulvodynia—Younger Age and Combined Therapies Associate With Significant Reduction in Self-Reported Pain

“…In a previous study [13] vulvodynia patients reported lower quality of life than kidney transplant recipients or people with prior osteoporosis-related fracture. In another study, chronic pelvic pain was associated with worse quality of life, independent of the causal factor [23]. Considering these results, we suggest that reducing vulvodynia related pain is the best approach to improve patients' quality of life.…”