Cheong Ying, Saran Mili, Hounslow James William, Reading Isabel Claire
Complete Fertility Centre Southampton, University Hospitals Southampton NSH Trust, Princess Anne Hospital , Mailpoint 105, Coxford Road, Southampton, SO16 5YA, UK.
University of Southampton Faculty of Medicine, Human Development and Health, Princess Anne Hospital, Mailpoint 815, Coxford Road, Southampton, SO16 5YA, UK.
BMC Womens Health. 2018 Jan 8;18(1):11. doi: 10.1186/s12905-017-0509-5.
Chronic pelvic pain is a debilitating condition. It is unknown if there is a clinical phenotype for adhesive disorders. This study aimed to determine if the presence or absence, nature, severity and extent of adhesions correlated with demographic and patient reported clinical characteristics of women presenting with CPP.
Women undergoing a laparoscopy for the investigation of chronic pelvic pain were recruited prospectively; their pain and phenotypic characteristics were entered into a hierarchical cluster analysis. The groups with differing baseline clinical and operative characteristics in terms of adhesions involvement were analyzed.
Sixty two women were recruited where 37 had adhesions. A low correlation was found between women's reported current pain scores and that of most severe (r = 0.34) or average pain experienced (r = 0.44) in the last 6 months. Three main groups of women with CPP were identified: Cluster 1 (n = 35) had moderate severity of pain, with poor average and present pain intensity; Cluster 2 (n = 14) had a long duration of symptoms/diagnosis, the worst current pain and worst physical, emotional and social functions; Cluster 3 (n = 11) had the shortest duration of pain and showed the best evidence of coping with low (good) physical, social and emotional scores. This cluster also had the highest proportion of women with adhesions (82%) compared to 51% in Cluster 1 and 71% in Cluster 2.
In this study, we found that there is little or no correlation between patient-reported pain, physical, emotional and functional characteristics scores with the presence or absence of intra-abdominal/pelvic adhesions found during investigative laparoscopy. Most women who had adhesions had the lowest reported current pain scores.
慢性盆腔疼痛是一种使人衰弱的病症。目前尚不清楚粘连性疾病是否存在临床表型。本研究旨在确定粘连的有无、性质、严重程度和范围是否与慢性盆腔疼痛女性的人口统计学特征及患者报告的临床特征相关。
前瞻性招募因慢性盆腔疼痛接受腹腔镜检查的女性；将她们的疼痛和表型特征纳入分层聚类分析。对粘连累及情况方面基线临床和手术特征不同的组进行分析。
招募了62名女性，其中37名有粘连。女性报告的当前疼痛评分与过去6个月最严重疼痛评分（r = 0.34）或平均疼痛评分（r = 0.44）之间的相关性较低。确定了三组主要的慢性盆腔疼痛女性：第1组（n = 35）疼痛严重程度中等，平均疼痛强度和当前疼痛强度较差；第2组（n = 14）症状/诊断持续时间长，当前疼痛最严重，身体、情感和社会功能最差；第3组（n = 11）疼痛持续时间最短，在身体、社会和情感评分低（良好）方面应对能力最佳的证据最充分。与第1组的51%和第2组的71%相比，该组粘连女性的比例也最高（82%）。
在本研究中，我们发现患者报告的疼痛、身体、情感和功能特征评分与在诊断性腹腔镜检查中发现的腹腔内/盆腔粘连的有无之间几乎没有或没有相关性。大多数有粘连的女性报告的当前疼痛评分最低。
