Department of Clinical Psychology, Louisiana State University, Baton Rouge, LA, USA.
Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
J Psychosom Obstet Gynaecol. 2021 Dec;42(4):261-271. doi: 10.1080/0167482X.2020.1735341. Epub 2020 Mar 6.
Chronic pelvic pain (CPP) in women is often associated with marked emotional distress and disability, with particular impairments in sexual functioning. Research supports the efficacy of interdisciplinary chronic pain rehabilitation programs (ICPRPs) in treating chronic pain, however less is known about their utility in CPP.
This retrospective study examined pain-related sexual impairment, emotional symptoms, and pain severity in CPP patients before and after completing a 3-4 week ICPRP. Predictors of post-treatment sexual impairment were also investigated. Participants included 58 female CPP patients and 58 age-matched females with non-pelvic chronic pain (NPCP).
All participants reported robust improvements across outcome measures. Women with CPP reported greater pre- and post-treatment impairment in sexual function than NPCP patients, despite significant treatment-related improvements. In contrast, CPP patients also reported higher levels of depression at baseline but showed greater treatment related-improvements. In participants with CPP, treatment-related improvements in depression, alexithymia, and pain severity significantly explained decreases in pain-related sexual impairment following treatment, whereas none of these variables explained sexual impairment outcomes in women with NPCP.
Results demonstrate that ICPRPs can effectively treat CPP, particularly through changes in depression and alexithymia. Future research should examine whether specific interventions can be added in ICPRPS to address CPP-related sexual impairment.
女性慢性盆腔疼痛（CPP）常伴有明显的情绪困扰和残疾，尤其在性功能方面受损严重。研究支持多学科慢性疼痛康复计划（ICPRP）治疗慢性疼痛的疗效，但对于其在 CPP 中的应用知之甚少。
本回顾性研究在完成 3-4 周 ICPRP 前后，检查了 CPP 患者的疼痛相关性功能障碍、情绪症状和疼痛严重程度。还研究了治疗后性功能障碍的预测因素。参与者包括 58 名女性 CPP 患者和 58 名年龄匹配的非盆腔慢性疼痛（NPCP）女性。
所有参与者在所有结果测量上均报告有明显改善。CPP 患者报告的性功能障碍在治疗前和治疗后均比 NPCP 患者更严重，尽管治疗相关的改善显著。相比之下，CPP 患者在基线时也报告了更高水平的抑郁，但显示出更大的治疗相关改善。在 CPP 患者中，治疗相关的抑郁、述情障碍和疼痛严重程度的改善显著解释了治疗后疼痛相关性功能障碍的减少，而 NPCP 患者的这些变量均不能解释性功能障碍的结果。
结果表明，ICPRP 可以有效地治疗 CPP，尤其是通过改变抑郁和述情障碍。未来的研究应探讨是否可以在 ICPRPS 中添加特定的干预措施来解决 CPP 相关的性功能障碍。
