Shrikhande Allyson, Patil Soha, Subhan Merzia, Moody Erika, Natarajan Janaki, Tailor Yogita, Mamsaang Marjorie, James Neha, Leishear Kimberlee, Vyas Rakhi, Sandhu Sandra, Ahmed Tayyaba, Filart Rosemarie, Daniel Gabrielle, Kerin Orbuch Iris, Larish Yaniv, Liu Lora
Pelvic Rehabilitation Medicine Clinical Research Foundation, West Palm Beach, FL, USA.
The Feinstein Institute for Medical Research, Manhasset, NY, USA.
Int J Womens Health. 2023 Jan 23;15:91-101. doi: 10.2147/IJWH.S365637. eCollection 2023.
The purpose of this paper is to evaluate the efficacy of a multimodal, outpatient neuromuscular protocol in treating remaining sensitization and myofascial pain in endometriosis patients post-surgical excision.
A retrospective longitudinal study was conducted for women aged 22 to 78 with a history of surgically excised endometriosis. 60 women with an average duration of pain of 8.63 ± 7.65 years underwent a treatment protocol consisting of ultrasound guided trigger point injections, peripheral nerve blocks, and pelvic floor physical therapy for 6 weeks. Concomitant cognitive behavioral therapy once weekly for a total of 12 weeks was also undertaken. Pain intensity and pelvic functionality were assessed at new patient consults and 3-month follow ups using Visual Analogue Scale (VAS) and Functional Pelvic Pain Scale (FPPS).
At new patient consults, average VAS and FPPS were 7.45 ± 2.11 (CI 6.92-7.98) and 14.35 ± 6.62 (CI 12.68 -16.02), respectively. At 3-month follow ups, average VAS and FPPS decreased to 4.12 ± 2.44 (CI 3.50-4.73; p < 0.001) and 10.3 ± 6.55 (CI 8.64-11.96; p < 0.001), respectively. Among FPPS categories, sleeping, intercourse, and working showed the highest statistical significance.
Data suggests the multimodal protocol was effective in treating the remaining underlying sensitization and myofascial pain seen in Endometriosis patients post-surgical excision, particularly in decreasing pain and improving function during work and intercourse.
本文旨在评估一种多模式门诊神经肌肉治疗方案对子宫内膜异位症患者术后残留敏感化及肌筋膜疼痛的治疗效果。
对年龄在22至78岁、有手术切除子宫内膜异位症病史的女性进行了一项回顾性纵向研究。60名平均疼痛持续时间为8.63±7.65年的女性接受了为期6周的治疗方案，包括超声引导下触发点注射、周围神经阻滞和盆底物理治疗。同时还进行了为期12周、每周一次的认知行为疗法。在新患者就诊时以及3个月随访时，使用视觉模拟量表（VAS）和功能性盆腔疼痛量表（FPPS）评估疼痛强度和盆腔功能。
在新患者就诊时，平均VAS和FPPS分别为7.45±2.11（置信区间6.92 - 7.98）和14.35±6.62（置信区间12.68 - 16.02）。在3个月随访时，平均VAS和FPPS分别降至4.12±2.44（置信区间3.50 - 4.73；p < 0.001）和10.3±6.55（置信区间8.64 - 11.96；p < 0.001）。在FPPS的各项分类中，睡眠、性交和工作方面的统计学意义最为显著。
数据表明，该多模式治疗方案对治疗子宫内膜异位症患者术后残留的潜在敏感化及肌筋膜疼痛有效，尤其在减轻疼痛以及改善工作和性交期间的功能方面效果显著。
