Abstract | OBJECTIVES: METHODS: A study was performed of 111 patients with chronic pelvic pain whose pain persisted after hysterectomy. Patients were screened with the Pelvic Pain and Urgency/Frequency symptom scale, and underwent Potassium Sensitivity Testing. Patients were treated with dietary changes alone or in combination with cystoscopic hydrodistention or oral pentosan polysulfate, or both of these, for 3 to 6 months. RESULTS: Of the 111 patients enrolled, 79% (n=88) were diagnosed with bladder dysfunction consistent with interstitial cystitis. For patients treated with dietary modification alone (n=33), the mean score on the Pelvic Pain and Urgency/Frequency questionnaire improved 15.4%, from 13.18 at baseline to 11.15 at follow-up. For patients treated with pentosan polysulfate or cystoscopic hydrodistention, or both, plus diet changes (n=78), Pelvic Pain and Urgency/Frequency scores improved 34.2%, from 15.01 to 9.87. CONCLUSION: In this study, nonsurgical treatment for interstitial cystitis resulted in a marked improvement in symptoms that had not improved with surgery. Without determining the origin of bladder pain, gynecologists should not proceed to hysterectomy in patients with chronic pelvic pain.
|
Authors | Maurice K Chung |
Journal | JSLS : Journal of the Society of Laparoendoscopic Surgeons
(JSLS)
2004 Oct-Dec
Vol. 8
Issue 4
Pg. 329-33
ISSN: 1086-8089 [Print] United States |
PMID | 15554275
(Publication Type: Journal Article)
|
Topics |
- Chronic Disease
- Cystitis, Interstitial
(complications, diagnosis, epidemiology, therapy)
- Diagnostic Errors
- Female
- Humans
- Hysterectomy
- Pelvic Pain
(etiology, surgery)
- Postoperative Complications
- Prevalence
- Unnecessary Procedures
|