Just skimmed through that article...interestingly, adhesions don't rate a mention!!
Love & hugs, Jo
At Tue, 10 Sep 2002, clare wrote:
>
>Hi:
>
>I found this on Medscape. Wishing you all pain free moments, hours and
>days.
>
>--
>Clare
>
>Interventions for treating chronic pelvic pain in women
>Updated: 04/01/2002
>
>from Cochrane Review Abstracts
>Stones RW, Mountfield J.
>
>A substantive amendment to this systematic review was last made on 27
>July 2000. Cochrane reviews are regularly checked and updated if
>necessary.
>Background: Chronic pelvic pain is common in women in the reproductive
>age group and it causes disability and distress and results in
>significant costs to health services. The pathogenesis of chronic
>pelvic pain is poorly understood. Often, investigation by laparoscopy
>reveals no obvious cause for pain. There are several possible
>explanations for chronic pelvic pain including undetected irritable
>bowel syndrome, the vascular hypothesis where pain is thought to arise
>from dilated pelvic veins in which blood flow is markedly reduced and
>altered spinal cord and brain processing of stimuli in women with
>chronic pelvic pain. As the pathophysiology of chronic pelvic pain is
>not well understood, its treatment is often unsatisfactory and limited
>to symptom relief. Currently, the main approaches to treatment include
>counselling or psychotherapy, attempting to provide reassurance using
>laparoscopy to exclude serious pathology, progestogen therapy such as
>medroxyprogesterone acetate, and surgery to interrupt nerve pathways.
>
>Objectives: We aimed to identify and review treatments for chronic
>pelvic pain in women in the reproductive years. The review included
>studies of patients with a diagnosis of pelvic congestion syndrome or
>adhesions but excluded those with pain known to be caused by i)
>endometriosis, ii) primary dysmenorrhoea (period pain), iii) pain due to
>active chronic pelvic inflammatory disease, or iv) irritable bowel
>syndrome.
>
>Search strategy: The search strategy adopted by the Cochrane Menstrual
>Disorders and Subfertility Group was used.
>
>Selection criteria: Randomised controlled trials (RCTs) with women who
>had chronic pelvic pain, excluding endometriosis, primary dysmenorrhoea,
>pain due to chronic pelvic inflammatory disease, or irritable bowel
>syndrome. The reviewers were prepared to consider studies of any
>intervention including lifestyle, physical, medical, surgical and
>psychological treatments. Outcome measures were pain rating scales,
>quality of life measures, economic analyses and adverse events.
>
>Data collection and analysis: For each included trial, information was
>collected regarding the method of randomisation, allocation concealment,
>blinding, whether an intention to treat analysis could possibly be
>performed and relevant interventions and outcomes (see previous
>sections). Data were extracted independently by the two reviewers,
>using forms designed according to the Cochrane guidelines.
>
>Main results: Nine studies were identified of which five were of good
>methodological quality. Two studies were reported in a brief abstract
>only and were excluded. Progestogen (Medroxyprogesterone acetate) was
>associated with a reduction of pain during treatment. Counseling
>supported by ultrasound scanning was associated with reduced pain and
>improvement in mood. A multidisciplinary approach was beneficial for
>some outcome measures. Adhesiolysis was not associated with an improved
>outcome apart from where adhesions were severe. Sertraline was not
>beneficial.
>
>Reviewers' conclusions: Further studies to confirm these observations
>are needed, together with full reporting of those studies which have
>been undertaken. Given the prevalence and health care costs associated
>with chronic pelvic pain in women, randomised controlled trials of other
>medical, surgical and psychological interventions are urgently required.
>
>Citation: Stones RW, Mountfield J. Interventions for treating chronic
>pelvic pain in women (Cochrane Review). In: The Cochrane Library, Issue
>2 2002. Oxford: Update Software.
>
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-- Love and gentle hugs, Joanne Eslick Founder Australian Adhesions Support Group http://www.bombobeach.com NSW Australian Co-ordinator of International Adhesions Society http://www.adhesions.org
-- I am not a medical person, and all my messages are based on personal experience. I am a fellow adhesions sufferer reaching out to help others.