Volume 03 Issue 02-2023
50
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
50-53
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Summary Chronic pain (CPP) is pain in the pelvic region that lasts for 6 months or more. Among localized pains, it is
pelvic pain that reveals the maximum gender differences, which makes it possible to consider it as an exclusively
female problem.
KEYWORDS
Pelvic pain, div functions, female problem, quality of life, social status.
INTRODUCTION
One of the most important modern problems is chronic
pelvic pain syndrome (CPB), which is a multifactorial
pathological condition, and its symptoms can be
observed in different degrees of expression and in
different
combinations,
creating
significant
differences in diagnosis. Chronic pelvic pain is a long-
lasting disease (more than 6 months), difficult to treat,
disorganizing central mechanism regulation, and
changing the mental and behavioral functions of the
organism [1]. Chronic pelvic pain is a difficult
invalidation clinical condition, which is observed in 26%
of the entire female population and can be caused by
degeneration, injury or dysfunction of the nervous
system. Nowadays, from 4 up to 25% of women,
regardless their age, ethnic and social status suffer
from CPB . About 2% of patients are unable to find the
objective cause of the development of the syndrome.
Chronic pain causes the deterioration of life quality in
Research Article
CHRONIC PELVIC PAIN SYNDROME IN WOMEN IN GYNECOLOGICAL
PRACTICE
Submission Date:
February 18, 2023,
Accepted Date:
February 23, 2023,
Published Date:
February 28, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue02-10
Karimova G.S.
Samarkand State Medical University, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 02-2023
51
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
50-53
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
several spheres, causing functional disorders,
psychosocial disturbances, and sexual dysfunction [2].
More than 60% of women visit Obstetrician-
gynecologist with CPB. WHO says that chronic pelvic
pain is observed in approximately 15% of women of
reproductive age in the world, and is the cause of every
tenth attendance to the gynecologist. The syndrome
often diagnoses women of reproductive and
premenopausal age and emotional women, prone to
anxiety and hypochondria [3]. The cause for the
development of disease is inflammatory processes in
small pelvis. As the result, stable functional disorders
develop in the peripheral nerve endings of the
sympathetic nervous system, and in the central
nervous system, a cross-sectional number of
pathological impulses are sent. Disorders also take
place in a spinal core , increases the sensitivity of
structures. Even small impulses appear like pain [4].
Chronic pelvic pain is considerably often observed in
gynecological pathologies (73.1%) or extragenital
diseases (21.9%), rather than self-standing nozologic
cases (1.5%), psychologic disorders (1.1%). Etiological
and pathogenetic multifactoriality, resistance to
treatment makes chronic pelvic pain a major current
interdisciplinary problem. Provocators of chronic
pelvic syndrome can be diseases of the genital organs
of an inflammatory nature (especially when combined
with varicose veins of the pelvic vein in 37-40% of cases
and endometriosis and 20-25% of cases), pathology of
the urinary system, intrauterine synechiae , primary
dysmenorrhea, abnormal development and abnormal
position of the female genital organs, genital prolapse,
ovulatory
pain,
neoplasia
and
small
pelvis,
endometriosis , varicose disease of the small pelvis,
trauma to the genital organs and relatives operations,
pain of intestinal origin (pelvic bottom prolapse
syndrome, anorectal spasm), pain in the spinal column,
physical exertion, frequent sexual contact [5].
Pelvic pains are pains in lower parts of stomach, in
suprapubic and suprailiac regions of pelvis, sacrum or
small of the back, in groin, crotch. Discomfort and pain
increase because of dynamic impacts, cold, increase of
pain in inner organs usilivayutsya. It is necessary to use
only the organs of the reproductive system. Peripheral
nervous system, blood vessels, muscles and fascia,
anterior abdominal wall and pelvic floor are also
located in this area, and, therefore, includes a huge
amount of pain on the side of the entire pelvic system.
Purpose of the study: Analysis of the causes of chronic
pelvic pain syndrome in women and diagnostic
methods for this pathology.
MATERIAL AND RESEARCH METHODS
Retrospective analysis of historical diseases of 190
patients aged 25 to 50 years in 2018-2021. In
hospitalized women, along with gynecological
diseases, symptoms of chronic pelvic pain of varying
intensity were also observed. Of the surveyed 181 (95%)
women were giving birth, 9 (5%) nulliparous, but who
had pregnancies. In the obstetric and gynecological
anamnesis of women, the following were revealed: in
49 (25.7%) women, a burdened obstetric and
gynecological anamnesis was observed, i.e. childbirth
with complications (trauma of the birth canal,
weakness of labor, prolonged labor with stimulation,
labor with a large fetus, postpartum septic
complications) in 26 (13.6%), caesarean section in 39
(20.5%) - from 1 to 4 operations, miscarriages in 29
(15.2%), abortions in 31 (16.3%), acute and chronic
inflammation of the uterus and appendages with
exacerbations in 83 (43.6%), gynecological laparotomy
operations in 21 (11%) , adhesions of the pelvic organs in
7 (3.7%) of varying degrees, in 3 (1.5%), anomalies in the
location of the genital organs in 8 (4.2%), anomalies in
the development of the genital organs in 1 (0.5% ). For
the purpose of diagnosis, all women were used both
Volume 03 Issue 02-2023
52
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
50-53
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
general clinical and special methods of examination in
gynecology.
The causes that caused chronic pelvic pain were
clarified on the basis of general and special clinical and
instrumental methods of research, sometimes during
operations, as well as related specialists took part in
the diagnosis: urologist, surgeon, proctologist,
neurologist,
gastroenterologist,
orthopedist,
psychologist and other specialists.
RESULTS AND DISCUSSIONS
During the examination of this category of patients,
the average age of women was 37.5 years. Of these, 131
(69%) are residents of rural areas and 59 (31%) are
residents of the city. In women, among the reasons for
going to the hospital were complaints of long-term
pain in the pelvis, vagina, vulva, perineum, coccyx, in
the groin, above the womb, violations of sexual life,
vaginismus. According to the results of the
observation,
acute
and
chronic
inflammatory
processes and appendages (patients who represent
the patient group of the patient who developed the
inflammatory process and endometriosis ) are 119
(62.6%), endometriosis is 20 (10.5%), uterine fibroids 18
(9.4%), anomalies in the location of the uterus
(acquired) in 9 (4.7%), anomalies in the development of
internal genital organs (saddle uterus) in 1 (0.5%),
benign ovarian tumors in 10 (5.2%), adhesions in the
small pelvis in 9 (4.7%), intrauterine device in 12 (6.2%),
malignant neoplasms of the cervix in 1 (0.5%). In
addition, female genital diseases were associated with
pathological conditions related to adjacent organs:
ureteral tract diseases: chronic pyelonephritis,
hydronephrosis, nephroptosis were seen in 12 patients,
chronic cystitis in 10 women, a temporary disease in 3,
varicose veins in 21 internal organs, hemorrhoids in 13
women, 9 women suffered from intestinal problems, 5
women suffered from osteochondrosis and hernia of
the spinal column, 32 had psycho-emotional disorders.
It should be emphasized that in the course of the study,
several patients were found to have several diseases at
once in 57 (30%), i.e. combined causes that led to pelvic
pain. There is no universal algorithm for examining
patients with CPPS. Diagnosis was planned individually,
taking into account complaints, anamnesis of the
woman, objective data, special and additional
diagnostic methods. For the diagnosis of CPPS, the
following methods of investigation are carried out:
external and internal gynecological examination, the
laboratory stage of the examination is carried out for
the direct state of the organism and the functioning of
the entire system, ultrasound examination of the
organs of the div is performed in 190 women (100%),
hysterosalpingography 7 (8.9%) , analysis urinary tract
infections
54
(28.4%),
urography
9
(4.7%),
hysterosalpingography 10 (5.2%), hysteroscopy 5
(2.6%), cystoscopy 7 (3.6%), colonoscopy 11 (5 .7%),
diagnostic laparoscopy 5 (2.6%), MRT 4 (2.6%), MSKT 1
(0.5%). Allied specialists examined 84 patients for
pelvic pain, as a result, chronic pelvic pain syndrome
was established based on the sum of the signs. The
patient received complex simultaneous treatment,
which included standard therapy of the primary
disease, further correction of the hormonal
background, means, increasing microcirculation,
immunocorrectors and physiotherapeutic procedures,
physical therapy, introduction of anesthetic drugs,
psychotherapy.
CONCLUSIONS
In this way, the syndrome of chronic pelvic pain (SCPP)
is an actual multidisciplinary modern problem, the
solution of which requires the participation of many
specialists. Our studies showed that the causes of
chronic pelvic pain were most often simultaneous
causes, i.e. inflammatory processes of the pelvic
Volume 03 Issue 02-2023
53
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
02
P
AGES
:
50-53
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
organs, endometriosis of the uterus, uterine fibroids,
anomalies in the location of the uterus, adhesions of
the pelvic organs, prolapse of the walls of the vagina
and uterus, and others, were combined with such
pathologies as varicose veins of the pelvic organs,
chronic cystitis and urolithiasis, hemorrhoids, proctitis,
enterocolitis, osteochondrosis of the lumbar region
and sacrum, hernia of the spinal column.
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