Structural and Functional Basis of Chronic Pelvic Pain Syndrome during Combined Chronic Cystitis and Adenomyosis

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Sixty patients with chronic pelvic pain syndrome experienced urination and circulation abnormalities, with more pronounced urothelial damage in combined cystitis and adenomyosis, which improved with treatment.

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The paper examined 60 female patients with chronic pelvic pain syndrome who had combined chronic cystitis and adenomyosis, using comprehensive clinical assessment, complex urodynamic testing, and urogenital morphological examination. The authors reported that urodynamic studies showed various urinary disturbances and stasis-like circulation abnormalities in both vesical and uterine walls, while pathology of the combined proliferative and erosive/destructive cystitis included more pronounced inflammatory and destructive urothelial changes with superficial and deep erosions alongside proliferative and metaplastic alterations. They reported that combined treatment of chronic cystitis and adenomyosis eliminated destructive/inflammatory vesical mucosal alterations in 70% and 93% of patients, respectively, and more than basic therapy (60% and 77%), with pronounced pain improvement as well; the main limitation explicitly stated in the excerpt is the small, single-cohort design without clear long-term follow-up detail. This paper is centrally about endometriosis — it specifically focuses on adenomyosis combined with chronic cystitis as a structural and functional basis of chronic pelvic pain syndrome.

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Abstract

Comprehensive clinical and morphological examination of 60 female patients with chronic pelvic pain syndrome after combined chronic cystitis and adenomyosis was carried out. In all patients, the complex urodynamic examination revealed various disturbances of urination and stasis-like abnormalities of circulation in vesical and uterine walls. The pathomorphological peculiarities of the urogenital disorders during combination of adenomyosis and cystitis (of the combined proliferative and erosive/destructive type) is manifested by more pronounced destructive and inflammatory changes in urothelium characterized by the formation of superficial and deep erosions as well as by association of erosive/destructive damages to the urothelium with proliferative and metaplastic changes. Combined treatment of chronic cystitides and adenomyosis eliminated the destructive and inflammatory alterations in the vesical mucosa in 70 and 93% female patients, respectively (the corresponding values after basic therapy were 60 and 77%), and pronouncedly ameliorated pain syndrome.
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Comprehensive clinical and morphological examination of 60 female patients with chronic pelvic pain syndrome after combined chronic cystitis and adenomyosis was carried out. In all patients, the complex urodynamic examination revealed various disturbances of urination and stasis-like abnormalities of circulation in vesical and uterine walls. The pathomorphological peculiarities of the urogenital disorders during combination of adenomyosis and cystitis (of the combined proliferative and erosive/destructive type) is manifested by more pronounced destructive and inflammatory changes in urothelium characterized by the formation of superficial and deep erosions as well as by association of erosive/destructive damages to the urothelium with proliferative and metaplastic changes. Combined treatment of chronic cystitides and adenomyosis eliminated the destructive and inflammatory alterations in the vesical mucosa in 70 and 93% female patients, respectively (the corresponding values after basic therapy were 60 and 77%), and pronouncedly ameliorated pain syndrome. Similar content being viewed by others References I. A. Apolikhina, Ya. B. Mirkin, I. A. Eizenakh, et al., Eksp. Klin. Urol., No. 2, 84-90 (2012). E. L. Vishnevsky, D. Yu. Pushkar’, O. B. Loran, et al., Urofloumetriya [in Russian], Moscow (2004). V. I. Makolkin and S. I. Ovcharenko, Internal Diseases [in Russian], Moscow (1999). A. I. Neimark and N. V. Shelkovnikova, Urologiya, No. 5, 10-14 (2011). A. I. Neimark, N. V. Shelkovnikova, L. M. Nepomnyashchikh, and T. S. Taranina, Combined Pathology in Urogynecology: Diagnostics and Treatment [in Russian], Moscow (2014). N. V. Shelkovnikova and A. I. Neimark, Terra Medica, No. 3, 58 (2013). P. Abrams, W. Artibani, L. Cardozo, et al., Neurourol. Urodyn., 28, No. 4, 287 (2009). C. W. Butrick, JSLS, 11, No. 2, 182-189 (2007). M. Cervigni and F. Natale, Int. J. Urol., 21, Suppl. 1, 85-88 (2014). J. Q. Clemens, T. Markossian, and E. A. Calhoun, Urology, 73, No. 4, 743-746 (2009). A. Furuta, M. Kita, Y. Suzuki, et al., Am. J. Physiol. Regul. Integr. Comp. Physiol., 294, No. 5, R1510-R1516 (2008). B. S. Kahn, C. Tatro, C. L. Parsons, and J. J. Willems, J. Sex. Med., 7, No. 2, Pt. 2, 996-1002 (2010). K. J. Neis and F. Neis, Gynecol. Endocrinol., 25, No. 11, 757-761 (2009). J. D. Paulson and M. Delgado, JSLS, 11, No. 2, 175-181 (2007). E. J. Stanford, J. R. Dell, and C. L. Parsons, Urology, 69, No. 4, Suppl., 53-59 (2007). Author information Authors and Affiliations Corresponding author Additional information Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 158, No. 12, pp. 704-709, December, 2014 Rights and permissions About this article Cite this article Shelkovnikova, N.V., Lushnikova, E.L., Pichigina, A.K. et al. Structural and Functional Basis of Chronic Pelvic Pain Syndrome during Combined Chronic Cystitis and Adenomyosis. Bull Exp Biol Med 158, 742–747 (2015). https://doi.org/10.1007/s10517-015-2852-6 Received: Published: Issue date: DOI: https://doi.org/10.1007/s10517-015-2852-6

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chronic_pelvic_painadenomyosis

MeSH descriptors

Adenomyosis Cystitis Pelvic Pain Adenomyosis Adult Chronic Disease Cystitis Female Humans Middle Aged Pelvic Pain

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