The development and efficacy of an interdisciplinary chronic pelvic pain program

Katz L, Laura Katz, Adria Fransson, Fransson A, Lisa Patterson, Patterson L
Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2020 · vol. 15(6) , pp. E323–E328 · doi:10.5489/cuaj.6842 · PMID:33212006 · PMC8195579 · W3100663728
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This paper describes the development of an interdisciplinary chronic pelvic pain program and reports significant patient improvements in quality of life, readiness for change, and self-efficacy post-treatment.

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The paper describes the development and short-term efficacy of an interdisciplinary chronic pelvic pain (CPP) program for women, addressing pelvic floor physiotherapy, psychoeducation, goal-setting, cognitive behavioral therapy, and mindfulness. Thirty-seven female patients referred from community urologists and obstetricians/gynecologists completed pre- and post-program psychometric questionnaires and an eight-day program when deemed appropriate after interdisciplinary assessment. Significant improvements were found in impact on quality of life, readiness for change, and pain-related self-efficacy, alongside reductions in pain catastrophizing and fear of pain/re-injury, assessed with paired sample t-tests. The paper’s main limitation is that outcomes were measured only short-term pre/post with no control group described. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

INTRODUCTION: Chronic pelvic pain (CPP) is a significant issue, and approximately 14% of women experience CPP once in their life-time. While interdisciplinary pain management is considered the gold standard of treatment, few programs offer this type of treatment in Canada. The aims of this paper were to: 1) describe the development of an interdisciplinary CPP program; and 2) demonstrate changes in patient-related outcomes after attending an interdisciplinary CPP program. METHODS: Referrals were received from community urologists and obstetricians/gynecologists, and pain physicians at the Michael G. DeGroote Pain Clinic. Patients attended an orientation session, completed an interdisciplinary assessment, and if appropriate, attended an eight-day interdisciplinary CPP program. Each day consisted of group-based pelvic floor physiotherapy, psychoeducation, goal-setting, cognitive behavioral therapy, and mindfulness. Psychometric questionnaires were completed pre- and post-program by patients, and paired sample t-tests were used to evaluate the changes in patient-related outcomes after attending the program. RESULTS: Thirty-seven female patients completed the program, and results demonstrate that the CPP program was associated with significant improvements in impact of pelvic pain on quality of life, readiness for change, and pain-related self-efficacy, as well as decreases in pain catastrophizing and fear of pain/re-injury. CONCLUSIONS: CPP is a complex condition that requires interdisciplinary management and care. The results of this study demonstrate the short-term benefits of an interdisciplinary CPP program, highlight the unique needs of women with CPP, and implicate multiple factors for programming and treatment.
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Introduction

Chronic pelvic pain (CPP) is a significant issue, and approximately 14% of women experience CPP once in their lifetime. While interdisciplinary pain management is considered the gold standard of treatment, few programs offer this type of treatment in Canada. The aims of this paper were to: 1) describe the development of an interdisciplinary CPP program; and 2) demonstrate changes in patient-related outcomes after attending an interdisciplinary CPP program.

Methods

Referrals were received from community urologists and obstetricians/gynecologists, and pain physicians at the Michael G. DeGroote Pain Clinic. Patients attended an orientation session, completed an interdisciplinary assessment, and if appropriate, attended an eight-day interdisciplinary CPP program. Each day consisted of group-based pelvic floor physiotherapy, psychoeducation, goal-setting, cognitive behavioral therapy, and mindfulness. Psychometric questionnaires were completed pre- and post-program by patients, and paired sample t-tests were used to evaluate the changes in patient-related outcomes after attending the program.

Results

Thirty-seven female patients completed the program, and results demonstrate that the CPP program was associated with significant improvements in impact of pelvic pain on quality of life, readiness for change, and pain-related self-efficacy, as well as decreases in pain catastrophizing and fear of pain/re-injury.

Conclusions

CPP is a complex condition that requires interdisciplinary management and care. The results of this study demonstrate the short-term benefits of an interdisciplinary CPP program, highlight the unique needs of women with CPP, and implicate multiple factors for programming and treatment. Downloads Downloads Published How to Cite Issue Section License You, the Author(s), assign your copyright in and to the Article to the Canadian Urological Association. This means that you may not, without the prior written permission of the CUA: - Post the Article on any Web site - Translate or authorize a translation of the Article - Copy or otherwise reproduce the Article, in any format, beyond what is permitted under Canadian copyright law, or authorize others to do so - Copy or otherwise reproduce portions of the Article, including tables and figures, beyond what is permitted under Canadian copyright law, or authorize others to do so. The CUA encourages use for non-commercial educational purposes and will not unreasonably deny any such permission request. You retain your moral rights in and to the Article. This means that the CUA may not assert its copyright in such a way that would negatively reflect on your reputation or your right to be associated with the Article. The CUA also requires you to warrant the following: - That you are the Author(s) and sole owner(s), that the Article is original and unpublished and that you have not previously assigned copyright or granted a licence to any other third party; - That all individuals who have made a substantive contribution to the article are acknowledged; - That the Article does not infringe any proprietary right of any third party and that you have received the permissions necessary to include the work of others in the Article; and - That the Article does not libel or violate the privacy rights of any third party.

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