The effectiveness of non-steroidal anti-inflammatory drugs in the treatment of chronic pelvic pain syndrome

T.G. Romanenko, О. М. Суліменко
In: HEALTH OF WOMAN · 2018 · pp. 111–115 · doi:10.15574/hw.2018.133.111 · W3170014450
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NSAID treatment in women with chronic pelvic pain syndrome, combined with antibiotic therapy, improved pain, psychological status, and quality of life compared to non-NSAID treatment.

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This study assessed the effectiveness and safety of non-steroidal anti-inflammatory drugs (NSAIDs) in 101 reproductive-age women with chronic pelvic pain syndrome (CPPS) associated with chronic inflammatory processes of pelvic organs. In a randomized design, participants received complex antibiotic therapy plus antiplatelet agents and antihypoxants, with Group II additionally receiving the NSAID diclofenac suppositories (DICLOSAFE) while Group I did not; an explicit exclusion criterion was presence of endometriosis. At baseline and 6 months after completion, questionnaires evaluated pain severity, psychological status, and quality of life, and Group II showed positive dynamics in pain characteristics and statistically significant reductions in depression and personal anxiety compared with Group I. After treatment, Group II also demonstrated statistically significant improvements across physical and mental health components, with the paper concluding that pathogenetically grounded NSAID use improved quality-of-life indicators, while excluding women with endometriosis limits generalizability. The paper does not explicitly discuss endometriosis or adenomyosis; it excluded endometriosis patients, so inclusion here is due to an upstream keyword match in the corpus.

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Abstract

Evidence-based medicine is an approach to medical practice in which the decision on the appointment of therapeutic, diagnostic or preventive measures is based on the evidence of their effectiveness and safety. The objective: assessment of the effectiveness and safety of the use of NSAIDs in the treatment of chronic pelvic pain in women of reproductive age. Materials and methods. Under our supervision, there were 101 women of reproductive age with chronic pelvic pain syndrome (CPPS) on the background of chronic inflammatory processes of the pelvic organs. Patients, depending on the received treatment, were randomly divided into two groups: Group I (n=54) – complex antibiotic (AB) therapy was conducted in combination with antiplatelet agents, antihypoxants, analgesics; Group II (n=47) – complex antibiotic (AB) therapy was performed in combination with antiplatelet agents, antihypoxants and NSAIDs (DICLOSAFE, diclofenac sodium 100 mg). The exclusion criterion was the presence of an endometriosis in a patient. When patients were included in the study and 6 months after the completion of the treatment, a questionnaire was conducted to determine the severity of the pain syndrome, psychological status and quality of life. Results. Positive dynamics of quantitative and qualitative characteristics of the pain syndrome, as well as dynamics of its intensity as a result of conservative treatment for 6 months in group ІІ, was noted. Also, in group ІІ, statistically significant data on the reduction of depression and personal anxiety are noted, in contrast to the indicators of group I. The results of the questionnaire of patients in group II after treatment indicated improvement of all components of physical health. Statistically significant differences with the indicators of Group I were obtained on the scale of the effect of pain on daily activity (BP). In addition, after treatment in the II group, the patients showed statistically significant changes in mental health and all its components: vital activity (VT), social activity (SF), limitation of daily activity due to emotional problems (RE) and mental health I (MH). Conclusion. Pathogenetically grounded use of NSAIDs (DICLOSAFE suppositories) in the complex treatment of patients with CPPS allows to achieve a significant improvement in quality of life indicators due to the correction of pain syndrome. Key words: chronic pelvic pain syndrome, treatment, nonsteroidal anti-inflammatory drugs.
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Materials

and methods. Under our supervision, there were 101 women of reproductive age with chronic pelvic pain syndrome (CPPS) on the background of chronic inflammatory processes of the pelvic organs. Patients, depending on the received treatment, were randomly divided into two groups: Group I (n=54) – complex antibiotic (AB) therapy was conducted in combination with antiplatelet agents, antihypoxants, analgesics; Group II (n=47) – complex antibiotic (AB) therapy was performed in combination with antiplatelet agents, antihypoxants and NSAIDs (DICLOSAFE, diclofenac sodium 100 mg). The exclusion criterion was the presence of an endometriosis in a patient. When patients were included in the study and 6 months after the completion of the treatment, a questionnaire was conducted to determine the severity of the pain syndrome, psychological status and quality of life. Results. Positive dynamics of quantitative and qualitative characteristics of the pain syndrome, as well as dynamics of its intensity as a result of conservative treatment for 6 months in group ІІ, was noted. Also, in group ІІ, statistically significant data on the reduction of depression and personal anxiety are noted, in contrast to the indicators of group I. The results of the questionnaire of patients in group II after treatment indicated improvement of all components of physical health. Statistically significant differences with the indicators of Group I were obtained on the scale of the effect of pain on daily activity (BP). In addition, after treatment in the II group, the patients showed statistically significant changes in mental health and all its components: vital activity (VT), social activity (SF), limitation of daily activity due to emotional problems (RE) and mental health I (MH). Conclusion. Pathogenetically grounded use of NSAIDs (DICLOSAFE suppositories) in the complex treatment of patients with CPPS allows to achieve a significant improvement in quality of life indicators due to the correction of pain syndrome. Key words: chronic pelvic pain syndrome, treatment, nonsteroidal anti-inflammatory drugs.

References

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endometriosischronic_pelvic_pain

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