The role of vasoactive medicine in treatment and rehabilitation of women with chronic pelvic pain syndrome

Salman H Al-Shukri, Igor V. Kuzmin, Н. О. Шабудина, Margarita N. Slesarevskaya, Yuriy A Ignashov
In: Regional blood circulation and microcirculation · 2017 · vol. 16(2) , pp. 25–31 · doi:10.24884/1682-6655-2017-16-2-25-31 · W2906583058
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This review article examines the therapeutic potential of vasoactive agents in managing women diagnosed with chronic pelvic pain syndrome. The authors analyze existing literature to evaluate how improving microcirculation and blood flow contributes to symptom relief and rehabilitation in this patient population. The paper highlights that vascular dysfunction plays a significant role in the pathophysiology of chronic pelvic pain, suggesting that targeting hemodynamic abnormalities is a viable clinical strategy. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

Purpose of the study: to analyze thee influence of vasoactive drugs in combination treatment in women with chronic pelvic pain syndrome (CPPS). Methods. 177 women with CPPS were examined. The average age was from 18 to 84 years (32.6±9.3). The duration of the disease ranged from 6 months to 6 years (an average of 2.7±0.9 years). To study the microcirculation of the bladder, the original technique of intravesical high-frequency ultrasonic dopplerography was used. An assessment of the intensity of the pain syndrome and urination disorders was carried out using the PUF questionnaire, and an evaluation of the psychoemotional status using the depression scale of A.T. Back. Results. After the examination, all patients with CPPS (n=177) were divided into 2 groups. In the 1st group (n=88) patients got standard therapy in the form of instillations of the bladder and suppositories with nonsteroidal anti-inflammatory drug. In the 2nd group (n=89), the patients received therapy in combination with a vasoactive drug (pentoxifylline in a dose 200 mg per day), 10 days. Analysis of the results of intravesical dopplerography of the bladder revealed differences in the state of microcirculation in women with CPPS, depending on the treatment regimen. The parameters of the microcirculatory bed have significantly improved at the arterial and capillary levels in patients with CPPS who got combined therapy with vasoactive drugs. The conducted therapy led to a significant decrease in the severity of the symptoms, which was confirmed with the questionnaire «Scale of Pelvic Pain Symptoms, Mandatory, Frequent Urination» and evaluation of the psychoemotional state according to the depression scale of A.T. Back. Conclusion. Insufficient effectiveness of standard CPPS therapy is caused in particular by altered blood flow in the bladder in this category of patients. Therefore, it is advisable to include vasoactive drugs in combination therapy of CPPS in women.
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Роль вазоактивных препаратов в лечении и реабилитации женщин с синдромом хронической тазовой боли https://doi.org/10.24884/1682-6655-2017-16-2-25-31 Аннотация Об авторах С. Х. Аль-ШукриРоссия И. В. Кузьмин Россия Н. О. Шабудина Россия М. Н. Слесаревская Россия Ю. А. Игнашов Россия Список литературы 1. Аблуллаева У. А. Современные аспекты комплексного лечения хронических тазовых болей в гинекологической практике: автореф. дис. канд. мед. наук. М., 2004. 24 с. 2. Аль-Шукри С. Х., Кузьмин И. В., Слесаревская М. Н. и др. Внутрипузырная ультразвуковая допплерография в оценке состояния кровотока в стенке мочевого пузыря у женщин с ирритативными симптомами // Регионарное кровообращение и микроциркуляция. 2014. № 1. С. 48-54. 3. Аль-Шукри С. Х., Кузьмин И. В., Слесаревская М. Н. и др. Особенности нарушений микроциркуляции в стенке мочевого пузыря у женщин с лейкоплакией мочевого пузыря // Уролог. ведомости. 2016. Т. 6. № 3. С. 11-18. 4. Белова А. Н. Хроническая тазовая боль. М.: Антидор, 2007. 572 с. 5. Козлов В. А., Артюшенко Н. К., Шалак О. В. и др. Ультразвуковая допплерография в оценке состояния гемодинамики в тканях шеи, лица и полости рта в норме и при некоторых патологических состояниях. СПб.: СП Минимакс, 2000. C. 5-31. 6. Кузьмин И. В. Оценка качества жизни у больных с гиперактивностью мочевого пузыря // Нефрология. 2006. Т. 10. № 4. С. 93-97. 7. Лоран О. Б., Зайцев А. В., Годунов Б. Н. Особенности диагностики и лечения хронического цистита у женщин // Акушерство и гинекол. 2000. № 3. С. 40-43. 8. Савицкий Г. А., Иванова Р. Д., Щеглов И. Ю. и др. Хирургическое лечение синдрома тазовых болей в гинекологической клинике. СПб., 2000. 137 с. 9. Слесаревская М. Н., Кузьмин И. В., Игнашов Ю. А. Особенности симптоматики и психоэмоционального статуса у женщин с синдромом хронической тазовой боли // Уролог. ведомости. 2015. Т. 5. № 3. С. 16-19. 10. Слесаревская М. Н., Соколов А. В., Жарких А. В. Преимущества лазерной коагуляции лейкоплакии мочевого пузыря // Уролог. ведомости. 2012. Т. 2. № 1. С. 19-25. 11. Слесаревская М. Н., Соколов А. В., Жарких А. В. и др. Применение внутрипузырной лазерной терапии в комплексном лечении хронического цистита // Уролог. ведомости. 2013. Т. 3. № 2. С. 12-15. 12. Abrams P., Cardozo L., Fall M. et al. The standardisation of terminology of lower urinary tractfunction: report from the Standardisation Subcommitte of the International Continence Society // Urology. 2003. Vol. 61. № 1. P. 37-49. 13. Beck A. T., Ward C. H., Mendelson M. et al. An inventory for measuring depression // Arch. Gen. Psychiatry. 1961. Vol. 4. P. 561-571. 14. Berry S. H., Elliott M. N., Suttorp M. et al. Prevalence of symptoms of bladder pain syndrome/interstitial cystitis among adult females in the United States // J. Urol. 2011. Vol. 186. № 2. P. 540-544. 15. Foley K. M., Posner J. B. Pain and its management // Cecil Textbook of Medicine. 18th ed. Philadelphia: WB Saunders, 1988. P. 104-112. 16. Graziottin A., Gambini D., Bertolasi L. Genital and sexual pain inwomen // Guidelines on Chronic Pelvic Pain / D. Engeler, A. P. Baranowski, J. Borovicka [et al.]. Eur. Association of Urology, 2015. 83 p. 17. Malykhinf A. P. Neural mechanisms of pelvic organ crosssensitization // Neuroscience. 2007. Vol. 149. № 3. P. 660-672. 18. Michael Y. L., Kawachi I., Stampfer M. J. et al. Quality of life among women with interstitial cystitis // J. Urology. 2000. Vol. 164. № 2. P. 423-427. 19. Parsons C. L., Dell J., Stanford E. J. et al. Increased prevalence of interstitial cystitis: previously unrecognized urologic and gynecologic cases identified using a new symptom questionnaire and intravesical potassium sensitivity // Urology. 2002. Vol. 60. № 4. P 573-578. 20. Rothrock N. E., Lutgendorf S. K., Hoffman A., Kreder K. J. Depressive symptoms and quality of life in patients with interstitial cystitis // J. Urology. 2002. Vol. 167. № 4. P. 1763-1767. Рецензия Для цитирования: Аль-Шукри С.Х., Кузьмин И.В., Шабудина Н.О., Слесаревская М.Н., Игнашов Ю.А. Роль вазоактивных препаратов в лечении и реабилитации женщин с синдромом хронической тазовой боли. Регионарное кровообращение и микроциркуляция. 2017;16(2):25-31. https://doi.org/10.24884/1682-6655-2017-16-2-25-31 For citation: Al-Shukri S.H., Kuzmin I.V., Shabudina N.O., Slesarevskaya M.N., Ignashov Yu.A. The role of vasoactive medicine in treatment and rehabilitation of women with chronic pelvic pain syndrome. Regional blood circulation and microcirculation. 2017;16(2):25-31. (In Russ.) https://doi.org/10.24884/1682-6655-2017-16-2-25-31 JATS XML

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