POLYMORPHISM OF CHRONIC PELVIC PAIN IN PATIENTS WITH ENDOMETRIOSIS

The purpose of the study is to establish casual relationships of chronic pelvic pain in women with genital endometriosis. There were examined 120 women with genital endometriosis and chronic pelvic pain: main group 1 (n=44) and 2 (n=41) and comparison group 3 (n=35), without pelvic pain, average age of patients was 35.28±0.59 years. Assessment of pelvic pain was carried out using the 10-point visual analog scale (VAS), the McGill pain questionnaire. The level of personal anxiety was determined according to J. Taylor's method. Hamilton's scale (HAM-D) was used to assess symptoms of depression. The levels of interleukins (IL)-10, IL-6, and tumor necrosis factor-α (TNF-α) were determined using a solid-phase enzyme-linked immunosorbent assay. Diseases of the gastrointestinal tract in group 1 - 75.0% versus 37.14% in group 3, and diseases of the genitourinary system had a statistically significant (p<0.05) advantage in the progression of pelvic pain in. According to the McGill questionnaire, the highest level of pain intensity was determined in the group 1 - 2.45±0.17 (0.76), the lowest in the group 3 - 1.65±0.17 (0.75), which is statistically reliable between groups (p=0.001). Correlation analysis in women of the main clinical groups determined that the level of depressive disorder (r=0.35; p=0.001) and the level of personal anxiety (r=0.28; p=0.003) were directly related to the duration of chronic pelvic pain by a direct relationship of medium strength. A direct moderate correlation was established between the intensity of pelvic pain according to VAS and the duration of pain (r=0.3;1 p<0.001). A decrease in the anti-inflammatory IL-10 and an increase in the pro-inflammatory IL-6, TNF-α was determined during the progression of pain compared to patients without pelvic pain (p < 0.05), TNF-α was correlated with the duration of the pain history, which was accompanied by frequent relapses of the disease and increased levels of anxiety and depression. Risk factors for pelvic pain were identified in patients with endometriosis, an objective assessment of pain, psycho-emotional status, and cytokine imbalance was given. An effective relationship between the chronicity of pelvic pain, cytokine profile, disorders of psycho-emotional status, and accompanying extragenital pathology was established.