Effectiveness of complex therapy uncomplicated chronic pelvic pain syndrome

In: Russian Journal of Physiotherapy, Balneology and Rehabilitation · 2024 · vol. 22(4) , pp. 281–290 · doi:10.17816/rjpbr627503 · W4396895678
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This study found that a combined therapy of extracorporeal magnetic stimulation of pelvic organs and herbal rectal preparations effectively treated chronic pelvic pain syndrome, yielding long-term clinical effects correlated with ultrasound parameters.

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Abstract

BACKGROUND: Therapeutic measures for chronic pelvic pain are of a pronounced interdisciplinary nature and consist of a complex of various means of influence: pharmacotherapy, physiotherapy and psychotherapy, physical therapy, surgical treatment. The solution to problems is usually achieved by prescribing venotonic drugs of systemic action, which increase venous tone, normalize capillary permeability and resistance, improve the rheological properties of blood, and for the same purpose use antihomotoxic drugs of plant origin. In addition, physiotherapy methods have become widespread in the treatment of patients with pelvic pain syndrome. Currently, pulsed magnetic therapy technologies have been developed in detail, but we hypothesized that the combined use of extracorporeal magnetic stimulation of the pelvic organs and the use of local regeneration cream can ensure mutual enhancement of the effectiveness of therapeutic effects. AIM: To study the clinical effectiveness and characteristics of vascular reactions in response to combined treatment of pelvic pain syndrome with herbal preparations and extracorporeal magnetic stimulation of the pelvic floor. MATERIALS AND METНODS: A randomized placebo-controlled study was conducted in 91 patients with chronic pelvic pain (more than 6 months in history). The patients were divided into 3 groups and did not differ significantly in the main studied parameters (age, parity, menstrual function, severity and duration of pain). The 1st group (n=30) patients independently carried out daily monotherapy with a cream stick of plant origin ― rectally, the 2nd group group (n=31) included women who, from the 5th to the 15th day of the menstrual cycle, had a menstrual cycle for 10 days procedures for extracorporeal magnetic stimulation of the neuromuscular apparatus of the pelvic floor; after completing the course of physiotherapy, a herbal preparation of rectal origin was prescribed daily; group 3 (n=30) included female patients who underwent physiotherapy procedures. RESULTS: It was found that patients suffering from chronic pelvic pain need to undergo complex treatment, including physiotherapy techniques and rectal preparations of herbal origin. In groups receiving combination therapy for chronic pelvic pain, a long-term clinical effect was obtained; these data correlate with ultrasound parameters. CONCLUSION: It has been established that women suffering from chronic pelvic pain should undergo a comprehensive treatment including physiotherapy techniques, in particular extracorporeal magnetic stimulation of the pelvic organs, and rectal preparations of herbal origin.
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Abstract

BACKGROUND: Therapeutic measures for chronic pelvic pain are of a pronounced interdisciplinary nature and consist of a complex of various means of influence: pharmacotherapy, physiotherapy and psychotherapy, physical therapy, surgical treatment. The solution to problems is usually achieved by prescribing venotonic drugs of systemic action, which increase venous tone, normalize capillary permeability and resistance, improve the rheological properties of blood, and for the same purpose use antihomotoxic drugs of plant origin. In addition, physiotherapy methods have become widespread in the treatment of patients with pelvic pain syndrome. Currently, pulsed magnetic therapy technologies have been developed in detail, but we hypothesized that the combined use of extracorporeal magnetic stimulation of the pelvic organs and the use of local regeneration cream can ensure mutual enhancement of the effectiveness of therapeutic effects. AIM: To study the clinical effectiveness and characteristics of vascular reactions in response to combined treatment of pelvic pain syndrome with herbal preparations and extracorporeal magnetic stimulation of the pelvic floor.

Materials

AND METНODS: A randomized placebo-controlled study was conducted in 91 patients with chronic pelvic pain (more than 6 months in history). The patients were divided into 3 groups and did not differ significantly in the main studied parameters (age, parity, menstrual function, severity and duration of pain). The 1st group (n=30) patients independently carried out daily monotherapy with a cream stick of plant origin ― rectally, the 2nd group group (n=31) included women who, from the 5th to the 15th day of the menstrual cycle, had a menstrual cycle for 10 days procedures for extracorporeal magnetic stimulation of the neuromuscular apparatus of the pelvic floor; after completing the course of physiotherapy, a herbal preparation of rectal origin was prescribed daily; group 3 (n=30) included female patients who underwent physiotherapy procedures.

Results

It was found that patients suffering from chronic pelvic pain need to undergo complex treatment, including physiotherapy techniques and rectal preparations of herbal origin. In groups receiving combination therapy for chronic pelvic pain, a long-term clinical effect was obtained; these data correlate with ultrasound parameters.

Conclusion

It has been established that women suffering from chronic pelvic pain should undergo a comprehensive treatment including physiotherapy techniques, in particular extracorporeal magnetic stimulation of the pelvic organs, and rectal preparations of herbal origin. Full Text About the authors Larisa G. Sozaewa Russian Medical Academy of Continuous Professional Education Email: [email protected] ORCID iD: 0000-0002-1793-5684 SPIN-code: 5452-8168 MD, Cand. Sci. (Med.), Associate Professor Russian Federation, MoscowInna S. Evstigneeva Russian Medical Academy of Continuous Professional Education Author for correspondence. Email: [email protected] ORCID iD: 0000-0001-9128-0965 SPIN-code: 5163-7726 MD, Cand. Sci. (Med.), Associate Professor Russian Federation, MoscowOlga A. Romanovskaya S.P. Botkin City Clinical Hospital Email: [email protected] ORCID iD: 0000-0001-9429-6102 SPIN-code: 6356-0638 Russian Federation, Moscow

References

- Endometriosis. Clinical recommendations. Moscow; 2020. 182 р. (In Russ). - Gynaecology: National guide. Ed. by G.M. Savelieva, G.T. Sukhikh, V.N. Serova, et al. Moscow: GEOTAR-Media; 2017. Р. 417–429. (In Russ). - Orazov MR, Radzinsky VE, Dolgov ED. Chronic pelvic pain in endometriosis: from therapeutic abstraction to clinical definition. A review. Gynecology. 2023;25(3):308–313. EDN: QCZSMT doi: 10.26442/20795696.2023.3.202290 - Borisova LI, Ibragimova AR, Ivanova TV, et al. Problems of chronic pelvic pain in modern gynecology. Russ Bulletin Obstetrician Gynecologist. 2023;23(5):56–60. EDN: FGJBFI doi: 10.17116/rosakush20232305156 - Shmonin AA, Maltseva MN, Melnikova EV, Ivanova GE. Issues of compliance with drug treatment in medical rehabilitation. Doctor.Ru. 2017;(11):19–26. EDN: ZRXNAB - Yan Y, Dou C, Wang X, et al. Combination of tomographic ultrasound imaging and three-dimensional magnetic resonance imaging-based model to diagnose postpartum levator avulsion. Sci Rep. 2017;7(1):11235. doi: 10.1038/s41598-017-08201-9 - Orazov MR, Silantyeva ES, Soldatskaya RA, et al. The efficacy of physical therapy in treatment of pelvic floor distress in women of reproductive age. Doctor.Ru. 2020;19(8):71–76. EDN: GHMONP doi: 10.31550/1727-2378-2020-19-8-71-76 - Radzimińska A, Strączyńska A, Weber-Rajek M, et al. The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: A systematic literature review. Clin Interv Aging. 2018;(13):957–965. doi: 10.2147/CIA.S160057 - Pushkar DY, Kulikov AG, Kasyan GR, et al. Extracorporeal magnetic stimulation of the neuromuscular apparatus of the pelvic floor in urological practice. Russi J Physical Ther Balneother Rehab. 2019;18(4):264–267. EDN: BZBKOT doi: 10.17816/1681-3456-2019-18-4-264-276 - Ismail SI, Forward G, Bastin L, et al. Extracorporeal magnetic energy simulation of pelvic floor muscles for urodinamic stress incontinence of urine in women. J Obstat Gynaecol. 2009;29(1)35–39. doi: 10.1080/01443610802484393

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