Gabapentin for the management of chronic pelvic pain in women

Background Chronic pelvic pain (CPP) is a frequent presenting symptom in gynaecology outpatient clinics. Neuromodulator pharmacological agents could be an option for treatment based on its efficacy in treating chronic pain in other conditions. Purpose This study aimed at evaluating the efficacy of oral Gabapentin to alleviate pain in women with CPP.

In a randomized double-blinded placebo-controlled trial, 60 women suffering from chronic pelvic pain were randomly divided into two equal arms. The study group received Gabapentin 300 mg three times daily initially (900 mg), with 300 mg weekly incremental dose till pain was controlled, severe side effects occurred or maximum daily dose of 2700 mg was reached. The Primary outcome was the pain score improvement of CPP, defined as a 30% reduction in the pain score assessed by the 10-cm Visual Analogue Scale compared to baseline score.

In Gabapentin group, pain was significantly reduced at 12 and 24 weeks (mean = 5.12 ± 0.67 and 3.72 ± 0.69, respectively) than in placebo group (mean = 5.9 ± 0.92 and 5.5 ± 1.13, respectively); this difference was significant. At 24 weeks, there was significantly higher proportion of patients reporting 30% or more reduction in pain scores; 19 out of 20 patients (95%) in Gabapentin group compared to 8 out of 14 patients (57.1%) in placebo group. The relative risk for pain after gabapentin treatment was 0.5 with 95% confidence interval = 0.34 to 0.75 and number needed to treat = 3 (p = 0.007). Regarding adverse effects there was significantly higher incidence of dizziness with Gabapentin (26.1%) compared to placebo (3.3%).

Chronic pelvic pain in women may be treated sufficiently with Gabapentin. Trial registration The trial was registered in ClinicalTrials.gov registry with clinical trial registration number: NCT02918760. Similar content being viewed by others

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EA: data analysis, manuscript writing. E-ZH: project development, revised manuscript. MJM: data collection, manuscript drafting. Corresponding author Ethics declarations Conflict of interest The authors declare that they have no conflict of interest. Ethical approval All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration of the Principles of Ethical Medical Research [last updated in Brazil 2013]. Informed consent Informed consent was obtained from all individual participants included in the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article AbdelHafeez, M.A., Reda, A., Elnaggar, A. et al. Gabapentin for the management of chronic pelvic pain in women. Arch Gynecol Obstet 300, 1271–1277 (2019). https://doi.org/10.1007/s00404-019-05272-z Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-019-05272-z