Rivas-Penilla LF, Rodríguez-Colorado ES, Gorbea-Chávez V, Granados-Martínez V, Ramírez-Isarraraz C

Language: Spanish
References: 13
Page: 603-610
PDF size: 196.04 Kb.

ABSTRACT

Objective: To compare the outcomes of electrostimulation with a superficial and an intravaginal electrode in patients with chronic pelvic pain.
Materials and Methods: Retrospective cohort study performed in patients attended, between April 2017 and April 2019, at the Gynecological Urology Clinic of the National Institute of Perinatology where they received electrostimulation sessions to relieve chronic pelvic pain. Patients with chronic pelvic pain who received treatment with vaginal electrode or surface electrode, 8 to 12 sessions, were included as analgesic therapy with superficial transcutaneous electrical stimulation. Pain intensity was assessed with a visual analog scale (VAS) and the percentage decrease at the beginning, middle and end of treatment. Descriptive statistics were performed and both groups were compared with t Student and paired t to assess the intragroup difference, statistical significance was determined with p ‹ 0.05.
Results: 132 patients were compared: 87 with intravaginal electrode (group 1) and 45 with superficial electrodes (group 2). The VAS values and percentage improvement of the first session, the mid-treatment session and the last session were statistically significant in each group (p = 0.001), the initial VAS of 7.54 and VAS at the end of the treatment of 2.44. When comparing improvement between groups, no statistically significant difference was found between one electrode and another (p › 0.05).
Conclusions: Patients with chronic pelvic pain can be treated by electrostimulation with superficial or intravaginal electrode and, after at least 8 sessions, perceive a significant decrease or, its complete disappearance.

REFERENCES

1. Engeler D, Baranowski AP, Borovicka J, Cottrell AM, et al. EAU Guidelines on Chronic Pelvic Pain. EAU. 2018. http:// uroweb.org/guidelines/compilations-of-all-guidelines/

2. Cottrell AM, Schneider MP, Goonewardene S, Yuan Y, et al. Benefits and Harms of Electrical Neuromodulation for Chronic Pelvic Pain: A Systematic Review. Eur Urol Focus 2019. https://doi.org/10.1016/j.euf.2019.09.011

3. Carranza-Lira S, Romero-Cuadra I. Frecuencia de presentación y características de dolor pélvico crónico en la consulta ginecológica. Rev Med Inst Mex Seguro Soc 2018; 56 (3). http://www.redalyc.org/articulo.oa?id=457757174004

4. Till SR, Wahl HN, As-Sanie S. The role of nonpharmacologic therapies in management of chronic pelvic pain: what to do when surgery fails. Curr Opin Obstet Gynecol 2017; 29: 231-39. http://doi.org/10.1097/GCO.0000000000000376

5. Biemans J, Van Balken M. Efficacy and Effectiveness of Percutaneous Tibial Nerve Stimulation in the Treatment of Pelvic Organ Disorders: A Systematic Review. Neuromodulation 2013; 16 (1): 25-34. http://doi.org/10.1111/j.1525- 1403.2012.00504.x

6. Sharma N, Rekha K, Srinivasan JK. Efficacy of transcutaneous electrical nerve stimulation in the treatment of chronic pelvic pain. J Mid-life Health. 2017; 8 (1): 36. http:// doi.org/10.4103/jmh.JMH_60_16

7. Tutolo M, Ammirati E, Heesakkers J, Kessler T et al. Efficacy and safety of sacral and percutaneous tibial neuromodulation in non-neurogenic lower urinary tract dysfunction and chronic pelvic pain: A systematic review of the literature. EAU 2018; 73 (3): 406-18. https://doi.org/10.1016/j. eururo.2017.11.002

8. Roy H, Offiah I, Dua A. Neuromodulation for Pelvic and Urogenital Pain. Brain Sci 2018; 8 (10): 2-16. http://doi. org/10.3390/brainsci8100180.

9. Dionisi B, Senatori R. Effect of transcutaneous electrical nerve stimulation on the postpartum dyspareunia treatment. J Obstet Gynaecol Res 2011; 37 (7): 750-53. http://doi.org/10.1111/j.1447-0756.2010.01425.x

10. Bernardes N, Bahamodes L. Intravaginal electrical stimulation for the treatment of chronic pelvic pain. J Reprod Med 2005; 50: 267-72. https://pubmed-ncbi-nlm-nih-gov. pbidi.unam.mx:2443/15916211/

11. Solano Sanchez S, Maldonado Miranda E. Efecto de la estimulación nerviosa eléctrica transcutánea en el piso pélvico evaluada mediante trazo electromiográfico en mujeres con dispareunia superficial antes y después del tratamiento. An Med Mex 2015; 60 (2): 104-9. https://www.medigraphic. com/pdfs/abc/bc-2015/bc152e.pdf

12. Martin S, Han E, Peters K. A Novel Approach to Managing Post Retropubic Vaginal Sling Pain. Urology 2020; 137: 196-99. https://doi.org/10.1016/j.urology.2019.11.008.

13. Wang J, Chen Y, Chen J, Zhang G et al. Sacral Neuromodulation for Refractory Bladder Pain Syndrome/Interstitial Cystitis: a Global Systematic Review and Meta-analysis. Sci Rep 2017; 7 (1). http://doi.org/10.1038/s41598-017- 11062-x.