背景:慢性盆腔疼痛(CPP)和慢性盆腔疼痛综合征(CPPS)没有明确的病因,即使它们对生活质量的影响得到证实。此外,有证据表明大量CPP/CPPS的肌筋膜功能障碍,所以筋膜的作用可以假设。
方法:这项探索性配对病例对照研究的目的是评估筋膜应变(FS)是否代表与CPP/CPPS相关的因素。该研究遵循了“加强流行病学观察研究报告”(STROBE)声明。我们收集了参加诊所的189名受试者(病例:58;对照:131)的数据。参与者通过2:1的入学率进行管理。要求提供临床信息的标准化小册子,以前的FS和以下问卷:“美国国立卫生研究院慢性前列腺炎症状指数”(NIH-CPSI),“医院焦虑和抑郁量表”(HADS),“恐惧回避信念问卷”(FABQ)。每位受试者都进行了评估,以检测骨盆区域的异常评估结果。
结果:分析结果显示,泌尿生殖道感染和手术的比值比(OR)分别显著增加4.13,3.1和3.08.FS作为一个整体有显著提高的OR:2.22(1.14至4.33)。分析根据身体活动和工作类型进行了调整,OR降至1.94(0.82至4.61),失去其意义(p=0.129)。检测到症状影响与CPP/CPPS之间有很强的相关性(rpbs=0.710;p<0.001),考虑到焦虑,发现中度相关性(0.3结论:这项探索性研究表明,FS可能是发生CPP/CPPS的病因。然而,需要进一步研究筋膜功能障碍和CPP/CPPS的相关意义才能确认。
BACKGROUND: Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) do not have a definite cause, even if their impact on quality of life was demonstrated. Furthermore, there is evidence of myofascial dysfunctions in a large number of CPP/CPPS, so that the role of fascia can be hypothesized.
METHODS: The aim of this exploratory matched
case-control study was to assess whether fascial strains (FS) represent a factor associated with CPP/CPPS. The study followed the \"Strengthening the Reporting of Observational Studies in Epidemiology\" (STROBE) statement. We collected data from 189 subjects (cases: 58; controls: 131) who attended the clinic. The participants were managed through a 2:1 enrollment ratio. A standardized booklet requested for clinical information, previous FS and the following questionnaires: \"National Institutes of Health Chronic Prostatitis Symptom Index\" (NIH-CPSI), \"Hospital Anxiety and Depression Scale\" (HADS), \"Fear Avoidance Belief Questionnaire\" (FABQ). Each subject underwent a palpatory assessment to detect abnormal palpatory findings in the pelvic area.
RESULTS: The analyses showed that episiotomy, genito-urinary infections and surgery had a significantly increased odds ratio (OR) of 4.13, 3.1 and 3.08, respectively. FS as a whole had a significantly raised OR: 2.22 (1.14 to 4.33). The analysis was adjusted for physical activity and for type of job and OR decreased to 1.94 (0.82 to 4.61), losing its significance (p = 0.129). A strong correlation between symptoms\' impact and CPP/CPPS was detected (rpbs = 0.710; p < 0.001) and a moderate one (0.3 < rpbs < 0.7; p < 0.001) was found considering anxiety, depression and abnormal palpatory findings.
CONCLUSIONS: This exploratory study suggests that FS could represent an etiological factor for developing CPP/CPPS. However, further research on fascial dysfunctions and relative implications in CPP/CPPS is needed for confirmation.