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Persistent pelvic pain in tertiary multidisciplinary pain clinics: a comparative study with non-pelvic pain patients
Cecilie Therese Hagemann1,2, Jeanette Eliesen3, Mona Stedenfeldt4,5
1Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Objectives:
Persistent pelvic pain (PPP) is often regarded as multifactorial and complex. There is limited knowledge on how patients with PPP resemble and differ from those with persistent non-pelvic pain (PNPP). The specific aims of this study were to compare self-reported background and pain characteristics, affective symptoms, and quality of life at baseline between patients with PPP and those with PNPP at three multidisciplinary pain clinics in Norway, and to explore differences between men and women with PPP.
Methods:
This is a cross-sectional study, using registry data from three tertiary, multidisciplinary pain clinics. Patients ≥17 years answered web-based questionnaires on background, baseline pain symptoms, mental health, and quality of life. We used t-tests, chi square, and multivariable logistic regression.
Results:
Of 934 consenting patients (71 % of those attending), 30 had missing diagnoses, and 127 (13.6 %) were diagnosed with PPP. PPP patients less often reported widespread pain than PNPP patients (adjusted odds ratio (AOR) 0.2, 95 % confidence interval (CI) 0.2-0.4). We found high prevalence of fatigue, insomnia, and anxiety among all the pain patients, but PPP patients were more likely to report depression (AOR 1.6, 95 % CI 1.0-2.6) and pain catastrophizing (AOR 1.8, 95 % CI 1.2-2.8). All the pain patients had a low health-related quality of life. Women with PPP had higher prevalence of severe fatigue than men with PPP.
Conclusions:
This study confirms that pain clinic patients generally experience high levels of emotional distress and poor health-related quality of life. PPP patients tend to exhibit higher rates of pain catastrophizing, yet less widespread pain. Understanding the specific symptom profile of PPP patients is crucial for effective treatment in pain clinics. The potential underutilization of pain clinics in the treatment of PPP patients warrants further investigation.
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