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Dolor pélvico crónico en las mujeres: una revisión

Georgine Lamvu^1,2, Jorge Carrillo^1,2, Chensi Ouyang^1,2

¹Division of Surgery, Gynecology Section, Veterans Affairs Medical Center, Orlando VA Healthcare System, Orlando, Florida.

|June 15, 2021

Resumen

El dolor pélvico crónico (CPP) afecta a millones de personas en todo el mundo, a menudo con orígenes poco claros. La gestión efectiva requiere un enfoque biopsicosocial integral, que integre la historia clínica del paciente, la atención informada sobre el trauma y las estrategias de tratamiento interdisciplinario.

Área de la Ciencia:

Salud de las mujeres
Tratamiento del dolor
Gastroenterología

Sus antecedentes:

El dolor pélvico crónico (CPP) afecta al 26% de las mujeres en todo el mundo, lo que con frecuencia conduce a procedimientos invasivos a pesar de los orígenes no ginecológicos en el 80% de los casos.
Los pacientes y los médicos experimentan frustración debido a la falta percibida de tratamientos efectivos para la PCP.
La PCP a menudo ocurre con trastornos del dolor no pélvico y comorbilidades, exacerbando el dolor y la discapacidad.

Objetivo del estudio:

Revisar la evaluación y la gestión del CPP sobre la base de directrices consensuadas.
Mejorar la evaluación clínica, las estrategias de tratamiento y las interacciones paciente-clínico para la PCP.
Proporcionar un marco para abordar la naturaleza compleja y multifactorial de la CPP.

Principales métodos:

Resumen de las recomendaciones de las directrices de consenso para la evaluación y la gestión del PPC.
Destacando la importancia de una evaluación biopsicosocial exhaustiva, incluida la historia y la atención informada sobre el trauma.
Hacer hincapié en los enfoques de tratamiento multimodal e interdisciplinario y evitar el enfoque de la patología de un solo órgano.

Principales resultados:

El dolor musculoesquelético y la disfunción están presentes en el 50-90% de los pacientes con PCP.
Los factores biopsicosociales interactúan significativamente para contribuir e influir en el dolor pélvico crónico.
La evaluación integral requiere un historial detallado, educación del paciente sobre los mecanismos del dolor y tiempos de visita extendidos.

Conclusiones:

El manejo eficaz de la PCP requiere considerar el dolor mediado centralmente junto con los factores somáticos y viscerales pélvicos y no pélvicos.
Un modelo biopsicosocial holístico es crucial para comprender y tratar el dolor pélvico crónico.
La atención interdisciplinaria y los enfoques centrados en el paciente son vitales para mejorar los resultados en la gestión del CPP.

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