在女性中"来源不明"的慢性盆腔疼痛
Peter Petros1, Jacob Bornstein2, Kay Scheffler3
1Reconstructive Pelvic Floor Surgeon and Certified Urogynaecologist (retired), Sydney, NSW, Australia.
Annals of translational medicine
|May 9, 2024
概括
慢性盆腔疼痛 (CPP) 可能源于软弱的子宫神经带 (USLs) 无法支持神经. 手术修复USL可能可以治愈CPP和相关的膀问题,为这种常见的疾病提供缓解.
科学领域:
- 妇科 妇科医生 妇科
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 疼痛管理 疼痛管理
背景情况:
- 慢性盆腔疼痛 (CPP) 影响高达20%的女性,通常被认为是未知的来源和无法治愈的.
- 综合理论范式 (ITP) 提出了一种对CPP病原学的新理解.
- 松散或软弱的子宫神经带 (USLs) 有关于支持内脏神经 (VPs).
研究的目的:
- 审查基于慢性骨盆疼痛 (CPP) 综合理论范式 (ITP) 的实验性科学作品和手术.
- 探索子宫神经带 (USL) 松和CPP之间的联系,包括诸如后综合征 (PFS) 等相关症状.
- 根据ITP,讨论CPP的诊断和治疗方式.
主要方法:
- 对实验性科学文献和坚持整体理论范式 (ITP) 的外科病例研究进行审查.
- 分析涉及子宫关节 (USL) 松的拟议机制及其对内脏神经 (VPs) 的影响.
- 对诊断方法的评估,包括光圈测试和吸管插入,以确定USL松.
主要成果:
- 根据假设,慢性骨盆疼痛 (CPP) 是由于软弱的子宫神经带 (USLs) 无法支持内脏神经 (VPs) 的机械失能引起的.
- 当CPP与子宫脱落和膀症状 (后综合征 - PFS) 相结合时,通过USL修复可能可治愈.
- "佩斯卡托里冰山"效应强调,CPP通常是唯一报告的症状,掩盖了其他PFS症状.
结论:
- 综合理论范式 (ITP) 为与子宫神经带 (USL) 松相关的慢性骨盆疼痛 (CPP) 提供了一个潜在的可治愈的解释.
- 诊断可以通过通过机械USL支持 (光谱试验,卫生棉条) 立即缓解疼痛来确认.
- 治疗方案包括非手术方法 (运动,卫生棉条) 和手术修复USLs,往往可以改善同时存在的膀症状.
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