Quality of life associated to chronic pelvic pain is independent of endometriosis diagnosis-a cross-sectional survey

Health and Quality of Life Outcomes

João S Cunha Filho¹  Marcia F Chaves²  Virginia Rosa¹  Vanessa K Genro¹  Camila Scheffel¹  Luciano M Oliveira²  Carlos A Souza³ 

[1] Departamento de Ginecologia e Obstetrícia, Universidade Federal do Rio Grande do Sul Porto Alegre, Brasil;Serviço de Neurologia, Hospital de Clinicas de Porto Alegre, UFRGS, Porto Alegre, Brasil;Serviço de Ginecologia e Obstetrícia, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brasil

关键词: quality-of-life;    anxiety;    depression;    endometriosis;    chronic pelvic pain;   

Others  :  826658
DOI  :  10.1186/1477-7525-9-41

 received in 2011-04-03, accepted in 2011-06-10,  发布年份 2011

【 摘 要 】

Background

Pain is strongly related to poor quality of life. We performed a cross-sectional study in a universitary hospital to investigate quality of life in women suffering from chronic pelvic pain (CPP) due to endometriosis and others conditions.

Methods

Fifty-seven patients aged between 25 and 48 years-old submitted to laparoscopy because of CPP were evaluated for quality of life and depressive symptoms. Quality of life was accessed by a quality of life instrument [World Health Organization Quality of Life Assessment-Bref (WHOQOL-bref)]. Causes of pelvic pain were determined and severity of CPP was measured with a visual analogue scale. According to the intensity of pelvic pain score, patients were classified in two groups (group Low CPP < 25th percentile visual analogue scale and group High CPP > 25th percentile). Four dimensions on quality of life were measured (physical, psychological, social and environmental). We stratified the analysis of quality of life according CPP causes (presence or not of endometriosis in laparoscopy).

Results

Patients with higher pain scores presented lower quality of life status in psychological and environmental dimensions. We found a negative correlation between pain scores and psychological dimension of quality of life (r = -0.310, P = .02). Quality of life scores were similar between groups with and without endometriosis (physical 54.2 ± 12.8 and 51.1 ± 13.8, P = 0.504; psychological 56.2 ± 14.4 and 62.8 ± 12.4, P = 0.182; social 55.6 ± 18.2 and 62.1 ± 19.1, P = 0.325; environmental 59.2 ± 11.7 61.2 ± 10.8, P = 0.608; respectively)

Conclusions

Higher pain scores are correlated to lower quality of life; however the fact of having endometriosis in addition to CPP does not have an additional impact upon the quality of life.

【 授权许可】

   
2011 Souza et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Fall M, Baranowski AP, Fowler CJ, Lepinard V, Malone-Lee JG, Messelink EJ, Oberpenning F, Osborne JL, Schumacher S: EAU guidelines on chronic pelvic pain. Eur Urol 2004, 46:681-689.
• [2]Zondervan K, Barlow DH: Epidemiology of chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol 2000, 14:403-414.
• [3]Reiter RC: A profile of women with chronic pelvic pain. Clin Obstet Gynecol 1990, 33:130-136.
• [4]Dalpiaz O, Kerschbaumer A, Mitterberger M, Pinggera G, Bartsch G, Strasser H: Chronic pelvic pain in women: still a challenge. BJU Int 2008, 102:1061-1065.
• [5]Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF: Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996, 87:321-327.
• [6]Jones GL, Kennedy SH, Jenkinson C: Health-related quality of life measurement in women with common benign gynecologic conditions: a systematic review. Am J Obstet Gynecol 2002, 187:501-511.
• [7]Laursen BS, Bajaj P, Olesen AS, Delmar C, Arendt-Nielsen L: Health related quality of life and quantitative pain measurement in females with chronic non-malignant pain. Eur J Pain 2005, 9:267-275.
• [8]Tripoli TM, Sato H, Sartori MG, Fernando de Araujo F, Girão MJ, Schor E: Evaluation of Quality of Life and Sexual Satisfaction in Women Suffering from Chronic Pelvic Pain With or Without Endometriosis. The Journal of Sexual Medicine 2010. no-no
• [9]Berkley KJ, Rapkin AJ, Papka RE: The pains of endometriosis. Science 2005, 308:1587-1589.
• [10]Moen MH, Stokstad T: A long-term follow-up study of women with asymptomatic endometriosis diagnosed incidentally at sterilization. Fertil Steril 2002, 78:773-776.
• [11]Peveler R, Edwards J, Daddow J, Thomas E: Psychosocial factors and chronic pelvic pain: a comparison of women with endometriosis and with unexplained pain. J Psychosom Res 1996, 40:305-315.
• [12]Ford J, English J, Miles WA, Giannopoulos T: Pain, quality of life and complications following the radical resection of rectovaginal endometriosis. BJOG 2004, 111:353-356.
• [13]Romao AP, Gorayeb R, Romao GS, Poli-Neto OB, dos Reis FJ, Rosa-e-Silva JC, Nogueira AA: High levels of anxiety and depression have a negative effect on quality of life of women with chronic pelvic pain. Int J Clin Pract 2009, 63:707-711.
• [14]Reiter RC: Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol 1998, 41:422-435.
• [15]Fedele L, Bianchi S, Zanconato G, Bergamini V, Berlanda N, Carmignani L: Long-term follow-up after conservative surgery for bladder endometriosis. Fertil Steril 2005, 83:1729-1733.
• [16]Chaves ML, Izquierdo I: Differential diagnosis between dementia and depression: a study of efficiency increment. Acta Neurol Scand 1992, 85:378-382.
• [17]Chaves RKMOCCGACMLF: Evaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample. Dement Neuropsychol 2009, 3:88-93.
• [18]Fleck MP, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L, Pinzon V: [Application of the Portuguese version of the abbreviated instrument of quality life WHOQOL-bref]. Rev Saude Publica 2000, 34:178-183.
• [19]Gencoz F, Gencoz T, Soykan A: Psychometric properties of the Hamilton Depression Rating Scale and other physician-rated psychiatric scales for the assessment of depression in ESRD patients undergoing hemodialysis in Turkey. Psychol Health Med 2007, 12:450-459.
• [20]Beck AT: A systematic investigation of depression. Compr Psychiatry 1961, 2:163-170.
• [21]Koninckx PR, Martin D: Treatment of deeply infiltrating endometriosis. Curr Opin Obstet Gynecol 1994, 6:231-241.
• [22]Revised American Society for Reproductive Medicine classification of endometriosis: 1996 Fertil Steril 1997, 67:817-821.
• [23]Momoeda M, Taketani Y, Terakawa N, Hoshiai H, Tanaka K, Tsutsumi O, Osuga Y, Maruyama M, Harada T, Obata K, Hayashi K: Is endometriosis really associated with pain? Gynecol Obstet Invest 2002, 54(Suppl 1):18-21. discussion 21-13
• [24]Cox L, Ayers S, Nala K, Penny J: Chronic pelvic pain and quality of life after laparoscopy. Eur J Obstet Gynecol Reprod Biol 2007, 132:214-219.
• [25]Arruda MS, Petta CA, Abrao MS, Benetti-Pinto CL: Time elapsed from onset of symptoms to diagnosis of endometriosis in a cohort study of Brazilian women. Hum Reprod 2003, 18:756-759.
• [26]Chapron C, Lafay-Pillet MC, Monceau E, Borghese B, Ngo C, Souza C, de Ziegler D: Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis. Fertil Steril 2011, 95:877-881.
• [27]Marques A, Bahamondes L, Aldrighi JM, Petta CA: Quality of life in Brazilian women with endometriosis assessed through a medical outcome questionnaire. J Reprod Med 2004, 49:115-120.
• [28]Sutton CJ, Ewen SP, Whitelaw N, Haines P: Prospective, randomized, double-blind, controlled trial of laser laparoscopy in the treatment of pelvic pain associated with minimal, mild, and moderate endometriosis. Fertil Steril 1994, 62:696-700.
• [29]Mahmood TA, Templeton A: Prevalence and genesis of endometriosis. Hum Reprod 1991, 6:544-549.
• [30]Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ: Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 1991, 55:759-765.