The Detection And Analysis Of The Pain Threshold In Women With Chronic Pelvic Pain

Objective: Chronic Pelvic Pain(CPP)is a common disease in women,which can lead to loss of certain abilities.Because the feeling of pain is subjective,it is difficult to establish a good repeatability and accepted testing standards.Determination of the pain threshold in healthy women may provide a clear objective diagnostic criteria for CPP.So the purpose of this study is to analyze the significance in patients with chronic pelvic pain,the threshold of pain on pressure was detected in abdomen,vulva,pelvic floor muscles,bilateral accessories and uterine sacrum ligament in healthy women and patients with chronic pelvic pain.Methods:100 healthy women(control group)and 110 women with chronic pelvic pain(experimental group)were chosen.Requires the group of personnel in the stage of birth,menstrual cycle normal(28±3 days),non pregnancy,no acute infection of the genital tract and history of genital tract malignant tumor,According to the condition of the disease using the relevant detection means(ultrasound,cystoscopy,endoscopic and laparoscopic)to confirm the diagnosis.All study subjects are required aged at 18-65 years old,and signed the informed consent.The specialized forms were filled to collect data.Fill in the medical history questionnaire designed by the center,the experimental group also need to complete a simple Mc Gill pain questionnaire.The research objects should be carried out routine physical examination and pelvic examination..Automatic pain on pressure detectors for body surface and vaginal were applied to detect the pain threshold under the speed 0.5kg/cm2/s on 34 spots,which were in abdomen(14),vulvaResults:The incidence of urinary incontinence,pelvic organ prolapse,s(6),pelvic floor muscles(8)and vaginal front and back fornix,bilateral accessories and uterine sacrum ligament(6)(unit: kg/cm2).Record the pressure on the patient to feel pain,use the maximum pressure of 3kg/cm2 minus the subjects pain pressure value calculated the pain pressure value.The pain threshold detection time was 3 seconds,2 minutes interval,and repeated the detection of each site 3 times to calculate the pain threshold.The differences of pain threshold on various spots between the two groups were analyzed.Exual life disorder,dysmenorrhea,chronic pelvic inflammatory disease,endometriosis,irritable bowel syndrome and symptoms of interstitial cystitis in the experimental group was significantly higher than that in control group(P<0.05).In the experimental group,the rate of induced abortion was significantly higher than that of the control group(P=0.004).The total abortion rate of the experimental group was significantly higher than that of the control group(P=0.001).Statistical data also showed no differences between the experimental group and the control group of the menstrual cycle,pregnancy history and history of gynecological surgery(P>0.05).The Mc Gill pain score in the experimental group was calculated in the number of median,25% to 75%,and the results were 25.5(12-32),14.5(12-22)and 5.0(3-12).The average pain threshold detected in abdomen,vulva,pelvic floor,vaginal front and back fornix,bilateral accessories,uterine sacrum ligament among experimental group(1.58 + 0.42;0.95 + 0.43;0.98 + 0.52;1.09 + 0.33;0.71 + 0.34;1.01 + 0.44)were significantly lower than that among the control group(1.78 + 0.47;1.19 + 0.42;1.78 + 0.69;1.44 + 0.45;1.59 + 0.52;1.49 + 0.50)(P< 0.05).All reproductive tract pressure pain threshold(vulva,pelvic floor muscles and sacrospinous ligament,annex,Uterine bottom ligament and vaginal fornix)were created with other parts(r=0.59-0.92)and P was less than 0.001.To analyze the relationship between pain threshold and pain perception score(scores Mc Gill).The detection values of the left and right sides of the pelvic floor were negatively correlated with the Mc Gill scores(r=-0.63,P=0.03;r=-0.69,P=0.007).Posterior vaginal fornix pain detection threshold and Mc Gill feelings were negatively related(r=-0.52,P=0.03).No correlation was detected between the pain threshold and the emotional score in any of the test sites.Conclusion:Female chronic pelvic pain may be related to the drop of pain threshold and the raise of pain sensitivity in abdomen,perineum,vaginal and pelvic.The feeling of pain is subjective,and it is difficult to establish a good reproducibility and accepted testing standard.Through the determination of pelvic pressure pain threshold determined healthy women pain threshold,can provide a clear objective diagnostic criteria for CPP,also can be used for such as the bladder pain comprehensive syndrome,endometriosis,irritable bowel comprehensive syndrome and the objective description of specific parts of the nerve of machine.Urinary incontinence,pelvic organ prolapse,life no climax,dysmenorrhea,chronic pelvic inflammation,endometriosis,pelvic congestion comprehensive syndrome,irritable bowel in syndrome and bladder pain syndrome is associated with the occurrence of CPP.Abortion can increase the incidence of pelvic inflammatory disease,chronic pelvic inflammatory disease is one of the most common causes of CPP,pelvic pain incidence did not increase with the increase in the number of abortions,first abortion cause the risk of pelvic pain is very high,to avoid the occurrence of non medical abortion,fundamentally reduce the risk of CPP.