Persistent Pelvic Pain Management Strategies Utilised by Gynaecologists
Authors List
Holdaway, C., University of Otago - Wellington School of Medicine, Wellington, New Zealand (Presenter)
Brooking, E., Wellington Regional Hospital, Wellington, New Zealand
Derrett, J., Wellington Regional Hospital, Wellington, New Zealand
Lynch, L., Wellington Regional Hospital, Wellington, New Zealand
Scheck, S., University of Otago - Department of Obstetrics, Gynaecology and Women’s Health & Wellington Regional Hospital & Hutt Valley Hospital, Wellington, New Zealand
Introduction
Persistent pelvic pain (PPP) affects one in four women and gender diverse people in Aotearoa New Zealand (Grace & Zondervan, 2004). Multiple biopsychosocial factors can contribute towards pelvic pain. Traditionally, gynaecology services have prioritised surgical management for patients presenting with PPP by assessing for and treating endometriosis. Increasing awareness of multi-modal treatments has expanded management options to include a wide range of pain generators outside of endometriosis and extend beyond a purely biomedical approach.
Aims
Assess utilisation and patient outcomes of two treatment pathways for PPP by a public tertiary gynaecology service in Aotearoa: (1) referral for pelvic floor Botox, and (2) referral to a multidisciplinary pain service.
Methods
A retrospective cohort study was performed over a two-year period (2022-2023). Patients included were seen in a tertiary gynaecology clinic and were either referred for pelvic floor Botox or referred to the pain service. Electronic clinical documentation was reviewed to collect demographics, wait-times, the indication(s) for intervention, follow-up after the intervention, and patient outcome at time of data collection.
Results
61 patients were referred for pelvic floor Botox and had at least one procedure; 65.5% of patients had some improvement. 32 patients were referred to the pain service and had at least one clinical interaction; 51.9% of patients had some improvement.
Conclusions
Multi-modal treatments for PPP are utilised in gynaecology, albeit at lower rates than surgical intervention. Outcomes from both Botox treatment in conjunction with pelvic floor physiotherapy and multidisciplinary pain service were favourable for most patients. Further prospective research would give further insight into patient outcomes.
References
Grace, V. M., & Zondervan, K. T. (2004). Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. Australian and New Zealand Journal of Public Health, 28(4), 369–375. https://doi.org/10.1111/j.1467-842x.2004.tb00446.x
Holdaway, C., University of Otago - Wellington School of Medicine, Wellington, New Zealand (Presenter)
Brooking, E., Wellington Regional Hospital, Wellington, New Zealand
Derrett, J., Wellington Regional Hospital, Wellington, New Zealand
Lynch, L., Wellington Regional Hospital, Wellington, New Zealand
Scheck, S., University of Otago - Department of Obstetrics, Gynaecology and Women’s Health & Wellington Regional Hospital & Hutt Valley Hospital, Wellington, New Zealand
Introduction
Persistent pelvic pain (PPP) affects one in four women and gender diverse people in Aotearoa New Zealand (Grace & Zondervan, 2004). Multiple biopsychosocial factors can contribute towards pelvic pain. Traditionally, gynaecology services have prioritised surgical management for patients presenting with PPP by assessing for and treating endometriosis. Increasing awareness of multi-modal treatments has expanded management options to include a wide range of pain generators outside of endometriosis and extend beyond a purely biomedical approach.
Aims
Assess utilisation and patient outcomes of two treatment pathways for PPP by a public tertiary gynaecology service in Aotearoa: (1) referral for pelvic floor Botox, and (2) referral to a multidisciplinary pain service.
Methods
A retrospective cohort study was performed over a two-year period (2022-2023). Patients included were seen in a tertiary gynaecology clinic and were either referred for pelvic floor Botox or referred to the pain service. Electronic clinical documentation was reviewed to collect demographics, wait-times, the indication(s) for intervention, follow-up after the intervention, and patient outcome at time of data collection.
Results
61 patients were referred for pelvic floor Botox and had at least one procedure; 65.5% of patients had some improvement. 32 patients were referred to the pain service and had at least one clinical interaction; 51.9% of patients had some improvement.
Conclusions
Multi-modal treatments for PPP are utilised in gynaecology, albeit at lower rates than surgical intervention. Outcomes from both Botox treatment in conjunction with pelvic floor physiotherapy and multidisciplinary pain service were favourable for most patients. Further prospective research would give further insight into patient outcomes.
References
Grace, V. M., & Zondervan, K. T. (2004). Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of the health services. Australian and New Zealand Journal of Public Health, 28(4), 369–375. https://doi.org/10.1111/j.1467-842x.2004.tb00446.x
