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Reduced pain thresholds and signs of sensitization in women with persistent pelvic pain and suspected endometriosis
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Norrköping.ORCID iD: 0000-0002-4086-4634
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0003-1588-135X
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2019 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 98, no 3, p. 327-336Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Endometriosis is a gynecological disorder that may cause considerable pelvic pain in women of fertile age. Determining pain mechanisms is necessary in order to optimize the treatment of the disease. The objective of the study was to evaluate pain thresholds in women with persistent pelvic pain with and without confirmed endometriosis, and healthy, unaffected controls, and analyze how pain thresholds in these cohorts related to duration of pelvic pain, quality of life, and symptoms of anxiety and depression.

MATERIAL AND METHODS: Pain thresholds for heat, cold and pressure were assessed with quantitative sensory testing on six locations on a reference group of 55 healthy women and on 37 women with persistent pelvic pain who had been admitted for diagnostic laparoscopy on the suspicion of endometriosis. Validated instruments were applied to assess quality of life and symptoms of anxiety and depression. Data were analyzed by means of uni- and multivariate analysis of variance and Spearman's rank-order correlation.

RESULTS: The women with persistent pelvic pain had significantly lower pain thresholds compared with the reference women. In the women with pain, no differences were observed in pain thresholds between women with (n = 13) and women without (n = 24) biopsy-proven endometriosis. The duration of pelvic pain correlated significantly positively with reduced pain thresholds, ie, the longer the duration, the more sensitization. In the persistent pelvic pain group, pain thresholds for heat correlated significantly with the Short Form Health Survey 36 dimension of bodily pain, and thresholds for cold correlated with Short Form Health Survey 36 bodily pain and with symptoms of depression.

CONCLUSIONS: Our results showed widespread alterations in pain thresholds in women with persistent pelvic pain that are indicative of central sensitization and a time-dependent correlation. Women with pelvic pain and suspicion of endometriosis should probably be treated more thoroughly to prevent or at least minimize the concomitant development of central sensitization.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 98, no 3, p. 327-336
Keywords [en]
chronic pain, endometriosis, health-related quality of life, pain thresholds, persistent pelvic pain, quantitative sensory testing, sensitization
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:liu:diva-154816DOI: 10.1111/aogs.13508ISI: 000459481000007PubMedID: 30472739Scopus ID: 2-s2.0-85059291957OAI: oai:DiVA.org:liu-154816DiVA, id: diva2:1292513
Note

Funding agencies:  Medical Research Council of Southeast Sweden; Region Ostergotland; Linkoping University

Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2019-06-28Bibliographically approved

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The full text will be freely available from 2019-11-25 12:48
Available from 2019-11-25 12:48

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Grundström, HannaGerdle, BjörnAlehagen, SiwBerterö, CarinaKjölhede, Preben

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Grundström, HannaGerdle, BjörnAlehagen, SiwBerterö, CarinaKjölhede, Preben
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Division of Nursing ScienceFaculty of Medicine and Health SciencesDepartment of Gynaecology and Obstetrics in NorrköpingDivision of Community MedicinePain and Rehabilitation CenterDivision of Children's and Women's healthDepartment of Gynaecology and Obstetrics in Linköping
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Acta Obstetricia et Gynecologica Scandinavica
Obstetrics, Gynecology and Reproductive Medicine

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