The management of patients with chronic pelvic pain (CPP) is a serious problem, the solution of which is in the complex interdisciplinary approach. The article describes the neurological aspects of the disease, including musculoskeletal and neurogenic causes of pain. Treatment of patients should be aimed at both the anatomical cause of pain and the correction of emotional disorders. Education and patient involvement in the treatment program are important. In the presence of a nociceptive source of pain in the form of myofascial or joint pain, treatment is carried out in accordance with general recommendations for the treatment of musculoskeletal pain and includes non-steroidal anti-inflammatory drugs and myorelaxants administration. We present our own clinical observation, which reflects a comprehensive approach to the treatment of a patient with CPP. 

Diagnosis and treatment of chronic pelvic pain syndrome

Taking into account the many causes of diseases associated with dorsopathy, it is substantial to introduce new innovative technologies into the practice of health resort treatment on the basis of the modern concept of individual (personalized) complex therapy.In this article priorities in modern information medical technologies are considered. Examples of various applications of innovative technologies and comprehensive programs of rehabilitation therapy in the case of health-resort treatment of patients with pain syndromes caused by dorsopathy are demonstrated. Restorative physiotherapeutic treatment process, including dorsopathy treatment,should be accentuated from predominantly pathogenetic to etiotropic therapy, taking into account the characteristics of the patient’smetabolism. Corresponding integral innovative projects should be based on the methods of adaptive immunotherapy, psychotherapy and on the reconstruction of a favorable environment for the physical and mental well-being of a person. The modern paradigm inhealth resort treatment does not means to bringing the patient to the initial quasi-stable state of health, but in restoring health in healthy people. That is the aim of modern innovative technologies in health-resort treatment.

Innovative Technologies in the Health-Resort Treatment of Patients with Dorsopathy

Vulvodynia is a chronic persistent pain syndrome that affects the vulvar area and lasts more than 3 months without a clearly identifiable cause. Provoked localized pain in the vulval vestibule is the most prevalent type of vulvodynia and is interpreted as dysfunctional pain. Peripheral and central sensitization contribute to the onset and persistence of  vulvodynia. Chronic pain predictably causes significant issues  for a woman's psychological, sexual and physical health. The  diagnosis of vulvodynia includes an assessment of all the factors  associated with pain. Successful treatment of vulvodynia goes beyond identifying one trigger and prescribing one type  of treatment. Patient-centered interdisciplinary approach is the most promising, including psychotherapy, lifestyle changes,  drug therapy.

/pdf/vulvodynia-a-modern-perspective-on-the-problem-2yvutq3xit.pdf

Vulvodynia: a modern perspective on the problem

BACKGROUND: Chronic pelvic pain syndrome against the background of chronic abacterial prostatitis is most often associated with emotional and behavioral disorders, asthenic syndrome, erectile dysfunction, lower urinary tract symptoms, which significantly reduce the quality of life of patients and require additional medication correction. Despite the fact that there are currently more than 15 groups of drugs used in this case, their effectiveness remains insufficiently high. In this regard, the search for new innovative technologies for non-drug therapy of chronic pelvic pain and chronic abacterial prostatitis is relevant. 
AIM: Study of the effect of extracorporeal magnetic stimulation of the pelvic floor and transcranial magnetic therapy on the parameters of the psycho-emotional status and clinical parameters in patients with chronic pelvic pain syndrome against the background of chronic abacterial prostatitis. 
MATERIALS AND METHODS: The study included 52 patients with chronic pelvic pain syndrome against the background of chronic abacterial prostatitis aged 28 to 45 years. Subject to the principles of simple randomization, patients were divided into 2 groups. Patients of the control group (n=26) received a basic sanatorium complex with the inclusion of therapeutic exercises, dosed walking, drinking mineral water. Patients of the main group (n=26) in addition to the basic complex received extracorporeal magnetic stimulation of the pelvic floor and transcranial magnetic therapy. 
RESULTS: The use of extracorporeal magnetic stimulation of the pelvic floor and transcranial magnetic therapy in patients with chronic pelvic pain syndrome against the background of chronic abacterial prostatitis is accompanied by a significant decrease in the severity of pain syndrome, clinical symptoms of the disease and improvement in psycho-emotional status parameters. 
CONCLUSION: The inclusion of extracorporeal magnetic stimulation of the pelvic floor and transcranial magnetic therapy in the treatment complex of patients with chronic pelvic pain syndrome against the background of chronic abacterial prostatitis contributes to the regression of the clinical manifestations of the disease, pain syndrome, dysuria disorders, and a significant improvement in the parameters of the psycho-emotional state.

Assessment of the psycho-emotional status of patients with chronic pelvic pain syndrome using magnetotherapy

Genital Pain Syndromes and Sexual Pain Disorders

Management of patients with chronic pelvic pain (CPP) is an actual interdisciplinary problem of modern clinical medicine. CPP is chronic or persistent pain lasting more than 6 months, which is located in the structures related to the male or female pelvis and is associated with negative cognitive, behavioral, and emotional consequences, as well as with lower urinary tract, bowel, and pelvic floor symptoms, and reproductive and sexual dysfunction. In accordance with the biopsychosocial model, CPP is the result of a dynamic interaction of biological, psychological and sociocultural  factors. When diagnosing CPP, it is most acceptable to phenotype patients according to the UPOINTS classification. To implement the treatment strategy, it is necessary to adhere to a multidisciplinary personalized approach to pain management with active patient participation. Cognitive behavioral therapy (CBT) occupies an important place in the treatment of CPP. There is clinical and neurophysiological evidence of the efficiency of CBT in patients with CPP, a protocol has been developed for the combined use of CBT and physical therapy. CBT is recommended to be included in a comprehensive treatment and rehabilitation program for patients with CPP.

/pdf/chronic-pelvic-pain-from-correct-diagnosis-to-adequate-4alg97heo9.pdf

Chronic pelvic pain: from correct diagnosis to adequate therapy

Effectiveness of adaptol in the treatment of emotional disorders in patients with physical illnesses

Back Pain Phenotypes from the Perspective of the New D-TIMER Concept: From Clinical Heterogeneity to Personalised Therapy

Somatovegetative Disorders in General Practice: an Algorithm for General Practitioners. A Review

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