Psychotherapy With Somatosensory Stimulation for Endometriosis-Associated Pain: A Randomized Controlled Trial

Meissner, Karin; Schweizer-Arau, Annemarie; Limmer, Anna; Preibisch, Christine; Popovici, Roxana M.; Lange, Isabel; Oriol, Barbara de und Beissner, Florian (2017): Psychotherapy With Somatosensory Stimulation for Endometriosis-Associated Pain: A Randomized Controlled Trial. In: Obstetrical & Gynecological Survey, Bd. 72, Nr. 3: S. 163-165

Abstract

The underlying causal mechanisms for endometriosis are poorly understood. There is a weak correlation between the severity of organic pathology and reported pain intensity in women with endometriosis. Both systemic hormonal therapy and surgery improve symptoms of pelvic pain, but recurrence rates are high after the medication is discontinued or following surgery. A retrospective case study (Meissner 2010;Forsch Komplementarmed 17: 314) reported that a combination of psychotherapy and somatosensory stimulation (different techniques to stimulate acupuncture points) could be effective in improving pain and infertility associated with endometriosis, preferably when combined with other elements ofmultimodal pain therapy. This randomized controlled trial was designed to evaluate whether psychotherapy with somatosensory stimulation is effective for the treatment of pain and quality of life in patients with endometriosis-related pelvic pain. Eligible patients were adult females aged 18 to 40 years with a history of endometriosis and moderate to severe chronic pelvic pain. The predefined primary outcome was brain functional connectivity assessed by magnetic resonance imaging (MRI). The predefined secondary outcomes-maximal and average global pain, maximal pelvic pain, dyschezia, and dyspareunia-were assessed by validated 11-point numerical rating scales. Physical and mental quality of life was also assessed. Between March 2010 andMarch 2012, 67 patients (mean age, 35.6 years) were randomly assigned to intervention (n = 35) or wait-list control (n = 32). Follow-up data were available for 60 patients (90%) at 3 months, 41 patients (61%) at 6 months, and for 56 patients (84%) at 24 months. Compared with wait-list controls, patients in the intervention group showed improvements after 3 months in maximal global pain (mean group difference, -2.1;95% confidence interval [CI], -3.4 to -0.8;P = 0.002), average global pain (-2.5;95% CI, -3.5 to -1.4;P < 0.001), pelvic pain (-1.4;95% CI, -2.7 to -0.1;P = 0.036), dyschezia (-3.5;95% CI, -5.8 to -1.3;P = 0.003), physical quality of life (3.8;95% CI, 0.5-7.1, P = 0.026), and mental quality of life (5.9;95% CI, 0.6-11.3;P = 0.031). Improvements in dyspareunia did not differ significantly from wait-list controls (-1.8;95% CI, -4.4 to 0.7;P = 0.15). At 6 and 24 months, improvements in the intervention group remained stable, and after delayed intervention at 3 months, comparable symptom relief was achieved in the former control group at 6 and 12 months. These data show that psychotherapy with somatosensory stimulation reduces global pain, pelvic pain, and dyschezia and improved quality of life in a population of patients with endometriosis. Both groups showed stable improvements after 6 and 24 months, when all patients were treated.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0029-7828
• Sprache: Englisch