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Novel Pelvic Floor Pain Measures to Enhance Female Pelvic Pain Evaluation

新型盆底疼痛措施可增强女性盆腔疼痛评估

基本信息

批准号：
8314121
负责人：
Frank Fu-sheng Tu
金额：
$ 10.8万
依托单位：
NORTHSHORE UNIVERSITY HEALTHSYSTEM
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-15 至 2013-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8314121
关键词：
Abdomen Accounting Address Affect Age Analgesics Anxiety Area Bladder Botulinum Toxins Cognitive Therapy Combined Modality Therapy Constipation Cross-Sectional Studies Data Detection Development Diagnosis Diagnostic Diagnostic tests Disease Disease Progression Disease model Distress Epidemiology Esthesia Etiology Evaluation Exhibits Failure Female Functional disorder Gastroenterology Genitourinary system Goals Gynecologic Gynecologist Gynecology Human Hypersensitivity Inflammation Inflammatory Injection of therapeutic agent Interstitial Cystitis Intervention Irritable Bowel Syndrome Measures Mental Depression Mentorship Methods Multi-Institutional Clinical Trial Muscle Myalgia Natural History Neurologic Neurology Observational Study Outcome Study Pain Pain Assessment Tool Pain Disorder Pain Measurement Pain Threshold Pain intensity Pain-Free Palpation Pathway interactions Patients Pelvic Floor Muscle Pelvic Pain Pelvic floor structure Pelvis Peripheral Physical therapy Physiological Physiology Psychological Factors Psychology Qualifying Recording of previous events Relative (related person)Reporting Research Research Personnel Role Screening procedure Severities Structure Symptoms Syndrome Testing Time Tissues Training Universities Urology Vagina Validation Visceral Visceral pain Vulvodynia Wisconsin Woman Work base biopsychosocial burden of illness case control central sensitization chronic pelvic pain clinically relevant design disability dorsal horn effective therapy experience improved innovation insight instrument levator ani muscle male men novel obturator muscle painful bladder syndrome painful neuropathy pressure programs prospective psychologic reproductive response tool urologic

项目摘要

DESCRIPTION (provided by applicant): A major shortcoming in the present diagnostic framework for painful bladder syndrome (PBS) and related pelvic pain disorders is the failure to incorporate objective measures of pain sensitivity. As a gynecologist, the applicant's long-term research goal is to define modifiable disease mechanisms in urogenital pain syndromes. Through the present application, he seeks training in the physiological assessment of pain in order to mechanistically subtype pelvic pain patients. At present, failure to systematically diagnose heterogeneous etiologies in pelvic pain hinders the rational use of specific interventions. A two part-program is proposed. First, under a structured program of mentorship (drawn from gynecology, urology, gastroenterology, psychology, physiology, and neurology) he will study relevant pain physiology and pertinent correlates of the human pain experience. The candidate will engage in both formal didactic and experiential training in design of multi-site clinical trials, assessment of pain physiology in diseased states, and characterization of psychological determinants of pain experience. Simultaneously, he will gain practical experience while conducting a prospective observational study of one important but understudied aspect of PBS and related pelvic pain syndromes: pelvic floor pain dysfunction. The central hypothesis is that women suffering from PBS have increased pelvic floor pain sensitivity (i.e., worse pain when the muscles are examined by a clinician) compared to healthy controls. This hypothesis will be tested using three specific aims: 1) Determine whether pelvic floor (somatic) pain sensitivity is enhanced in PBS; 2) Determine correlates of enhanced bladder (visceral) pain sensitivity; and 3) To correlate urogenital distress among PBS patients and pain-free controls with pelvic muscle pain sensitivity, visceral pain sensitivity, and psychological factors. The approach is innovative, by employing accepted pain assessment tools to an important, understudied area: the pelvic floor musculature. The research proposed in this application is significant for improving diagnosis of PBS and other pelvic pain syndromes in both women and men. Objective, valid measures of pelvic floor pain dysfunction will allow rational application of mechanism-specific treatments, such as physical therapy, neuropathic pain medications, cognitive-behavioral therapy, or botulinum toxin injections. Public Narrative: The outcomes of this study will likely enhance our approach to the assessment of pain symptomatology not only in PBS, but in all pelvic pain syndromes associated with pelvic floor sensitivity or irritative voiding symptoms.

描述（由申请人提供）：目前膀胱疼痛综合征（PBS）和相关盆腔疼痛疾病诊断框架的主要缺点是未能纳入疼痛敏感性的客观测量。作为一名妇科医生，申请人的长期研究目标是确定泌尿生殖道疼痛综合征中可改变的疾病机制。通过本申请，他寻求疼痛的生理评估方面的培训，以便机械地对骨盆疼痛患者进行分型。目前，未能系统地诊断盆腔疼痛的异质性病因阻碍了特定干预措施的合理使用。提出了一个由两部分组成的方案。首先，在一个结构化的导师计划（来自妇科，泌尿科，胃肠病学，心理学，生理学和神经学）下，他将研究相关的疼痛生理学和人类疼痛体验的相关相关因素。候选人将参与多中心临床试验设计的正式教学和体验培训，疾病状态下疼痛生理学的评估以及疼痛体验的心理决定因素的表征。同时，他将获得实践经验，同时进行一项前瞻性观察性研究，研究PBS和相关盆腔疼痛综合征的一个重要但研究不足的方面：盆底疼痛功能障碍。中心假设是患有PBS的女性具有增加的骨盆底疼痛敏感性（即，当临床医生检查肌肉时，疼痛更严重）。将使用三个特定目的来检验该假设：1）确定PBS中骨盆底（躯体）疼痛敏感性是否增强; 2）确定膀胱（内脏）疼痛敏感性增强的相关性;以及3）将PBS患者和无痛对照组中的泌尿生殖道窘迫与骨盆肌肉疼痛敏感性、内脏疼痛敏感性和心理因素相关联。该方法是创新的，通过采用公认的疼痛评估工具，一个重要的，研究不足的领域：骨盆底肌肉组织。本申请中提出的研究对于改善女性和男性的PBS和其他盆腔疼痛综合征的诊断具有重要意义。目的：骨盆底疼痛功能障碍的有效措施将允许合理应用机制特异性治疗，如物理治疗，神经性疼痛药物，认知行为治疗或肉毒杆菌毒素注射。公开叙述：这项研究的结果可能会提高我们的方法，不仅在PBS中，但在所有与盆底敏感或刺激性排尿症状相关的盆腔疼痛综合征的疼痛病理学的评估。