Pelvic adhesions are found in up to 50% of women with CPP during investigative surgeries and adhesiolysis is often performed as part of their management although the causal or casual association of adhesions, and the clinical benefit of adhesiolysis in the context of CPP is still unclear. Our aim was to test the hypothesis of whether laparoscopic adhesiolysis leads to significant pain relief and improvement in quality of life (QoL) in patients with chronic pelvic pain (CPP) and adhesions.
Methods: This was a double-blinded RCT.
This study was conducted in 2 tertiary referral hospitals in United Kingdom over 4 years. Women with chronic pelvic pain (CPP) were randomized into having laparoscopic adhesiolysis or diagnostic laparoscopy.
Women were assessed at 0, 3 and 6 months for Visual analogue scale scores (VAS) and Quality of Life (QoL) measures (SF-12 and EHP-30).
Results: A total of 92 participants were recruited; 50 qualified to be randomized, with 26 in the adhesiolysis and 24 in the control group. The results are expressed in median (interquartile ranges).
In women who underwent adhesiolysis, there was a significant improvement at 6 months in VAS scores (-17.5 (-36.0 - -5.0) compared to controls (-1.5 (-15.0 - 4.5; p = 0.048); SF-12 scores physical component score (25.0 (18.8 - 43.8)) compared to controls (6.3 (-6.3 - 18.8); p = 0.021), SF-12 emotional component score 32.5 (4.4 - 48.8) compared to controls -5 (-21.3 - 15.0); p <0 -5="" -="" .0074="" 15.0="" 32.5="" 48.8="" and="" being="" compared="" controls="" domain="" ehp-30="" emotional="" nbsp="" p="" span="" the="" to="" well="">
Conclusions: This study stopped before recruitment reached the statistically powered sample size due to difficulty with enrollment and lack of continued funding. In selected population of women presenting to the gynecological clinic with chronic pelvic pain, adhesiolysis in those who have adhesions may be of benefit in terms of improvement of pain and their quality of life.Trial registration number: ISRCTN 43852269 http://www.controlled-trials.com/isrctn/pf/43852269
Author: Ying C CheongIsobel ReadingSarah BaileyKhaled SadekWilliam LedgerTin C Li
Credits/Source: BMC Women's Health 2014, 14:36
http://7thspace.com/headlines/453858/should_women_with_chronic_pelvic_pain_have_adhesiolysis.html
Showing posts with label human suffering. Show all posts
Showing posts with label human suffering. Show all posts
Saturday, March 08, 2014
Saturday, March 01, 2014
More from Dr Koya Mesh Failure & MESH TRAINING and REGULATION
More from Dr Koya Mesh Failure & MESH TRAINING and REGULATION
Hanifa B. Koya FRCOG, FRANZCOG
Gynaecologist
Wakefield Specialist Medical Centre
Wellington, New Zealand
21 March 2013
MESH TRAINING and REGULATION
"It has been estimated that 50% of women by the age of 50 years will have some degree of pelvic
organ prolapse (POP) and at least 10% by the age of 80 will require surgery. The vaginal
prolapse is classified as anterior, posterior and apical (vaginal vault). POP has always been
considered a difficult problem to manage and in a significant percentage of patients the prolapse
surgery has a tendency to fail.
The surgeons invariably felt that the failure was due to the poor quality of the patient’s tissues
and therefore looked for a substitute for conventional vaginal repair. A synthetic mesh therefore
seemed the ideal material to use. There are many different types of meshes used in POP
surgery (biological, absorbable synthetic, nonabsorbable and composite). Nearly all of the
meshes used for POP repairs are nonabsorbable synthetic i.e. lightweight monofilament
polypropylene. Ideal mesh properties for POP surgery should result in minimal infection,
minimal inflammatory reaction and avoidance of excessive fibrosis."
"If the Medical Profession and the Regulatory Board were ‘in control’, we would not be seeing so
much unhappiness and Class Action. The patients are generally suspicious of Industries
wanting to sell their products, but want to trust the Doctors and the Regulators. One cannot
regulate everything and credentialing retains a certain degree of trust. A further report was
released by the FDA in 2011 which said that “there were an enormous number of serious,
unique complications with use of vaginal mesh and that these cases were just the tip of
a looming iceberg.”
. " I wrote to Medsafe for three years regarding another product (Spray Gel) and really got nowhere. Medsafe informed me that they did not have all the jurisdiction and because we did not have
FDA, they could only take limited action."
Dr Hanifa Koya was the doctor who was instrumental in stopping Confluent's adhesion barrier Spray Gel after realizing it was actually causing more adhesions as she re-operated on patients who had Spray Gel ( now SparyShield ) instilled
Thank you Dr Koya for saving us!
Hanifa B. Koya FRCOG, FRANZCOG
Gynaecologist
Wakefield Specialist Medical Centre
Wellington, New Zealand
21 March 2013
MESH TRAINING and REGULATION
"It has been estimated that 50% of women by the age of 50 years will have some degree of pelvic
organ prolapse (POP) and at least 10% by the age of 80 will require surgery. The vaginal
prolapse is classified as anterior, posterior and apical (vaginal vault). POP has always been
considered a difficult problem to manage and in a significant percentage of patients the prolapse
surgery has a tendency to fail.
The surgeons invariably felt that the failure was due to the poor quality of the patient’s tissues
and therefore looked for a substitute for conventional vaginal repair. A synthetic mesh therefore
seemed the ideal material to use. There are many different types of meshes used in POP
surgery (biological, absorbable synthetic, nonabsorbable and composite). Nearly all of the
meshes used for POP repairs are nonabsorbable synthetic i.e. lightweight monofilament
polypropylene. Ideal mesh properties for POP surgery should result in minimal infection,
minimal inflammatory reaction and avoidance of excessive fibrosis."
"If the Medical Profession and the Regulatory Board were ‘in control’, we would not be seeing so
much unhappiness and Class Action. The patients are generally suspicious of Industries
wanting to sell their products, but want to trust the Doctors and the Regulators. One cannot
regulate everything and credentialing retains a certain degree of trust. A further report was
released by the FDA in 2011 which said that “there were an enormous number of serious,
unique complications with use of vaginal mesh and that these cases were just the tip of
a looming iceberg.”
. " I wrote to Medsafe for three years regarding another product (Spray Gel) and really got nowhere. Medsafe informed me that they did not have all the jurisdiction and because we did not have
FDA, they could only take limited action."
Thank you Dr Koya for saving us!
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