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Pain Symptoms in Fibromyalgia Patients with and without Provoked Vulvodynia.

Ghizzani A, Di Sabatino V, Suman AL, Biasi G, Santarcangelo EL, Carli G - Pain Res Treat (2014)

Bottom Line: The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls.Conclusions.Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Medicine and Development, Siena University Hospital, 53100 Siena, Italy.

ABSTRACT
Objective. The aim of the study was to compare the pain symptoms of fibromyalgia patients exhibiting (FMS+PVD) and not exhibiting (FMS) comorbidity with provoked vulvodynia. Study Design. The case control study was performed in 39 patients who had been diagnosed with FMS and accepted to undergo gynaecological examination and in 36 healthy women (C). All patients completed standardized questionnaires for pain intensity, pain area, and psychological functioning. The gynaecological examination included vulvar pain pressure reactivity (Q-tip), pelvic tone assessment (Kegel manoeuver), and a semistructured interview collecting detailed information about pelvic symptoms and sexual function. Results. FMS+PVD patients displayed a higher number of associated symptoms than FMS patients. The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls. Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients. Conclusions. The study reveals that increased vulvar pain excitability may occur in FMS patients independently of the presence of coital pain. Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.

No MeSH data available.


Related in: MedlinePlus

Widespread pain intensity. Pain scores (VAS = 0–100) in Kegel positive and Kegel negative FMS + PVD patients and in FMS patients.
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fig3: Widespread pain intensity. Pain scores (VAS = 0–100) in Kegel positive and Kegel negative FMS + PVD patients and in FMS patients.

Mentions: Pelvic floor hypertonicity did not occur in C and FMS patients, but was present in 10 out of 21 FMS + PVD patients. Multivariate ANOVA on quantitative sensory testing values and questionnaires scores of FMS patients and FMS + PVD patients positive and negative to the Kegel manoeuvre revealed significant differences in widespread pain intensity (VAS (F(1,37) = 7.038, P < 0.013), STAI-Y2 (F(1,37) = 3.966, P < 0.034) and CES-D (F(1,37) = 3.879, P < 0.031). Widespread pain intensity (Figure 3) was significantly higher in Kegel positive FMS + PVD than in FMS patients (F(1,20) = 4.467, P < 0.047) and not significantly different between Kegel negative FMS + PVD and FMS patients. Questionnaires scores did not differ significantly between FMS and the two FMS + PVD subgroups. Within the FMS + PVD patients, the subgroup with pelvic floor hypertonicity was significantly different from the subgroup without pelvic floor hypertonicity (Figure 3). In fact, Kegel positive FMS + PVD patients exhibited higher widespread pain intensity (VAS, t(1,20) = 4.064, P < 0.0001) (Figure 3), anxiety (STAI-Y2, t(1,20) = 4.054, P < 0.002); Kegel positive (Mean ± SD): 54.17 ± 5.94; Kegel-negative: 41.30 ± 6.46), and depression levels (CES-D, t(1,20) = 2.546, P < 0.05; Kegel positive: 30.50 ± 13.87; Kegel negative: 15.75 ± 7.74).


Pain Symptoms in Fibromyalgia Patients with and without Provoked Vulvodynia.

Ghizzani A, Di Sabatino V, Suman AL, Biasi G, Santarcangelo EL, Carli G - Pain Res Treat (2014)

Widespread pain intensity. Pain scores (VAS = 0–100) in Kegel positive and Kegel negative FMS + PVD patients and in FMS patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3927857&req=5

fig3: Widespread pain intensity. Pain scores (VAS = 0–100) in Kegel positive and Kegel negative FMS + PVD patients and in FMS patients.
Mentions: Pelvic floor hypertonicity did not occur in C and FMS patients, but was present in 10 out of 21 FMS + PVD patients. Multivariate ANOVA on quantitative sensory testing values and questionnaires scores of FMS patients and FMS + PVD patients positive and negative to the Kegel manoeuvre revealed significant differences in widespread pain intensity (VAS (F(1,37) = 7.038, P < 0.013), STAI-Y2 (F(1,37) = 3.966, P < 0.034) and CES-D (F(1,37) = 3.879, P < 0.031). Widespread pain intensity (Figure 3) was significantly higher in Kegel positive FMS + PVD than in FMS patients (F(1,20) = 4.467, P < 0.047) and not significantly different between Kegel negative FMS + PVD and FMS patients. Questionnaires scores did not differ significantly between FMS and the two FMS + PVD subgroups. Within the FMS + PVD patients, the subgroup with pelvic floor hypertonicity was significantly different from the subgroup without pelvic floor hypertonicity (Figure 3). In fact, Kegel positive FMS + PVD patients exhibited higher widespread pain intensity (VAS, t(1,20) = 4.064, P < 0.0001) (Figure 3), anxiety (STAI-Y2, t(1,20) = 4.054, P < 0.002); Kegel positive (Mean ± SD): 54.17 ± 5.94; Kegel-negative: 41.30 ± 6.46), and depression levels (CES-D, t(1,20) = 2.546, P < 0.05; Kegel positive: 30.50 ± 13.87; Kegel negative: 15.75 ± 7.74).

Bottom Line: The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls.Conclusions.Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.

View Article: PubMed Central - PubMed

Affiliation: Department of Molecular Medicine and Development, Siena University Hospital, 53100 Siena, Italy.

ABSTRACT
Objective. The aim of the study was to compare the pain symptoms of fibromyalgia patients exhibiting (FMS+PVD) and not exhibiting (FMS) comorbidity with provoked vulvodynia. Study Design. The case control study was performed in 39 patients who had been diagnosed with FMS and accepted to undergo gynaecological examination and in 36 healthy women (C). All patients completed standardized questionnaires for pain intensity, pain area, and psychological functioning. The gynaecological examination included vulvar pain pressure reactivity (Q-tip), pelvic tone assessment (Kegel manoeuver), and a semistructured interview collecting detailed information about pelvic symptoms and sexual function. Results. FMS+PVD patients displayed a higher number of associated symptoms than FMS patients. The vulvar excitability was significantly higher in FMS+PVD than in FMS and in both groups than in Controls. Half of FMS+PVD patients were positive to Kegel manoeuver and displayed higher scores in widespread pain intensity, STAI-Y2, and CESD levels than Kegel negative patients. Conclusions. The study reveals that increased vulvar pain excitability may occur in FMS patients independently of the presence of coital pain. Results suggest that coital pain develops in patients with higher FMS symptoms severity due to the cooperative effects of peripheral and central sensitization mechanisms.

No MeSH data available.


Related in: MedlinePlus