Cochrane · systematic review · CD008797
Non‐surgical interventions for the management of chronic pelvic pain
Cheong, YC, Smotra, G, Williams, ACDC · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
Gynaecology and FertilityAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
17
current version
GRADE rated
16
No studies
1
Included studies
NR
No studies 1 · 5.9%Ungraded 0 · 0%Very low 3 · 17.6%Low 5 · 29.4%Moderate 6 · 35.3%High 2 · 11.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Medical treatment compared with placebo for the management of chronic pelvic pain
Population: women with chronic pelvic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Improvement in pain score at end of treatment: progesterone versus placebo Medical treatment vs placebo | Peto OR 3 [1.7, 5.31] | 204 participants | Moderate |
Improvement in pain score (up to nine months after treatment): progesterone versus placebo Medical treatment vs placebo | Peto OR 2.09 [1.18, 3.71] | 204 participants | Moderate |
Weight gain: progesterone versus placebo Medical treatment vs placebo | Peto OR 7.82 [3.28, 18.65] | 85 participants | High |
Bloatedness: progesterone versus placebo Medical treatment vs placebo | Peto OR 3.2 [1.37, 7.47] | 85 participants | High |
Improvement in pain score: lofexidine versus placebo Medical treatment vs placebo | Peto OR 0.42 [0.11, 1.61] | 39 participants | Low |
Drowsiness/lethargy: lofexidine versus placebo Medical treatment vs placebo | Peto OR 3.8 [1.09, 13.26] | 39 participants | Moderate Downgraded: imprecision |
Dry mouth: lofexidine versus placebo Medical treatment vs placebo | Peto OR 8.6 [2.44, 30.31] | 39 participants | Moderate Downgraded: imprecision |
Medical treatment of chronic pelvic pain: head‐to‐head comparisons
Population: management of chronic pelvic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Improvement in pelvic pain at one year: goserelin versus progestogen | no estimate extracted | 47 participants | Moderate Downgraded: risk of bias |
Pain at 24 months: gabapentin versus amytriptyline | no estimate extracted | 40 participants | Low Downgraded: risk of bias |
CI: Confidence interval. | no estimate extracted | NR | No studies |
Psychological therapy compared with control interventions for the management of chronic pelvic pain
Population: women with chronic pelvic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Improvement in pain scores—Ultrasound scan and counselling session versus 'wait and see' Psychological therapy vs control interventions | Peto OR 6.77 [2.83, 16.19] | 90 participants | Low Downgraded: risk of bias |
Improvement in pain scores—Somatocognitive therapy (Mensendieck) versus standard gynaecological clinical care Psychological therapy vs control interventions | Peto OR 3.38 [0.97, 11.8] | 40 participants | Very low Downgraded: risk of bias, imprecision |
Improvement in pain scores—Integrated approach (somatic, psychological, dietary, environmental and physiotherapeutic factors) versus standard care Psychological therapy vs control interventions | Peto OR 1.52 [0.71, 3.27] | 106 participants | Low Downgraded: risk of bias, imprecision |
Improvement in pain scores—Writing therapy (disclosure of pain) versus non‐disclosure Psychological therapy vs control interventions | Peto OR 4.47 [1.41, 14.13] | 48 participants | Very low Downgraded: risk of bias, imprecision |
Improvement in pain scores—Psychotherapy versus placebo, measured at end of treatment Psychological therapy vs control interventions | Peto OR 0.79 [0.24, 2.59] | 51 participants | Low Downgraded: risk of bias, imprecision |
Complementary therapy compared with control interventions for the management of chronic pelvic pain
Population: women with chronic pelvic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Reduction in pain score: distension of painful pelvic structures versus counselling Complementary therapy vs control interventions | no estimate extracted | 48 participants | Moderate Downgraded: risk of bias |
Pain score after treatment: magnetic therapy versus control magnet Complementary therapy vs control interventions | no estimate extracted | 19 participants | Very low Downgraded: risk of bias, imprecision |