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• W2054573765 abstract "Démembrer les douleurs pelvipérinéales complexes et proposer un schéma de prise en charge adapté aux symptômes. Analyse de la littérature consacrée aux différentes douleurs pelviennes fonctionnelles. On retrouve une fréquence élevée d’associations des pathologies douloureuses pelviennes entre elles ; syndrome douloureux de la vessie (cystite interstitielle), syndrome de l’intestin irritable, douleurs de l’endométriose, vulvodynie, syndrome douloureux pelvien chronique (prostatite chronique). Les douleurs pelviennes sont souvent associées aux pathologies douloureuses type fibromyalgie ou syndrome douloureux régional complexe (algodystrophie). Les mécanismes physiopathologiques impliquées dans ces pathologies sont toutes très proches évoquant un élément déclenchant, une inflammation neurogène, des réponses réflexes musculaires et végétatives, une hypersensibilisation centrale, des réactions émotionnelles et des conséquences bio-psychosociales. Le concept de douleur viscérale évolue et devant des douleurs pelviennes complexes, de façon pragmatique, on peut isoler des composantes d’ordre neuropathique, des composantes de syndrome douloureux régional complexe, des composantes d’hypersensibilisation, des composantes émotionnelles proches d’un syndrome de stress post-traumatique. Quand on ne peut expliquer la douleur par une pathologie de l’organe, il faut considérer que la douleur s’exprime à travers l’organe. La douleur pelvipérinéale chronique peut s’autonomiser, un démembrement de ses mécanismes permettra d’envisager des propositions thérapeutiques personnalisées. Analysis of complex pelvic and perineal pain. Review of the literature concerning the various types of functional pelvic pain. Various forms of pelvic pain are frequently associated: painful bladder syndrome (interstitial cystitis), irritable bowel syndrome, endometriosis pain, vulvodynia, chronic pelvic pain syndrome (chronic prostatitis). Pelvic pain is often associated with fibromyalgia or complex regional pain syndrome (reflex sympathetic dystrophy). The pathophysiological mechanisms involved in these syndromes are all very similar, suggesting a triggering element, neurogenic inflammation, reflex muscular and autonomic responses, central hypersensitization, emotional reactions and biopsychosocial consequences. The concept of visceral pain is evolving and, in practice, complex pelvic pain can comprise neuropathic components, complex regional pain syndrome components, hypersensitization components, and emotional components closely resembling posttraumatic stress syndrome. When pain cannot be explained by an organ disease, the pain must be considered to be expressed via this organ. Chronic pelvic and perineal pain can become self-perpetuating and identification of its various mechanisms can allow the proposal of individually tailored treatments." @default.
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• W2054573765 date "2010-11-01" @default.
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• W2054573765 title "Approche globale des douleurs pelvipérinéales chroniques : du concept de douleur d’organe à celui de dysfonctionnement des systèmes de régulation de la douleur viscérale" @default.
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• W2054573765 doi "https://doi.org/10.1016/j.purol.2010.08.056" @default.
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