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Are fascial strains involved in chronic pelvic pain syndrome? An exploratory matched case–control study

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Abstract

Background

Chronic pelvic pain (CPP) and chronic pelvic pain syndrome (CPPS) do not have a definite cause, even if their impact on quality of life was demonstrated. Furthermore, there is evidence of myofascial dysfunctions in a large number of CPP/CPPS, so that the role of fascia can be hypothesized.

Methods

The aim of this exploratory matched case–control study was to assess whether fascial strains (FS) represent a factor associated with CPP/CPPS. The study followed the “Strengthening the Reporting of Observational Studies in Epidemiology” (STROBE) statement. We collected data from 189 subjects (cases: 58; controls: 131) who attended the clinic. The participants were managed through a 2:1 enrollment ratio. A standardized booklet requested for clinical information, previous FS and the following questionnaires: “National Institutes of Health Chronic Prostatitis Symptom Index” (NIH-CPSI), “Hospital Anxiety and Depression Scale” (HADS), “Fear Avoidance Belief Questionnaire” (FABQ). Each subject underwent a palpatory assessment to detect abnormal palpatory findings in the pelvic area.

Results

The analyses showed that episiotomy, genito-urinary infections and surgery had a significantly increased odds ratio (OR) of 4.13, 3.1 and 3.08, respectively. FS as a whole had a significantly raised OR: 2.22 (1.14 to 4.33). The analysis was adjusted for physical activity and for type of job and OR decreased to 1.94 (0.82 to 4.61), losing its significance (p = 0.129). A strong correlation between symptoms’ impact and CPP/CPPS was detected (rpbs = 0.710; p < 0.001) and a moderate one (0.3 < rpbs < 0.7; p < 0.001) was found considering anxiety, depression and abnormal palpatory findings.

Conclusion

This exploratory study suggests that FS could represent an etiological factor for developing CPP/CPPS. However, further research on fascial dysfunctions and relative implications in CPP/CPPS is needed for confirmation.

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Data availability

The data that support the findings of this study are available from the corresponding author, [FDF], upon reasonable request.

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This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Author notes

  1. Daniele Origo and Fulvio Dal Farra contributed equally to the work.

Authors and Affiliations

  1. Research Department, SOMA Osteopathic Institute Milan, Viale Sarca 336 F, 20126, Milan, Italy

    Daniele Origo, Fulvio Dal Farra, Maria Federica Bruni, Andrea Catalano, Lorenzo Marzagalli & Irene Bruini

  2. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy

    Fulvio Dal Farra

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  1. Daniele Origo
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by DO, FDF, MFB, AC, LM and IB. Data analysis was done by FDF and IB. The first draft of the manuscript was written by FDF and DO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Fulvio Dal Farra.

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Origo, D., Dal Farra, F., Bruni, M.F. et al. Are fascial strains involved in chronic pelvic pain syndrome? An exploratory matched case–control study. Int Urol Nephrol 55, 511–518 (2023). https://doi.org/10.1007/s11255-022-03448-2

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