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The role of immunoenzymatic therapy in the management of vestibulodynia associated with painful bladder syndrome

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DOI: 10.4236/ojog.2013.34A003    4,415 Downloads   5,769 Views   Citations

ABSTRACT

Background: Vestibulodynia (VBD) and painful bladder syndrome (PBS) are two common and often concomitant conditions. Objective: To assess the effectiveness of an enzymatic combination of papain, bromelain, trypsin, chymotrypsin and quercetin in the supportive treatment of VBD/PBS, patients underwent TENS + amitriptyline and pregabalin therapy as a multimodal treatment strategy. Method: 40 patients were randomly assigned to receive a systemic therapy: amitriptyline + pregabalin (Group A) versus amitriptyline + Pregabalin plus a systemic enzyme preparation (Group B). All patients received a transcutaneous electric nerve stimulation (TENS) therapy in a self-administered domiciliary protocol. Results: The VAS and the dyspareunia score after the treatment showed a significant difference in the two groups (VAS: Group A difference of 4.3, Group B difference of 3.1, p = 0.005; dyspareunia: Group A and Group B 1.8 vs. 0.8, p = 0.005). Conclusion: The positive results of our study prove the utility effectiveness of an enzyme combination to decrease and normalize the biomarkers of inflammation in VBD and PBS patients in a multimodal approach.

Conflicts of Interest

The authors declare no conflicts of interest.

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Murina, F. , Felice, R. , Francesco, S. and Mantegazza, V. (2013) The role of immunoenzymatic therapy in the management of vestibulodynia associated with painful bladder syndrome. Open Journal of Obstetrics and Gynecology, 3, 16-19. doi: 10.4236/ojog.2013.34A003.

References

[1] Moyal-Barracco, M. and Lynch, P.J. (2004) ISSVD terminology and classification of vulvodynia: A historical perspective. The Journal of Reproductive Medicine, 49, 772-777.
[2] Haefner, H.K., Collins, M.E., Davis, G.D., Edwards, L., Foster, D.C., Hartmann, E.D., et al. (2005) The vulvodynia guideline. Journal of Lower Genital Tract Disease, 9, 40-51. doi:10.1097/00128360-200501000-00009
[3] Butrick, C.W. (2003) Interstitial cystitis and chronic pelvic pain: New insights in neuropathology, diagnosis, and treatment. Clinical Obstetrics and Gynecology, 46, 811-823. doi:10.1097/00003081-200312000-00011
[4] Van de Merwe, J.P., Nordling, J., Bouchelouche, P., et al. (2007) Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: An ESSIC proposal. European Urology, 53, 60-67.
[5] Mccormack, W.M. (1990) Two urogenital sinus syndromes: Interstitial cystitis and focal vulvitis. The Journal of Reproductive Medicine, 35, 873-876.
[6] Peters, K., Girdler, B., Carrico, D., et al. (2008) Painful bladder syndrome/interstitial cystitis and vulvodynia: A clinical correlation. International Urogynecology Journal and Pelvic Floor Dysfunction, 19, 665-669.
[7] Myers, D.L. and Aguilar, V.C. (2002) Gynecologic manifestations of interstitial cystitis. Clinical Obstetrics and Gynecology, 45, 233-241. doi:10.1097/00003081-200203000-00024
[8] Bornstein, J., Goldschmid, N. and Sabo, E. (2004) Hyperinnervation and mast cell activation may be used as histopathologic diagnostic criteria for vulvar vestibulitis. Gynecologic and Obstetric Investigation, 58, 171-178. doi:10.1159/000079663
[9] Metts, J.F. (2001) Interstitial cystitis: Urgency and frequency syndrome. American Family Physician, 64, 1199-1206.
[10] Friedrich Jr., E.G. (1987) Vulvar vestibulitis syndrome. The Journal of Reproductive Medicine, 32, 110-114.
[11] Marinoff, S.C. and Turner, M.L.C. (1992) Vulvar vestibulitis syndrome. Dermatologic Clinics, 10, 435-444.
[12] Murina, F., Bianco, V., Radici, G., Felice, R., Di Martino, M. and Nicolini, U. (2008) Transcutaneous electrical nerve stimulation to treat vestibulodynia: A randomized controlled trail. BJOG: An International Journal of Obstetrics & Gynaecology, 115, 1165-1170. doi:10.1111/j.1471-0528.2008.01803.x
[13] Paxton, S. (1980) Clinical use of TENS: A survey of physical therapists. Physical Therapy, 60, 38-44.
[14] Robinson, A.J. and Snyder-Mackler, L., Eds. (2008) Clinical electrophysiology. Lippincott Williams & Wilkins, Philadelphia, 107-149.
[15] Lauer, D., Reichenbach, A. and Birkenmeier, G. (2001) Alpha 2-macroglobulin-mediated degradation of amyloid beta 1-42: A mechanism to enhance amyloid beta catabolism. Experimental Neurology, 167, 385-392. doi:10.1006/exnr.2000.7569
[16] Mettenburg, J.M. and Gonias, S.L. (2005) Beta-amyloid peptide binds equivalently to binary and ternary alpha2-macroglobulin-protease complexes. The Protein Journal, 24, 89-93. doi:10.1007/s10930-004-1515-7
[17] Kandere-Grzybowska, K., et al. (2006) Regulation of IL-1-induced selective IL-6 release from human mast cells and inhibition by quercetin. British Journal of Pharmacology, 148, 208-215. doi:10.1038/sj.bjp.0706695

  
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