A Cochrane review [Abstract] 2 about non-surgical interventions for the management of chronic pelvic pain included 13 studies, with a total of 750 subjects. MPA was more effective than placebo at the end of treatment in terms of the number of women achieving a greater than 50% reduction in visual analogue scale (VAS) pain score immediately after treatment (Peto OR 3.00, 95% CI 1.70 to 5.31, 2 studies, n=204). Evidence of benefit was maintained up to nine months. Head-to-head comparisons showed that women taking goserelin had greater improvement in pelvic pain score (MD 3, 95% CI 2.08 to 3.92, 1 study, n=47) at one year than those taking progestogen. The study comparing goserelin versus progestogen did not report on adverse effects.
Women who underwent reassurance ultrasound scans and received counselling were more likely to report improved pain than those treated with a standard 'wait and see' policy (Peto OR 6.77, 95% CI 2.83 to 16.19, n = 90).
Distension of painful pelvic structures was more effective for pain when compared with counselling (MD 35.8, 95% CI 23.08 to 48.52 on a zero to 100 scale, one study, n=48). No difference in pain levels was observed when magnetic therapy was compared with use of a control magnet.
Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison).
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