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Urolithiasis

, Volume 47, Issue 6, pp 575–581 | Cite as

Does extracorporeal shock wave lithotripsy-related pain get affected by menstrual cycle and menopause?

  • Ekrem IslamogluEmail author
  • Selim Tas
  • Kaan Karamik
  • Soner Yalcinkaya
  • Husnu Tokgoz
  • Murat Savas
Original Paper
  • 60 Downloads

Abstract

The objective of the study was to investigate the effect of the menstrual cycle and menopause on extracorporeal shock wave lithotripsy (ESWL)-related pain outcome. Since March 2017, we evaluated a total of 145 women who underwent the first session of ESWL for renal or ureteral stones. Patients were divided into two groups, as menstruating and menopaused women. For menstruating women, the number of days between the last day of mens and ESWL was noted and women were separated as in the follicular phase (1–14 days) or in the luteal phase (15–30 days) of menstruation. To control these two female groups, 149 men of similar age were included in the study. After the procedure, the experienced pain was recorded on a ten-point visual analog scale (VAS) by the patient and they also rated the severity of pain as no, mild, tolerable, and intolerable on the pain questionnaire. The mean age of the patients was 43 ± 15 years for the female group and 42 ± 13 years for the male group. While stone burden was not different between the female and male groups (p = 0.459), VAS score was not statistically different between genders (p = 0.293). However, men reported a higher rate of mild pain, while women reported a higher rate of tolerable pain (p = 0.008) in the pain questionnaire. Mean VAS score was significantly lower for the menopaused women group than menstruating women, young and old men (p = 0.001). In a subgroup analysis, menopaused women group reported lower VAS score and better pain questionnaire result than menstruating women (p < 0.001). There was no statistically significant difference between the follicular and luteal phase of the menstrual cycle in terms of mean VAS score and pain questionnaire results (p = 0.891 and 0.441, respectively). When compared with the young men group, the only significant difference was pain questionnaire results between women in the luteal phase (p = 0.014). Multiple regression analysis showed that only menstruation (β = 0.639, p < 0.001) was an independent factor for VAS score. Menstrual cycle phase had no effect on pain perception during the ESWL session and menopaused women felt less pain than menstruating women during this procedure. The control male group showed that the reduction of ESWL-related pain in menopause was not related to aging.

Keywords

Extracorporeal shock wave lithotripsy Menopause Menstrual cycle Pain Visual analog scale 

Notes

Acknowledgements

The authors would like to thank Dr.Basak Oguz and appreciate her support for the statistical analysis of this study.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2016) EAU guidelines on interventional treatment for urolithiasis. Eur Urol 69(3):475–482PubMedCrossRefGoogle Scholar
  2. 2.
    Eryıldırım B, Kuyumcuoğlu U, Tarhan F, Faydacı G, Uruç F (2009) Comparison of three analgesic treatment protocols for pain management during extracorporeal shock wave lithotripsy. Urol Int 82(3):276–279PubMedCrossRefGoogle Scholar
  3. 3.
    Racine M, Tousignant-Laflamme Y, Kloda LA, Dion D, Dupuis G, Choinière M (2012) A systematic literature review of 10 years of research on sex/gender and experimental pain perception—Part 1: Are there really differences between women and men? Pain 153(3):602–618PubMedCrossRefGoogle Scholar
  4. 4.
    Gibson SJ, Helme RD (2001) Age-related differences in pain perception and report. Clin Geriatr Med 17(3):433–456PubMedCrossRefGoogle Scholar
  5. 5.
    Greenwald HP (1991) Interethnic differences in pain perception. Pain 44(2):157–163PubMedCrossRefGoogle Scholar
  6. 6.
    Wise EA, Price DD, Myers CD, Heft MW, Robinson ME (2002) Gender role expectations of pain: relationship to experimental pain perception. Pain 96(3):335–342PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Riley JL III, Robinson ME, Wise EA, Myers CD, Fillingim RB (1998) Sex differences in the perception of noxious experimental stimuli: a meta-analysis. Pain 74(2–3):181–187PubMedCrossRefGoogle Scholar
  8. 8.
    Wiesenfeld-Hallin Z (2005) Sex differences in pain perception. Gend Med 2(3):137–145PubMedCrossRefGoogle Scholar
  9. 9.
    Craft RM, Mogil JS, Aloisi AM (2004) Sex differences in pain and analgesia: the role of gonadal hormones. Eur J Pain 8(5):397–411PubMedCrossRefGoogle Scholar
  10. 10.
    Vella M, Caramia M, Maltese M, Melloni D, Caramia G (2007) ESWL prediction of outcome and failure prevention. Urol Int 79(Suppl. 1):47–50PubMedCrossRefGoogle Scholar
  11. 11.
    Robert M, Lanfrey P, Rey G, Guiter J, Navratil H (1999) Analgesia in piezoelectric SWL: comparative study of kidney and upper ureter treatments. J Endourol 13(6):391–395PubMedCrossRefGoogle Scholar
  12. 12.
    Kiaei MM, Mohaghegh MR, Movaseghi G, Ghorbanlo M (2018) Enteral diclofenac controls pain and reduces intravenous injection during extracorporeal shock wave lithotripsy. Eur J Transl Myol 28(2):7353PubMedPubMedCentralGoogle Scholar
  13. 13.
    Tokgöz H, Yalçınkaya S, İslamoğlu E, Karamık K, Tokgöz Ö, Savaş M (2017) Lunar cycle may have an effect on Shock Wave Lithotripsy related pain outcome. Ghana Med J 51(4):181–186PubMedPubMedCentralGoogle Scholar
  14. 14.
    Ojha A, Shep D, Nivsarkar M, Patel S, Jaiswal V, Padh H (2009) Pharmacokinetic profile of a new formulation of injection diclofenac designed for intradeltoid use. Expert Opin Pharmacother 10(4):517–522PubMedCrossRefGoogle Scholar
  15. 15.
    Pogatzki-Zahn E (2013) Hormones and pain—a “rebirth”. Pain 154(4):495–496PubMedCrossRefGoogle Scholar
  16. 16.
    Fillingim RB (2000) Sex, gender, and pain: women and men really are different. Curr Rev Pain 4(1):24–30PubMedCrossRefGoogle Scholar
  17. 17.
    Altok M, Akpinar A, Güneş M, Umul M, Demirci K, Baş E (2016) Do anxiety, stress, or depression have any impact on pain perception during shock wave lithotripsy?. Can Urol Assoc J 10(5–6):E171PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Berwin JT, El-Husseiny T, Papatsoris AG, Hajdinjak T, Masood J, Buchholz N (2009) Pain in extracorporeal shock wave lithotripsy. Urol Res 37(2):51–53PubMedCrossRefGoogle Scholar
  19. 19.
    Iacovides S, Avidon I, Baker FC (2015) Does pain vary across the menstrual cycle? A review. Eur J Pain 19(10):1389–1405PubMedCrossRefGoogle Scholar
  20. 20.
    Pamuk ON, Cakir N (2005) The variation in chronic widespread pain and other symptoms in fibromyalgia patients. The effects of menses and menopause. Clin Exp Rheumatol 23(6):778PubMedGoogle Scholar
  21. 21.
    Fillingim RB, Ness TJ (2000) Sex-related hormonal influences on pain and analgesic responses. Neurosci Biobehav Rev 24(4):485–501PubMedCrossRefGoogle Scholar
  22. 22.
    Rezaii T, Hirschberg AL, Carlström K, Ernberg M (2012) The influence of menstrual phases on pain modulation in healthy women. J Pain 13(7):646–655PubMedCrossRefGoogle Scholar
  23. 23.
    Hanci V, Ayoglu H, Yilmaz M, Yurtlu S, Okyay RD, Erdogan G, Turan I (2010) Effect of menstrual cycle on the injection pain due to propofol. Eur J Anaesthesiol 27(5):425–427PubMedCrossRefGoogle Scholar
  24. 24.
    Stening K, Eriksson O, Wahren L, Berg G, Hammar M, Blomqvist A (2007) Pain sensations to the cold pressor test in normally menstruating women: comparison with men and relation to menstrual phase and serum sex steroid levels. Am J Physiol Regul Integr Comp Physiol 293(4):R1711–R1716PubMedCrossRefGoogle Scholar
  25. 25.
    Vignolo V, Vedolin GM, de Araujo CDRP, Conti PCR (2008) Influence of the menstrual cycle on the pressure pain threshold of masticatory muscles in patients with masticatory myofascial pain. Oral Surg Oral Med Oral Pathol Oral Radiol 105(3):308–315CrossRefGoogle Scholar
  26. 26.
    Kowalczyk WJ, Evans SM, Bisaga AM, Sullivan MA, Comer SD (2006) Sex differences and hormonal influences on response to cold pressor pain in humans. J Pain 7(3):151–160PubMedCrossRefGoogle Scholar
  27. 27.
    Meriggiola MC, Nanni M, Bachiocco V, Vodo S, Aloisi AM (2012) Menopause affects pain depending on pain type and characteristics. Menopause 19(5):517–523PubMedCrossRefGoogle Scholar
  28. 28.
    Gratz I, Allen E, Afshar M, Joslyn AF, Buxbaum J, Prilliman B (1996) The effects of the menstrual cycle on the incidence of emesis and efficacy of ondansetron. Anesth Analg 83(3):565–569PubMedCrossRefGoogle Scholar
  29. 29.
    Cimino R, Farella M, Michelotti A, Pugliese R, Martina R (2000) Does the ovarian cycle influence the pressure-pain threshold of the masticatory muscles in symptom-free women?. J Orofac Pain 14(2):169–184Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Health Sciences, Antalya Training and Research HospitalAntalyaTurkey

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