Structural and Functional Basis of Chronic Pelvic Pain Syndrome during Combined Chronic Cystitis and Adenomyosis.

Comprehensive clinical and morphological examination of 60 female patients with chronic pelvic pain syndrome after combined chronic cystitis and adenomyosis was carried out. In all patients, the complex urodynamic examination revealed various disturbances of urination and stasis-like abnormalities of circulation in vesical and uterine walls. The pathomorphological peculiarities of the urogenital disorders during combination of adenomyosis and cystitis (of the combined proliferative and erosive/destructive type) is manifested by more pronounced destructive and inflammatory changes in urothelium characterized by the formation of superficial and deep erosions as well as by association of erosive/destructive damages to the urothelium with proliferative and metaplastic changes. Combined treatment of chronic cystitides and adenomyosis eliminated the destructive and inflammatory alterations in the vesical mucosa in 70 and 93% female patients, respectively (the corresponding values after basic therapy were 60 and 77%), and pronouncedly ameliorated pain syndrome.