Comparative efficacy between fluoroscopy guided radiofrequency ablation of superior hypogastric plexus and radiofrequency ablation of both superior hypogastric plexus and ganglion impar in endometriosis related pelvic pain

PROPOSED TOPIC OF RESEARCH:

COMPARATIVE EFFICACY BETWEEN FLUOROSCOPY GUIDED RADIOFREQUENCY ABLATION OF SUPERIOR HYPOGASTRIC PLEXUS & RADIOFREQUENCY ABLATION OF BOTH SUPERIOR HYPOGASTRIC PLEXUS AND GANGLION IMPAR IN ENDOMETRIOSIS RELATED PELVIC PAIN

OBJECTIVES OF PROPOSED RESEARCH:

To observe separate efficacy of radiofrequency ablation (RFA) of Superior Hypogastric Plexus and RFA of Superior Hypogastric Plexus with Ganglion Impar and also compare between their efficacy in endometriosis related pelvic pain.

BACKGROUND OF PROPOSED RESEARCH:

Endometriosis is one of the most common and debilitating diseases of women in reproductive age group. It constitute a great burden of different kinds of pelvic pain in women . There is significant impact of endometriosis, and particularly pain symptoms, not only on quality of life, but also on a range of activities and life domains including physical functioning, everyday activities and social life, education and work, sex, intimacy and intimate partnerships, and mental health and emotional well being. A significant number of patients, suffering from endometriosis associated pelvic pain are either non-responsive or inadequately responsive to available treatment modalities and research is ongoing to find new therapeutic options for this disease. For these patients, radiofrequency ablation of nerve plexuses carrying pain sensation from those viscera may be an effective alternative. There is scarcity of literatures on efficacy of RFA of superior hypogastric plexus as well as superior hypogastric plexus with ganglion impar in endometriotic pelvic pain reduction. So, our humble approach in this study is not only to assess the efficacy of these two procedures separately, but also compare between their efficacy in endometriotic pain reduction.

RESEARCH HYPOTHESIS:

Significant reduction of pain in terms of VAS score in Endometriosis related pain  following RFA of both Superior Hypogastric Plexus as well as Superior Hypogastric Plexus with Ganglion Impar. There will be significant difference of VAS score between these two procedures and combined approach will be more efficacious to reduce pain significantly.

METHODOLOGY:

STUDY DESIGN- Parallel group, open label, randomised controlled trial

STUDY DURATION- 18 months

PLACE OF STUDY- Department of Physical Medicine & Rehabilitation, IPGME&R and SSKM Hospital

STUDY POPULATION- Patients attending OPDs and admitted in IPDs of Department of Obstetrics & Gynaecology and Department of Physical Medicine and Rehabilitation.

SAMPLE SIZE- TOTAL 38 (19 in each group)