Chronic pelvic pain (CPP) is a common condition among women of reproductive age. It frequently co-occurs with other pelvic and extra-pelvic pain conditions, including immunologic disorders. The co-occurrence of immunologic hyperstimulation and diffuse mast cell activation might have a negative impact on the progression of CPP diseases and also influence outcome of therapeutic treatment. The aim of this study is to assess the effect of micronized palmitoylethanolamide (m-PEA), an N-acylethanolamine known to modulate mast cell activity, on bladder pain and bladder functions in patients with CPP with and without concomitant allergy. Bladder pain was evaluated using the visual analog scale, while functional bladder capacity, daily frequency and nocturia were obtained from bladder diary and uroflometry. The presence of allergy did not change pain intensity mean scores. Average pain intensity score significantly decreased with m-PEA adjuvant therapy. The functional bladder capacity was lower while daily frequency and nocturia were higher in CPP patients with allergy. Functional bladder capacity increased while daily frequency and nocturia decreased after m-PEA adjuvant therapy in both CPP patients with and without allergy. The quality of life (12-item Short Form Health Survey) was not modified by allergy co-occurrence. m-PEA treatment improved the quality of life and physical and mental components in CPP patients with and without allergy. These results support the hypothesis of an important role of mast cell activation in symptomatology and organ functionality in CPP patients and confirm the ability of m-PEA to reduce CPP and limit pelvic disease progression by controlling mast cell activation.
Corresponding Author: SOMMARIVA M.|