Research trends and clinical evidence: A comparison of surgical vs. conservative approaches for chronic pelvic pain syndrome – a systematic review and bibliometric analysis

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Published Jun 9, 2025
https://doi.org/10.35335/midwifery.v13i2.1945
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Vol. 13 No. 2 (2025): June: Health Sciences and related fields

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I Gede Agus Rio Saputra
Rumah Sakit Ibu dan Anak Puri Bunda Denpasar, Indonesia
Anak Agung Ngurah Gede Anggra Pramana
Rumah Sakit Bangli Medika Canti, Indonesia
Kadek Fajar Marta
Rumah Sakit Ibu dan Anak Puri Bunda Denpasar, Indonesia

Abstract

Chronic Pelvic Pain Syndrome (CPPS) is a complex medical condition that affects patients' physical, emotional, and social quality of life. Its management involves two main approaches: surgical and conservative. However, there are significant differences in the effectiveness, risks, and long-term impacts of each approach. This study aims to evaluate the effectiveness of surgical and conservative approaches in managing CPPS through a systematic review and bibliometric analysis, focusing on pain reduction, improvement in quality of life, and risk of complications. This research employs the Systematic Literature Review (SLR) method, following the PRISMA guidelines to search, screen, and evaluate relevant literature from databases such as PubMed, Scopus, and the Cochrane Library. The quality of the relevant studies is assessed using standardized appraisal tools. Quantitative data are analyzed through bibliometric analysis to identify differences in effectiveness between surgical and conservative approaches. The results indicate that the surgical approach is more effective in reducing severe and refractory pain compared to conservative therapy, but it is associated with a higher risk of complications. Conversely, the conservative approach provides benefits for mild to moderate symptoms with minimal risk and lower cost. In the context of Indonesia, the conservative approach is more suitable to be implemented as the first-line treatment for CPPS, with surgical options considered for cases that do not respond to initial therapy.

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How to Cite
Saputra, I. G. A. R., Pramana, A. A. N. G. A. and Marta, K. F. (2025) “Research trends and clinical evidence: A comparison of surgical vs. conservative approaches for chronic pelvic pain syndrome – a systematic review and bibliometric analysis”, Science Midwifery, 13(2), pp. 423-434. doi: 10.35335/midwifery.v13i2.1945.

References

Adamian, L., Urits, I., Orhurhu, V., Hoyt, D., Driessen, R., Freeman, J. A., Kaye, A. D., Kaye, R. J., Garcia, A. J., & Cornett, E. M. (2020). A comprehensive review of the diagnosis, treatment, and management of urologic chronic pelvic pain syndrome. Current Pain and Headache Reports, 24, 1–11.
Andreini, D., Bettinelli, C., Andreini, D., & Bettinelli, C. (2017). Systematic literature review. Business Model Innovation: From Systematic Literature Review to Future Research Directions, 1–23.
Ashraf, S., Clarkson, T., & Malykhina, A. P. (2024). Therapeutic Approaches for Urologic Chronic Pelvic Pain Syndrome; Management: Research Advances, Experimental Targets, and Future Directions. The Journal of Pharmacology and Experimental Therapeutics, 390(2), 222–232.
Berlina, L., & Ichwanuddin, I. (2024). Hernia Nukleus Pulposus. Termometer: Jurnal Ilmiah Ilmu Kesehatan Dan Kedokteran, 2(3), 175–197.
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Creswell, J. W., & Creswell, J. D. (2018). Mixed methods procedures. Research Defign: Qualitative, Quantitative, and Mixed M Ethods Approaches, 31(3), 75–77.
Espiño-Albela, A., Castaño-García, C., Díaz-Mohedo, E., & Ibáñez-Vera, A. J. (2022). Effects of pelvic-floor muscle training in patients with pelvic organ prolapse approached with surgery vs. conservative treatment: a systematic review. Journal of Personalized Medicine, 12(5), 806.
Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020‐compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), e1230.
Hao, D., Yurter, A., Chu, R., Salisu-Orhurhu, M., Onyeaka, H., Hagedorn, J., Patel, K., D’Souza, R., Moeschler, S., & Kaye, A. D. (2022). Neuromodulation for management of chronic pelvic pain: a comprehensive review. Pain and Therapy, 11(4), 1137–1177.
Islamia, J. M. (2016). Research design Research design. Research in Social Science: Interdisciplinary Perspectives, September, 68–84. file. E:/Documents/Dosen/Buku Metodologi/[John_W. _Creswell] _Research_Design_Qualitative, _Q (Bookos. Org). Pdf.
Jahanshahi Hesari, N., Asgari, P., Naderi, F., & Heidari, A. (2021). Effectiveness of positive mindfulness therapy and emotion-focused cognitive-behavioral therapy in improving pain perception and sleep quality in fibromyalgia patients. International Journal of Musculoskeletal Pain Prevention, 6(4), 564–572.
Jonis, Y. M. J., Wolfs, J., Hummelink, S., Tielemans, H. J. P., Keuter, X. H. A., van Kuijk, S., Ulrich, D. J. O., van der Hulst, R., & Qiu, S. S. (2024). The 6 month interim analysis of a randomized controlled trial assessing the quality of life in patients with breast cancer related lymphedema undergoing lymphaticovenous anastomosis vs. conservative therapy. Scientific Reports, 14(1), 2238.
Klein, I., Kalichman, L., Chen, N., & Susmallian, S. (2021). A pilot study evaluating the effect of early physical therapy on pain and disabilities after breast cancer surgery: Prospective randomized control trail. The Breast, 59, 286–293.
Murphy, K., Nasralla, M., Pron, G., Almohaimede, K., & Schievink, W. (2024). Management of Tarlov cysts: an uncommon but potentially serious spinal column disease—review of the literature and experience with over 1000 referrals. Neuroradiology, 66(1), 1–30.
Napitupulu, C. A., Ismunandar, H., & Himayani, R. (2023). Radikulopati Lumbal. Medical Profession Journal of Lampung, 13(5), 832–838.
Parati, G., Kjeldsen, S., Coca, A., Cushman, W. C., & Wang, J. (2021). Adherence to single-pill versus free-equivalent combination therapy in hypertension: a systematic review and meta-analysis. Hypertension, 77(2), 692–705.
Parsons, B. A., Baranowski, A. P., Berghmans, B., Borovicka, J., Cottrell, A. M., Dinis‐Oliveira, P., Elneil, S., Hughes, J., Messelink, B. E. J., & de C Williams, A. C. (2022). Management of chronic primary pelvic pain syndromes. BJU International, 129(5), 572–581.
Pirie, K., Traer, E., Finniss, D., Myles, P. S., & Riedel, B. J. (2022). Current approaches to acute postoperative pain management after major abdominal surgery.
Putri, N. A., Agistany, N. F. F., Akhyar, R. B. F., Chauna, S., Annisa, W. N., & Haikal, Z. (2023). Inguinal Hernia: Diagnosis and Management. Jurnal Biologi Tropis, 23(1), 96–103.
Rifki, M., Rusdani, R., & Eryaningrum, N. (2023). Faktor-Faktor Yang Berhubungan Dengan Kejadian Hemoroid Pada Pasien Di Poli Bedah RSUD Raja Ahmad Tabib Tahun 2019-2022. Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam, 13(3), 457–467.
Rusmayanti, M. Y., & Kurniawan, S. N. (2023). Hnp Lumbalis. Journal of Pain, Headache and Vertigo, 4(1), 7–11.
Setiawan, K., & Hengky, T. (2024). Diagnosis and Management of Limb Varicose Veins. Cermin Dunia Kedokteran, 51(5), 166–261.
Shrikhande, A., Ullger, C., Seko, K., Patil, S., Natarajan, J., Tailor, Y., & Thompson-Chudy, C. (2021). A physiatrist’s understanding and application of the current literature on chronic pelvic pain: a narrative review. Pain Reports, 6(3), e949.