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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2015-10-66-76</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-275</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ТЕРАПИЯ БОЛИ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>PAIN THERAPY</subject></subj-group></article-categories><title-group><article-title>Диагностика и лечение тазовой боли</article-title><trans-title-group xml:lang="en"><trans-title>Diagnosis and treatment of pelvic pain</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Баринов</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Barinov</surname><given-names>A. N.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Первый Московский государственный медицинский университет им. И.М. Сеченова<country>Россия</country></aff><aff xml:lang="en">First State Medical University named after I.M. Sechenov<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2015</year></pub-date><pub-date pub-type="epub"><day>30</day><month>12</month><year>2015</year></pub-date><volume>0</volume><issue>10</issue><fpage>66</fpage><lpage>76</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Баринов А.Н., 2015</copyright-statement><copyright-year>2015</copyright-year><copyright-holder xml:lang="ru">Баринов А.Н.</copyright-holder><copyright-holder xml:lang="en">Barinov A.N.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/275">https://www.med-sovet.pro/jour/article/view/275</self-uri><abstract><p>Традиционно лечением тазовой боли занимаются гинекологи и урологи, но даже в развитых странах у большинства пациентов причины хронической тазовой боли (ХТБ) остаются не до конца выясненными. Для персонифицированного уточнения патогенеза ХТБ и подбора оптимальной терапии необходим мультидисциплинарный подход: органы малого таза тесно связаны между собой, имеют общую афферентную и эфферентную иннервацию, кровообращение, мышечно-связочный аппарат. Таким образом, поражение одного органа часто вовлекает в патологический процесс другие и приводит к перекрестной сенситизации структур периферической и центральной нервной системы, участвующих в регуляции деятельности органов таза и мышечно-суставного аппарата тазового пояса. Упорное безосновательное преувеличение роли инфекционных заболеваний в патогенезе тазовой боли приводит к выбору неправильной тактики лечения и, как следствие, хронизации заболевания. В настоящее время значительная роль в формировании ХТБ отводится дисплазии тазобедренных суставов и коксартрозу, дисфункции крестцово-подвздошных сочленений с вторичными миофасциальными синдромами тазового дна и тоннельными невропатиями передней брюшной стенки и промежности. Эти заболевания в большей степени относятся к компетенции неврологов, ортопедов и ревматологов, чем урологов, гинекологов и даже проктологов.</p></abstract><trans-abstract xml:lang="en"><p>Traditionally, treatment of pelvic pain is the responsibility of gynecologists and urologists, though even in the developed countries causes of chronic pelvic pain (CPP) are not always clear in most patients. A multidisciplinary approach is imperative for individual-based clarification of CPP pathogenesis and choosing the optimum treatment: pelvic organs are closely interrelated, having common afferent and efferent nerves, blood circulation, muscles and ligaments. Thus, problems in one organ often involve the adjacent organs in the pathogenetic process resulting in cross-sensitization of the peripheral and central nervous systems taking part in the regulation of the pelvic function and pelvic muscular-articular apparatus. Persistent groundless exaggeration of the role of infectious diseases in the pathogenesis of pelvic pain leads to failure of treatment and, consequently, chronic disease. Currently, a significant role in CPP is assigned to hip dysplasia and coxarthrosis, sacroiliac joint dysfunction with secondary myofascial pelvic syndrome and tunnel neuropathies of anterior abdominal wall and perineum. These diseases are largely under the responsibility of neurologists, orthopedists and rheumatologists rather than urologists, gynecologists and even proctologists.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>тазовая боль</kwd><kwd>Артрозилен</kwd><kwd>Пиаскледин</kwd><kwd>pelvic pain</kwd><kwd>artrosilene</kwd><kwd>piascledine</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Zondervan KT, Yudkin PL, Vessey MP et al. 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