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PPOD SYNDROME SCREENING QUESTIONNAIRE


Because there is no one specific test that can diagnose the individual suffering from the mechanically induced PPOD Syndrome, a helpful means of potentially identifying individuals with this disorder has been by the use of a questionnaire which profiles some of the characteristics of the PPOD patient. Although this questionnaire cannot absolutely establish whether or not you are an individual experiencing the effects of this disorder, its use in the clinical setting as been found to be helpful at identifying those individuals most likely suffering the effects of the mechanically induced PPOD Syndrome.

In using this questionnaire, read through each section and identifiy the symptoms you are currently experiencing, or in the case of the listed surgical procedures, have had performed in the past. Complete all sections to obtain your final score. This will determine the relative probability that you are experiencing the effects of the mechanically induced PPOD Syndrome. It is important to realize that many of the symptoms described in this questionnaire may represent other conditions requiring appropriate treatment. It is for this reason that the identification of any symptoms listed in the questionnaire should be followed by professional evaluation to more clearly established their cause. If however, your history is typical of the mechanically induced PPOD Syndrome, and subsequent evaluation confirms its presence, help is available. Ongoing clinical research has led to the development of effective treatment protocol to deal with the devastating effects of this disorder.

PELVIC PAIN

Chronic pelvic pain has been and continues to be the enigma of gynecology. It is one of the most common and yet frustrating complaints seen in gynecological practice today. Typically, the pain is felt on one or both sides of the front of the pelvis (in the region over the ovary) or above the pubic area. In men, this pain may be thought to be due to a developing hernia and may also involve the testicle. Occasionally, sharp or burning pain can extend into the genital region. The pain can be constant or intermittent, and is sometimes increased in its intensity after physical exertion or sitting for long periods of time. In individuals who have had symptoms for a long period of time, there may be a history of having undergone various surgical procedures in an attempt to alleviate the pelvic pain. Frequently however, these procedures have provided little, short-term, or no significant improvement.

Unilateral (left or right sided) anterior pelvic pain

Bilateral pelvic pain

Pelvic pain above pubic bone

Genital pain, numbness or tingling

Laparoscopy without identification of specific cause for pelvic pain

Partial or complete hysterectomy for pelvic pain without significant relief

Hernioplasty or orchioectomy without significant relief of pain

BLADDER DYSFUNCTION

Like pelvic pain, female urinary incontinence is a frequent and often frustrating condition encountered in urological practice. To emphasize this point, an editorial in the journal Obstebrics and Gynecology pointed out that "it is well known that most operations for urinary incontinence are successful for a few months only". Urological symptoms associated with the mechanically induced PPOD Syndrome frequently have their onset in association with pregnancy or delivery, but rather than resolving following the birth of the child, the symptoms continue and may progressively become worse. If the onset is unrelated to pregnancy, many times the individual can recall an accident, fall or some type of injury to the back that had occurred at about the time their symptoms began. Although there are many individual symptoms of bladder dysfunction associated with the mechanically induced PPOD Syndrome, the most commonly encountered and typically representative are those of frequency, urgency, dribbling, incontinence, sluggishness, and retention.

Urinary frequency

Urinary urgency

Urinary dribbling

Urinary incontinence

Urinary sluggishness

Urinary retention

Recurring urinary tract infections

Waking more than twice at night to empty the bladder

Wetting the bed

Normal urge to void replaced by supra pubic pressure or pelvic distention

Bladder surgery for urinary incontinence

Two or more bladder surgeries for recurring incontinence

GYNECOLOGIC AND SEXUAL DYSFUNCTION

The area of sexual dysfunction in the individual with mechanically induced PPOD has provided some of most thought provoking insight into the far-reaching effects of the mechanically induced PPOD Syndrome. Many symptoms of sexual dysfunction, of which mainstream thought currently regards as being psychogenic in nature, have shown dramatic improvement as a result of treatment of the mechanically induced PPOD Syndrome. And, as a result, and implicate a physical, rather than psychological cause of these disorders. Symptoms of this type include; dyspareunia (pelvic pain during intercourse) and anorgasmy (diminished or loss of ability to achieve normal orgasm). In males, there may be difficulty or inability of attaining or maintaining an erection. Additional gynecological and sexual symptoms include; persistent vaginal discharge, deficient coital (sexual) lubrication and loss of libido (sex drive). Although other gynecological and sexual symptoms have been implicated in the mechanically induced PPOD Syndrome, those listed above are most likely representative of mechanically induced pelvic pain and organic dysfunction.

Pelvic pain with intercourse

Pelvic pain with intercourse in the same location as non-coital pelvic pain (pelvic pain apart from intercourse)

Loss of ability to achieve normal orgasm

Deficient sexual lubrication

Loss of libido

Persistent vaginal discharge

Difficulty or inability attaining or maintaining erection

ENTEROLOGIC DYSFUNCTION

Bowel dysfunction, when present, generally tends to be a bit less variable in its presentation. The symptoms of bowel dysfunction typically found in the mechanically induced PPOD patient include chronic constipation, diarrhea, or alternating periods of constipation and diarrhea. Along with these typical symptoms of bowel dysfunction however, there may be other disturbances such as: excessive flatulence (gas), painful spasm of the anal sphincter, proctalgia (pain in the rectum), and rectal incontinence.

Chronic constipation

Chronic diarrhea

Alternating constipation and diarrhea

Proctalgia

Rectal incontinence

Painful spasm of the anal sphincter

BACK AND LEG PAIN

While many individuals with mechanically induced PPOD have a history of low back and/or leg pain, by no means does the absence of back or leg pain rule out the possibility of mechanically induced PPOD. In fact, some of the most severely involved and dramatic cases have been those of individuals having no significant history of back pain whatsoever. However, because certain features associated with the type of back disorder commonly involved in the mechanically induced PPOD Syndrome have frequently been encountered, their presence, in conjunction with other PPOD symptoms further indicates the likelihood that pelvic pain and organic dysfunction may be of mechanical origin.

History of chronic or recurrent low back pain

Buttock or leg pain on same side as pelvic pain

Pain in both buttocks or both legs

 

 

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Copyright © 1994, 1999, 2000 James E. Browning, D.C.; Thomas M. Wetherbee