PRZEWLEKŁY ZESPÓŁ BÓLOWY MIEDNICY MNIEJSZEJ - WYTYCZNE EUROPEJSKIEGO TOWARZYSTWA UROLOGICZNEGO (4/4)

<br /> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSo7NZMXBvitdWQDCkwWAV_YnacVxKY6LmEGz2lQBFZLUt3nYynO2UWiboYkW70bx1DpxdY-chdRQe1SSXUisW0HdJwFhx4EBqqpWhh3xYjC9XyRJEnLHJtu3TxI_E16ncgEHJRgdlM8A/s1600/a.png" imageanchor="1" style="border: 0px; clear: left; color: #333333; float: left; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin-bottom: 1em; margin-right: 1em; margin-top: 0px; outline: none; padding: 0px; text-decoration: none; transition: all 0.25s; vertical-align: baseline;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhSo7NZMXBvitdWQDCkwWAV_YnacVxKY6LmEGz2lQBFZLUt3nYynO2UWiboYkW70bx1DpxdY-chdRQe1SSXUisW0HdJwFhx4EBqqpWhh3xYjC9XyRJEnLHJtu3TxI_E16ncgEHJRgdlM8A/s200/a.png" style="border: 0px none; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; height: auto; line-height: inherit; margin: 0px; max-width: 100%; outline: none; padding: 0px; position: relative; vertical-align: baseline;" width="115" /></a><span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Moszny Pain Syndrome</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Leczenie przewlekłego bólu moszny opiera się na zasadach leczenia objawów bólu przewlekłego, jak opisano w czasie tych wytycznych [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_388" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">388</span></a><span style="margin: 0px; padding: 0px;"> ]</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Przewlekły ból ginekologiczny</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Trudno jest porównywać duże zróżnicowanie narkotyków z punktu widzenia skuteczności i bezpieczeństwa, ponieważ mają one tak różnorodne wykorzystuje do tego / wskazań.</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><br /></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W tych pacjentów, u których ginekologicznych CPP ma związku z którymkolwiek z dobrze zdefiniowanych warunkach, często jest trudny do określenia ścieżki terapeutycznej innego niż multidyscyplinarnego przewlekłego bólu planu zarządzania Abdominoplastyka-miednicy. </span><span style="margin: 0px; padding: 0px;">W przeglądzie Cochrane sugeruje, mogą istnieć pewne dowody (umiarkowane) wspieranie stosowania progestagenów. </span><span style="margin: 0px; padding: 0px;">Choć skuteczna, lekarze muszą być obeznani z progestagennych skutków ubocznych (np przyrostu masy ciała, bloatedness-najczęstsze niekorzystnych skutków), które mogą zatrzymanie niektórych pacjentów przed zaakceptowaniem takiego leczenia. </span><span style="margin: 0px; padding: 0px;">Gonadotropiny takie jak goserelina, są również, że w celu tego bólu. </span><span style="margin: 0px; padding: 0px;">Jednakże, w porównaniu z progestagenów ich skuteczności pozostaje ograniczona, tak jak w przypadku, gdy porównanie gabapentyny amitryptylina. </span><span style="margin: 0px; padding: 0px;">Jakość dowodów jest generalnie niska i jest pobierana z pojedynczych badań [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_303" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">303</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Aktualne hormonalne środki antykoncepcyjne (np łączny i doustnych pigułek antykoncepcyjnych pigułki zawierające tylko progesteron) i wewnątrzmaciczne urządzenia antykoncepcyjne (Mirena IUS ™) mają wiele skutków biologicznych. </span><span style="margin: 0px; padding: 0px;">Ich mechanizm działania, nie mogą być za pośrednictwem pierwotnego lub wtórnego działania antykoncepcyjnego. </span><span style="margin: 0px; padding: 0px;">Dla złożonych doustnych środków antykoncepcyjnych i metodach tylko progestagen, główne mechanizmy hamowanie owulacji i zmiany w śluzie szyjki macicy, które hamują penetrację plemników. </span><span style="margin: 0px; padding: 0px;">Metody hormonalne, szczególnie niskie dawki progesteronu tylko produkty i awaryjne pigułki antykoncepcyjne, mają wpływ na endometrium, które teoretycznie mogłyby mieć wpływ na implantację. </span><span style="margin: 0px; padding: 0px;">Thier skuteczność jako środki antykoncepcyjne wahają się od 92-99.9% [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_312" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">312</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Dokładny mechanizm antykoncepcyjnymi wkładkami wewnątrzmacicznymi jest niejasna. </span><span style="margin: 0px; padding: 0px;">Aktualne dane wskazują, że wpływ wywierają swoje pierwotne przed zapłodnieniem, zmniejszając możliwość plemników do zapłodnienia skuteczność ovum.Thier zbliża się 99% [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_313" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">313</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Hormonu uwalniającego gonadotropinę (GnRH), wiążą się ze swoistymi receptorami na gonadotrophs przysadki.</span><span style="margin: 0px; padding: 0px;">Długotrwała aktywacja receptorów GnRH przez GnRH prowadzi do odczulania, aw konsekwencji do tłumionego wydzielanie gonadotropin. </span><span style="margin: 0px; padding: 0px;">Z drugiej strony, antagoniści GnRH konkurować z GnRH receptory na błonach komórkowych gonadotropowe hamują indukowaną GnRH transdukcji sygnału i w konsekwencji wydzielania gonadotropiny. </span><span style="margin: 0px; padding: 0px;">Związki te są wolne od działania agonistyczne, które mogą być korzystne w pewnych zastosowaniach klinicznych, takich jak redcuing wielkości mięśniaków macicy, endometriozy i krwawienia [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_314" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">314</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Miednicy i chroniczna Anal Pain</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Toksyny botulinowej (dna miednicy)</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Botulinowa Toksyna (BTX-A) został wstrzyknięty do punktów spustowych. </span><span style="margin: 0px; padding: 0px;">Jest to bardziej kosztowne niż lidokaina i nie okazał się być bardziej skuteczna [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_389" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">389</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Recenzje nie obsługują iniekcji BTX-A na punkty spustowe [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_390" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">390</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Nadaktywność mięśni dna miednicy odgrywa rolę w KPP. </span><span style="margin: 0px; padding: 0px;">BTX-A, jako zwiotczających mięśnie, może być stosowany w celu zmniejszenia ciśnienia w spoczynku mięśni dna miednicy. </span><span style="margin: 0px; padding: 0px;">U kobiet z wysokim ciśnieniem spoczynku na mięśnie dna miednicy, to stwierdzono, że BTX-A to ciśnienie obniża się znacząco. </span><span style="margin: 0px; padding: 0px;">Wielkość zmniejszenia był znacznie wyższy niż w grupie placebo. </span><span style="margin: 0px; padding: 0px;">Na skali bólu (VAS), nie ma różnic między grupami stwierdzono w tym stosunkowo niewielkim badaniu z randomizacją [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_391" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">391</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">BTX-A mogą być także wstrzykiwane na poziomie zwieracza poprawić oddawanie moczu lub defekacji. </span><span style="margin: 0px; padding: 0px;">Rozluźnienie zwieracza cewki moczowej w łagodzi problemy z pęcherzem i wtórnie skurcz. </span><span style="margin: 0px; padding: 0px;">W badaniu kohorty 13 pacjentów z CPP, BTX-A wstrzyknięto do zewnętrznego zwieracza cewki moczowej. </span><span style="margin: 0px; padding: 0px;">Subiektywnie, 11 pacjentów odnotowano istotnych zmian w objawach bólu, z 7,2 do 1,6 na skali VAS [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_392" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">392</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Toksyny botulinowej (syndrom chronicznego bólu odbytu)</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">CPP związane ze skurczem mięśni dźwigacza odbytu i leczenia puborectalis i mięsień łonowo-guziczny przez BTX-A wydaje się być obiecujące, niektóre kobiety, jak pokazano w pilotażowym badaniu (n = 12). </span><span style="margin: 0px; padding: 0px;">Kryteria włączenia do badania były zależne tylko od pochwy manometrii z nadmierna aktywność mięśni dna miednicy, zdefiniowana jako pochwy odpoczynku ciśnienia> 40 cm H </span></span><span class="subscript" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">2</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> O. </span><span style="margin: 0px; padding: 0px;">Chociaż dyspareunia i bolesne miesiączkowanie poprawie, non-miesiączkowe bóle miednicy wyniki nie zostały znacząco zmienione [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_393" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">393</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W poniższym podwójnie zaślepionym, randomizowanym, kontrolowanym placebo badaniu, ta sama grupa zdefiniowana miednicy bóle mięśniowe według dwóch kryteriów czułości na kurczenie i nadciśnienie tętnicze (> 40 cm H </span></span><span class="subscript" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">2</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> O) i objęto 60 kobiet. </span><span style="margin: 0px; padding: 0px;">W tym większym badaniu, nie menstruacyjny ból miednicy uległ znacznej poprawie w porównaniu do pacjentów leczonych placebo (VAS zdobyć 51 vs. 22; p = 0,009). </span><span style="margin: 0px; padding: 0px;">Stwierdzono zatem, że BTX-A jest skuteczna w zmniejszaniu dna miednicy, ból mięśni związanego z dopuszczalnych działań niepożądanych, takich jak sporadycznego nietrzymania moczu i kału na stres [</span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_391" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">391</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jednak niedawno, mała RCT nie wykazały żadnych korzyści z BTX-A [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_394" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">394</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Przerywany przewlekły zespół bólowy anal</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Ze względu na krótki czas trwania epizodów, leczenie i profilaktyka jest często niewykonalne. </span><span style="margin: 0px; padding: 0px;">Wziewnie beta-2 adrenergicznego salbutamolu skuteczne w RCT u pacjentów z częstymi objawami i skrócenia czasu trwania bólu [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_395" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">395</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">]. </span><span style="margin: 0px; padding: 0px;">Inne opcje leczenia są tematem diltiazem i BTX-A [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_396" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">396</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jednakże, nie jest jeszcze pewne kontrowersje w odniesieniu do czasu trwania bólu przewlekłego przerywany i przewlekłego zespołu bólowego anal. </span><span style="margin: 0px; padding: 0px;">RCT często stosują różne definicje, wydłużenie czasu trwania bólu (z przesunięciem do przewlekłego bólu) w celu uwzględnienia większej liczby pacjentów i lepiej ocenić czynność badania z narkotykami.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_2_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.2.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Leki przeciwbólowe</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Jeśli korzystanie z prostych środków przeciwbólowych nie dostarczy odpowiedniej korzyści, a następnie rozważyć wykorzystanie środków neuropatycznego, jeśli nie ma poprawy, należy rozważyć udziałem specjalistycznego centrum zarządzania ból mają interes w bólu miednicy. </span><span style="margin: 0px; padding: 0px;">CPP jest dobrze zdefiniowany i obejmuje wiele mechanizmów, jak opisane w poprzednich rozdziałach. </span><span style="margin: 0px; padding: 0px;">Zarządzanie wymaga całościowego podejścia ze składników biologicznych, psychologicznych i społecznych. </span><span style="margin: 0px; padding: 0px;">Nieliczne badania specjalnie spojrzał na leki stosowane w KPP [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_304" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">304</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], zatem szersze spojrzenie na literaturę podjęto, wymagane są dalsze szczegółowe badania. </span><span style="margin: 0px; padding: 0px;">Agenci zainteresowane są podzielone dla ułatwienia opisu. </span><span style="margin: 0px; padding: 0px;">Kombinacje często zapewniają większe korzyści niż poszczególnych agentów. </span><span style="margin: 0px; padding: 0px;">Mogą one również umożliwić niższe pojedynczych dawek, a tym samym zminimalizowanie skutków ubocznych. </span><span style="margin: 0px; padding: 0px;">Celem zastosowania tych leków do umożliwienia pacjentom przy polepszaniu ich QoL. </span><span style="margin: 0px; padding: 0px;">Najlepiej jest to zmierzono oceniając ich funkcje, jak również nasilenie bólu. </span><span style="margin: 0px; padding: 0px;">W przypadku stosowania tych środków nie pozwala na to, to powinny one być cofnięte. </span><span style="margin: 0px; padding: 0px;">Niestety, awaria jednego agenta, aby zapewnić korzyści nie oznacza, że istnieje alternatywa. </span><span style="margin: 0px; padding: 0px;">Jeśli korzyści jest ograniczona przez efekty uboczne, a najniższa skuteczna dawka powinna zostać znaleziony (przez zwiększania dawki). </span><span style="margin: 0px; padding: 0px;">Czasami u pacjentów wolą wyższy poziom bólu i mają mniej skutków ubocznych.</span></span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_2_2_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.2.2.1.</span></span><span style="margin: 0px; padding: 0px;"> Mechanizmy działania</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Mechanizmy działania omawiane są odpowiednio w pozycjach leków poniżej.</span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="5_2_2_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">5.2.2.2.</span></span><span style="margin: 0px; padding: 0px;"> Porównania w obrębie i między grupami pod względem skuteczności i bezpieczeństwa</span></h4> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Paracetamol (acetaminofen)</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Paracetamol jest dobrze tolerowanym lekiem przeciwbólowym w klasie własnych. </span><span style="margin: 0px; padding: 0px;">To przeciwgorączkowe przeciwbólowe z centralnym mechanizmie działania [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_397" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">397</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jest często dostępne bez recepty bez recepty. </span><span style="margin: 0px; padding: 0px;">Istnieją dowody na to, że paracetamol jest korzystne w zarządzaniu somatyczne i bóle artretyczne [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_398" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">398</span></a><span style="margin: 0px; padding: 0px;"> ]</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Niesteroidowe leki przeciwzapalne (NLPZ)</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Te środki przeciwzapalne, przeciwgorączkowe, przeciwbólowe, których działanie polega na hamowaniu enzymu cyklooksygenazy (COX). </span><span style="margin: 0px; padding: 0px;">Mają działanie obwodowe, stąd ich stosowanie w warunkach stwarzających mechanizmów obwodowych lub zapalne. </span><span style="margin: 0px; padding: 0px;">Są one powszechnie wykorzystywane do bólu miednicy, wielu dostępnych bez recepty i na ogół dobrze tolerowane są. </span><span style="margin: 0px; padding: 0px;">Nie ma dowodów wskazujących na dobre NSAID jeden nad drugim na ból miednicy.</span><span style="margin: 0px; padding: 0px;">Wytyczne do użycia NSAID i COX-2, czynniki selektywne zostały opracowane. </span><span style="margin: 0px; padding: 0px;">Mają więcej skutków ubocznych niż paracetamol, w tym niestrawność, bóle głowy i senność.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dowody na ich korzyść w CPP jest słaba lub nieistniejąca i często są ograniczone skutki uboczne.</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Na ból miednicy, w których procesy zapalne są uważane za ważne, takich jak bolesne miesiączkowanie [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_399" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">399</span></a><span style="margin: 0px; padding: 0px;"> ], NLPZ są bardziej skuteczne niż placebo i paracetamolu, ale z większą częstością występowania działań niepożądanych.</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Na ból miednicy, w której mechanizmy centralne mogą być obciążone, takich jak endometrioza [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_315" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">315</span></a><span style="margin: 0px; padding: 0px;"> ], to brakuje dowodów na NLPZ pomimo ich wspólnego użytku.</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Na poziomie praktycznym, jeśli NLPZ są uważane do użytku, powinny one być sądzony (po uwzględnieniu środkami ostrożności i przeciwwskazania) i pacjenta pod kątem poprawy funkcji, jak również działanie przeciwbólowe.</span><span style="margin: 0px; padding: 0px;">Jeżeli nie osiąga się lub niepożądane ograniczają, to powinny one być cofnięte.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">neuromodulatorów</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Są to czynniki, które nie są proste, ale przeciwbólowe stosowane do modulowania lub neuropatycznego związanego z ośrodkowym układem ból. </span><span style="margin: 0px; padding: 0px;">Istnieje kilka klas powszechnie stosowane w uznanych korzyści z bólu medycyny. </span><span style="margin: 0px; padding: 0px;">Są one brane regularnie, mają skutki uboczne, które mogą ograniczyć stosowanie u niektórych pacjentów. </span><span style="margin: 0px; padding: 0px;">W Wielkiej Brytanii, National Institute for Health and Clinical Excellence (NICE) dokonał przeglądu zarządzania farmakologicznego bólu neuropatycznego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_400" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">400</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Nie wszystkie środki są dopuszczone do użytku w leczeniu bólu, ale nie jest to historia i dowody na ich korzyść. </span><span style="margin: 0px; padding: 0px;">Dowody w leczeniu CPP brakuje, ale jest obecny w innych bolesnych warunkach. </span><span style="margin: 0px; padding: 0px;">W tym rozdziale, większość dowodów jest ze źródeł innych niż miednicy bólu. </span><span style="margin: 0px; padding: 0px;">Ogólny sposób wykorzystania tych środków jest zwiększenie dawki przed korzyści i skutków ubocznych. </span><span style="margin: 0px; padding: 0px;">Celem jest, aby pacjenci mają poprawę ich jakości życia, która jest często najlepiej ocenianego przez zmiany w ich funkcji. </span><span style="margin: 0px; padding: 0px;">Oczywiste jest, aby korzystać z tych środków w kombinacji, ale badania porównujące różne środki ze sobą lub w połączeniu, brakuje. </span><span style="margin: 0px; padding: 0px;">Niektóre z tych czynników są również używane do szczególnych warunków.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Leki przeciwdepresyjne</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">trójpierścieniowe leki przeciwdepresyjne</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W trójpierścieniowe leki przeciwdepresyjne (TCA'S) mają wiele mechanizmów działania tym, blokowanie receptorów acetylocholiny, hamowanie serotoniny i noradrenaliny wychwytu i blokady receptorów histaminowych H1. </span><span style="margin: 0px; padding: 0px;">To także wpływa na przeciwlękowe [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_401" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">401</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], i często są ograniczone przez ich skutków ubocznych. </span><span style="margin: 0px; padding: 0px;">TCA mają długą historię stosowania w medycynie bólu i zostały poddane przeglądowi Cochrane [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_402" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">402</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], co sugeruje, że są one skuteczne w leczeniu bólu neuropatycznego. </span><span style="margin: 0px; padding: 0px;">Amitryptylina jest najczęściej używany element w dawkach od 10 do 75 mg / dzień (dochodząc do 150 mg / dzień). </span><span style="margin: 0px; padding: 0px;">Jest miareczkowano korzyści lub skutków ubocznych i może być podjęta w nocy [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_493" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">493</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">]. </span><span style="margin: 0px; padding: 0px;">Imipramina oraz nortryptylina są wykorzystywane jako alternatywy.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Inne leki przeciwdepresyjne</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Duloksetyna jest inhibitorem wychwytu (SNRI) przeciwdepresyjny serotoniny i noradrenaliny dopuszczony do użytku w tym depresji, wysiłkowego nietrzymania moczu oraz ból neuropatyczny. </span><span style="margin: 0px; padding: 0px;">Jest umiarkowanie mocne dowody na to korzystne w neuropatii cukrzycowej i fibromialgii w dawce 60 mg / dzień [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_403" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">403</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Skutki uboczne są powszechne, co może spowodować jego przerwanie.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Selektywne inhibitory wychwytu zwrotnego serotoniny (SSRI), leki przeciwdepresyjne z mniejszą ilością skutków ubocznych. </span><span style="margin: 0px; padding: 0px;">Są one skuteczne w leczeniu depresji, ale nie było wystarczających badań w celu wykazania ich korzyść w miednicy lub bólu neuropatycznego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_402-404" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">402-404</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Leki przeciwdrgawkowe</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Środki przeciwdrgawkowe, są powszechnie stosowane w leczeniu bólu neuropatycznego. </span><span style="margin: 0px; padding: 0px;">Istnieją badania ogólne i niektórzy patrząc zwłaszcza na ból miednicy. </span><span style="margin: 0px; padding: 0px;">Indywidualne środki zostały systematycznemu przeglądowi. </span><span style="margin: 0px; padding: 0px;">Ich stosowanie jest sugerowane w wytycznych NICE neuropatycznego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_400" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">400</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Karbamazepina ma długą historię stosowania w leczeniu bólu neuropatycznego. </span><span style="margin: 0px; padding: 0px;">Istnieją dowody na jego rzecz [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_405" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">405</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Próby były zazwyczaj krótkotrwałe, pokazując jedynie umiarkowaną korzyść. </span><span style="margin: 0px; padding: 0px;">Są niepożądane; </span><span style="margin: 0px; padding: 0px;">niektóre z nich mogą być poważne. </span><span style="margin: 0px; padding: 0px;">To już nie jest lekiem pierwszego wyboru. </span><span style="margin: 0px; padding: 0px;">Inne leki przeciwdrgawkowe dostępne są z mniej poważnymi skutkami ubocznymi.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Gabapentyna jest powszechnie stosowany w przypadku bólu neuropatycznego i systematycznie sprawdzana [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_406" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">406</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Zapewnia dobrą jakość z ulgi NNT około sześć. </span><span style="margin: 0px; padding: 0px;">Skutki uboczne są powszechne, zwłaszcza senność, zawroty głowy i obrzęki obwodowe. </span><span style="margin: 0px; padding: 0px;">Na wyższych poziomach dawek, należy odnieść się do lokalnych formularies, a wielu lekarzy nie rutynowo przekracza 2,4 g / dobę w dawkach podzielonych (najczęściej trzy razy dziennie). </span><span style="margin: 0px; padding: 0px;">W jednym badaniu kobiet z CPP nie sugeruje, że gabapentyna samodzielnie lub w połączeniu z amitryptylina zapewnia lepsze działanie przeciwbólowe następnie amitryptylina sam [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_407" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">407</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Pregabalina jest powszechnie stosowany neuromodulatorem dobrą udowodnionej skuteczności w niektórych neuropatycznego ale NTT zmienia się w zależności od stanu [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_408" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">408</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Dawka korzyścią zawiera się w zakresie od 300 do 600 mg / dzień. </span><span style="margin: 0px; padding: 0px;">To samo systematycznego przeglądu stwierdzono, że dawki mniejsze niż 150 mg / dzień jest mało prawdopodobne, aby zapewnić korzyści. </span><span style="margin: 0px; padding: 0px;">Podobnie jak w przypadku gabapentyny, efekty uboczne są stosunkowo powszechne i nie mogą być tolerowane przez pacjentów. </span><span style="margin: 0px; padding: 0px;">Inne leki przeciwdrgawkowe są dostępne, ale nie są powszechnie używane do zarządzania ból.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Pozostałe środki mogą być stosowane w leczeniu bólu neuropatycznego, ale najlepiej jest podawany tylko przez specjalistów w leczeniu bólu i znane z ich stosowaniem. </span><span style="margin: 0px; padding: 0px;">Mają tendencję do być uznane za standardowe opcje zostały wyczerpane. </span><span style="margin: 0px; padding: 0px;">Podobnie jak w przypadku wszystkich dobrych leczenia bólu, są one wykorzystywane jako część kompleksowego planu zarządzania wielowymiarową.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">opioidy</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Opioidy stosuje się do przewlekłego bólu niezłośliwych i może być korzystne dla niewielkiej liczby pacjentów. </span><span style="margin: 0px; padding: 0px;">Często pacjenci będą przerywać przyjmowania opioidów doustnych z powodu skutków ubocznych lub niedostatecznej analgezji [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_409" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">409</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Powinny one być używane tylko w połączeniu z planem zarządzania z konsultacji lekarzy doświadczonych w ich użyciu. </span><span style="margin: 0px; padding: 0px;">Sugeruje się, że jednostka leczenia bólu powinny być zaangażowane wraz z pacjentem i ich lekarza podstawowej opieki zdrowotnej.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Istnieją również ustalone wytyczne dotyczące stosowania opioidów w leczeniu bólu, a także biorąc pod uwagę potencjalne ryzyko [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_410" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">410</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Dostępna jest także informacja dostępna online dla pacjentów [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_411" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">411</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_412" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">412</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Istnieje kilka środków dostępnych na grupy. </span><span style="margin: 0px; padding: 0px;">Można je podzielić na słabe (na przykład kodeina, tramadol i dwuhydrokodeina) lub silnych opioidów (np morfina, oksykodon, fentanyl i hydromorfonu). </span><span style="margin: 0px; padding: 0px;">Podawanie doustne jest korzystne, ale jeśli źle tolerowane, przezskórnym (Patch) trasa może mieć zalety. </span><span style="margin: 0px; padding: 0px;">Bardziej inwazyjne metody są mniej powszechnie stosowane oraz w sferze jednostek specjalistycznych. </span><span style="margin: 0px; padding: 0px;">Skutki uboczne są powszechne, w tym zaparcia, nudności, zmniejszenie QoL, tolerancji opioidów, hormonalnych i efektów immunologicznych wraz ze zmianami psychologicznymi i wymaga aktywnego zarządzania.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Istnieje coraz większe zrozumienie przeczulicy indukowanej przez opioidy; </span><span style="margin: 0px; padding: 0px;">sytuacja, w której pacjenci przyjmujący opioidy paradoksalnie stają się bardziej wrażliwe na bodźce bólowe [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_413" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">413</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_414" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">414</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jest to kolejna przyczyna dla tych leków do stosowania w kontrolowany sposób, przez długotrwałym bólu niezłośliwych.</span></span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Morfina jest standardem opioidów, z którymi wielu lekarzy są znane. </span><span style="margin: 0px; padding: 0px;">Celem jest, aby stosować wolne lub preparat o przedłużonym uwalnianiu, rozpoczynając od małej dawki i miareczkowanie dawki raz na 3 dni do 1 tygodnia przed poprawę zarówno funkcji i bólu. </span><span style="margin: 0px; padding: 0px;">Skutki uboczne powinny być również monitorowane i udało się odpowiednio.</span><span style="margin: 0px; padding: 0px;">Szczególną uwagę należy zwrócić na zarządzanie zaparcia.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Istnieje szereg innych czynników, a niektóre są dostępne wymienione poniżej:</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="bodytekstbold" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Transdermalny fentanyl</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">  może być brane pod uwagę przy preparaty doustne są ograniczone (np iliostomy). </span><span style="margin: 0px; padding: 0px;">Może być także korzystne, gdy są nie do zaakceptowania efektów ubocznych z innych opioidów.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="bodytekstbold" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Metadon</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">  ma długą historię stosowania jako opioidu. </span><span style="margin: 0px; padding: 0px;">Istnieje teoretyczna zaletą korzyści z jego receptora N-metylo-D-asparaginianu (NMDA), aktywność antagonisty. </span><span style="margin: 0px; padding: 0px;">Może to mieć znaczenie w leczeniu bólu neuropatycznego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_415" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">415</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="bodytekstbold" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Oksykodon</span></span><span style="margin: 0px; padding: 0px;">  może mieć większą skuteczność niż morfina, w pewnych sytuacjach, takich jak stany hiperalgezji w tym bólu trzewnego [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_416" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">416</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="bodytekstbold" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Tramadol</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">  jest uznanym środkiem przeciwbólowym z podwójnymi wpływu na receptory opioidowe i uwalniania serotoniny. </span><span style="margin: 0px; padding: 0px;">Niedawno tapentadolu, został zwolniony z działania opioidów i noradrenaliny hamowanie wychwytu zwrotnego. </span><span style="margin: 0px; padding: 0px;">Jest jeszcze zbyt wcześnie, aby ocenić jego rzeczywistą wartość w arsenale do leczenia bólu.</span></span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Leczenie chirurgiczne</span></span></span></h2> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Surgery</span></span></span></h3> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Pęcherz Pain Syndrome (BPS)</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">pęcherz rozdęcie</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Chociaż pęcherza hydrodistension jest powszechną metodą leczenia BPS, uzasadnienie naukowe są niewystarczające. </span><span style="margin: 0px; padding: 0px;">może to być część diagnostyki, ale nie ograniczają rolę terapeutyczną.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Hydrodistension i toksyna botulinowa A (BTX-A)</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">BTX-A mogą mieć wpływ na antynocyceptywne szlaków aferentnych pęcherza, produkujących objawowych i urodynamicznych ulepszeń [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_102" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">102</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Leczenie hydrodistension i hydrodistension powiększonej dopęcherzowego BTX-A został porównany [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_417" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">417</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Było objawowe poprawę u wszystkich pacjentów. </span><span style="margin: 0px; padding: 0px;">Jednakże w hydrodistension tylko grupowej, 70% zwrócone poprzednich objawów po 1 miesiącu, natomiast w BTX-A leczonych pacjentów wynik SAS, i funkcjonalne cystometrycznych pojemność pęcherza poprawie po 3 miesiącach.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">BTX-A trójkątny tylko wtrysk wydaje skuteczne i długotrwałe, jak 87% pacjentów zgłaszało poprawę po 3-miesięcznej obserwacji [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_418" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">418</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Ponad 50% odnotowano dalszą korzyść 9 miesięcy po pierwszym zabiegu. </span><span style="margin: 0px; padding: 0px;">Oczyszczanie gdy był potrzebny, otrzymano podobne wyniki. </span><span style="margin: 0px; padding: 0px;">Autorzy doszli do wniosku, że takie leczenie jest bezpieczne, skuteczne i mogą być powtarzane.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przezcewkowa (TUR), koagulacja i laserowe</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Endourological zniszczenie tkanki pęcherza ma na celu wyeliminowanie uszkodzeń nabłonka dróg moczowych, głównie Hunnera. </span><span style="margin: 0px; padding: 0px;">Ponieważ resekcja 1970 i oglądaniem zostały zgłoszone do osiągnięcia złagodzenie objawów, często przez ponad 3 lat [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_419" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">419</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_420" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">420</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Przedłużone łagodzenie bólu i nagłych został opisany dla przezcewkową ablacji laserowej, jak również [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_421" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">421</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Otwarty Chirurgia BPS</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">BPS jest łagodny i nie skraca życia, a więc procedury operacyjne rankingu ostatnie miejsce w algorytmie leczenia. </span><span style="margin: 0px; padding: 0px;">Nie ma dowodów na to łagodzi ból. </span><span style="margin: 0px; padding: 0px;">Chirurgia BPS ogniotrwałych jest właściwe tylko w ostateczności dla pacjentów z chorobą oporną na schyłkową. </span><span style="margin: 0px; padding: 0px;">Główne operacja powinna być poprzedzona dokładnej oceny przedoperacyjnej, ze szczególnym uwzględnieniem określenia odpowiedniej lokalizacji choroby i podtypu. </span><span style="margin: 0px; padding: 0px;">Jeśli operacja jest uważana za nasza rada jest, aby skierować pacjenta do ośrodka specjalistycznego doświadczenie w zarządzaniu CPP z podejścia multidyscyplinarnego zespołu.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Cztery główne techniki są często:</span></div> <div class="bodytekst_opsomming_cijfers_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">1.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> moczu bez cystektomii. </span><span style="margin: 0px; padding: 0px;">Już w 1967 roku stwierdzono, że augmentacji pęcherza bez usunięcia chorej tkanki nie było właściwe [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_422" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">422</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Raporty unresected pęcherze BPS przestaje wywoływać objawy po utracie kontaktu z moczem są rzadkością [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_99" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">99</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_423" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">423</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">2.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Supratrigonal cystektomii z późniejszym powiększania pęcherza stanowi najbardziej preferowane techniki chirurgicznej wstrzemięźliwości-konserwujące. </span><span style="margin: 0px; padding: 0px;">Różne odcinki jelit są stosowane do powiększania trójkątny [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_424-426" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">424-426</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">3.</span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Subtrigonal cystektomii. </span><span style="margin: 0px; padding: 0px;">Subtrigonal wycięcie ma potencjał usuwania trójkąta jako ewentualne miejsca choroby, jednak kosztem jest wówczas wymóg moczowodu reimplantacji. </span><span style="margin: 0px; padding: 0px;">Choroby trójkątny podano w u 50% pacjentów, a winę niepowodzenia chirurgicznego na trójkącie pozostają na miejscu i [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_427" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">427</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">W przeciwieństwie do innych badaniach [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_428" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">428</span></a><span style="margin: 0px; padding: 0px;"> ] opisali sześć spośród 17 pacjentów jest całkowicie wyleczony przez supratrigonal resekcji [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_427" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">427</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">]. </span><span style="margin: 0px; padding: 0px;">Niedawne badania na kobiecej seksualności po cystektomii i ortotopowej jelita krętego zastępczego pęcherza jelitowego wykazały ulgę w bólu u wszystkich pacjentów, ale tylko jeden odzyskała normalną aktywność seksualną [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_429" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">429</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_opsomming_cijfers_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px 40px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -40px; outline: 0px; padding: 0px; vertical-align: baseline; width: 40px;"><span style="margin: 0px; padding: 0px;">4.</span></span><span style="margin: 0px; padding: 0px;"> cystektomii z tworzeniem się w jelicie krętym kanałem nadal zajmuje pierwsze miejsce w aktualnych trendów praktyki USA dla chirurgii BPS [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_430" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">430</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Ze względów kosmetycznych, korzystny jest kontynentem dywersji, zwłaszcza u młodszych pacjentów. </span><span style="margin: 0px; padding: 0px;">Po ortotopowej augmentacji pęcherza, zwłaszcza przy usuwaniu trójkąt, wytwarzający puste przestrzenie mogą być niekompletne i wymagają okresowego siebie cewnikowania. </span><span style="margin: 0px; padding: 0px;">Pacjenci rozważają te procedury muszą być zdolne do wykonywania, przyjmowania i tolerowanie siebie cewnikowania. </span><span style="margin: 0px; padding: 0px;">U pacjentów z BPS których rozwinie nawracające bóle w rozszerzonej pęcherza lub kontynentu woreczka po enterocystoplasty lub kontynentu moczu, Retubularisation uprzednio wykorzystanego odcinka jelita tworząc przewód moczowy został rekomendowany [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_431" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">431</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Ważne jest, aby pamiętać, że ciąża z kolejnym segmentem dolnym cesarskiego cięcia odnotowano po ileocystoplasty [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_431" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">431</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_432" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">432</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Prostata Pain Syndrome (PPS)</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie ma dowodów, do zarządzania operacyjnego, w tym przezcewkowej nacięcie szyi pęcherza, radykalnej resekcji przezcewkowej prostaty, aw szczególności, radykalnej prostatektomii w leczeniu przewlekłego bólu u pacjentów z PPS.</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Cewki moczowej Pain Syndrome</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Nie ma specyficznego leczenia, które może być zalecane. </span><span style="margin: 0px; padding: 0px;">Kierownictwo powinno być wielodyscyplinarne i multimodalnego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_433" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">433</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Laseroterapia regionu trójkątny może być specyficzne leczenie. </span><span style="margin: 0px; padding: 0px;">Jedno badanie porównujące dwie formy laser odnotowano dobre wyniki, ale nie porównać z pozorowaną leczenia [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_434" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">434</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Większość publikacji na temat leczenia zespołu bólowego moczowej pochodzić z psychologami [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_164" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">164</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Domniemywa zrosty w obrębie jamy brzusznej</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W przypadku pacjentów z CPP gynaeocological i szacowanego adhezji, nie ma zgody co do tego, czy zrostów należy przeprowadzić w celu poprawy ból [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_435" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">435</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_436" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">436</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Obszerne operacja endometriozy jest trudne i wciąż uważany za kontrowersyjną, gdyż jest co najmniej jeden RCT pokazano żadnych korzyści w łagodzeniu bólu w usuwaniu początku dużej endometriozy porównaniu do operacji sham [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_437" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">437</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_438" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">438</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">U pacjentów z adenomyosis, jedyna operacja lecznicza jest histerektomia ale pacjenci mogą korzystać z terapii hormonalnej i przeciwbólowych (patrz 5.2.1)</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="onderlijnen" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; text-decoration: underline; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">Neuralgia sromowych i chirurgia</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Dekompresja uwięziony lub uszkodzonego nerwu jest rutynowym podejściem i prawdopodobnie powinny mieć zastosowanie do nerwu sromowego ma ona zastosowanie do wszystkich innych nerwów. </span><span style="margin: 0px; padding: 0px;">Istnieje kilka sposobów i podejścia wyboru prawdopodobnie zależy od rodzaju patologii. </span><span style="margin: 0px; padding: 0px;">Najbardziej tradycyjnym podejściem jest transgluteal;</span><span style="margin: 0px; padding: 0px;">Jednakże, podejście transperineal może stanowić alternatywę, zwłaszcza w przypadku uszkodzenia nerwów uważa się za związane z poprzednim zabiegu miednicy [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_171" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">171</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_231" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">231</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_439-443" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">439-443</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Obecnie nastąpiła tylko jedna prospektywnym badaniu z randomizacją [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_441" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">441</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Badanie to sugeruje, że jeśli pacjent miał ból dla <6 40="" 66="" b="" chirurgii="" do="" dzie="" je="" jest="" l="" lat="" li="" obecny="" pacjent="" pewn="" popraw="" por="" przez="" w="" wida="" wnaniu="" z=""> 6 lat). </6></span><span style="margin: 0px; padding: 0px;">Operacja nie jest odpowiedź dla wszystkich pacjentów. </span><span style="margin: 0px; padding: 0px;">On mówi do pacjentów, którzy przeszli zabieg chirurgiczny, zapewniając diagnoza była jednoznaczna, większość pacjentów jest wdzięczny, że zostały poddane operacji, ale wiele z nich nadal ma objawy, które wymagają zarządzania.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Neuromodulacji</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Rola neuromodulacji w leczeniu bólu miednicy powinny być uznane przez specjalistów w leczeniu bólu w obrębie miednicy. </span><span style="margin: 0px; padding: 0px;">Techniki te są wykorzystywane jedynie jako część szerszego planu zarządzania i wymagają regularnej obserwacji. </span><span style="margin: 0px; padding: 0px;">Podstawą badań jest opracowanie i techniki rozszerzania (np stymulacja rdzenia kręgowego (SCS), stymulacja korzeni sakralna, stymulacja zwoju korzenia grzbietowego lub stymulacji nerwów obwodowych). </span><span style="margin: 0px; padding: 0px;">Są to drogie techniki interwencyjne pacjentów opornych na inne sposoby leczenia. </span><span style="margin: 0px; padding: 0px;">Dlatego niewłaściwe jest do przedstawienia szczegółowego przeglądu w niniejszej publikacji. </span><span style="margin: 0px; padding: 0px;">W Wielkiej Brytanii wytyczne zostały opublikowane przez SCS w bólu neuropatycznego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_444" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">444</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Podkreśla powyższe komentarze. </span><span style="margin: 0px; padding: 0px;">Niniejsze wytyczne sugerują okres próbny stymulacji przed pełnym wdrożeniem. </span><span style="margin: 0px; padding: 0px;">Neuromodulacji nadal jest znalezienie jej rolę w leczeniu bólu w obrębie miednicy. </span><span style="margin: 0px; padding: 0px;">Odnotowano coraz więcej dowodów w badaniach małych serii przypadków lub pilotażowych, ale bardziej szczegółowe badania są wymagane [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_445" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">445</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Jej rola w nadreaktywnego pęcherza i nietrzymania stolca jest bardziej wytrzymała, ale jest ograniczona do bólu.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Pęcherz Pain Syndrome</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Porównanie sakralnej neuromodulacji (SNM) vs. stymulacji nerwu sromowego (PNS), wykazały ogólną poprawę 59% objawów z PNS vs. 44% z SNM. </span><span style="margin: 0px; padding: 0px;">Większość pacjentów, którzy testowali zarówno elektrodę sakralną oraz sromowych wybrał PNS jako lepszej strony. </span><span style="margin: 0px; padding: 0px;">Kontynuacja wykazały znaczną poprawę mikcji zmienne i zatwierdzone BPS kwestionariusze objawem. </span><span style="margin: 0px; padding: 0px;">Ponad 90% pacjentów leczonych neuromodulacji stwierdziła, że są one poddawane implantacji ponownie [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_446" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">446</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Długoterminowe wyniki zweryfikowano w retrospektywnym badaniu pacjentów od 1994 do 2008 roku [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_447" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">447</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Implantacja SNM stałe przeprowadzono w pacjentów, u których co najmniej 50% poprawę w zakresie objawów z czasowym testu oceny nerwów obwodowych [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_447" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">447</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Średni czas obserwacji wynosił 61,5 miesięcy. </span><span style="margin: 0px; padding: 0px;">Dobry długoterminowy sukces SNM zaobserwowano u 72% z 28% stawką eksplantacji. </span><span style="margin: 0px; padding: 0px;">Najczęstszym powodem eksplantacji było słabe wyniki (54% nieudanych pacjentów). </span><span style="margin: 0px; padding: 0px;">Stopa wersja wynosiła 50%. </span><span style="margin: 0px; padding: 0px;">W badaniu z udziałem kobiet poddanych implantacji urządzenia stałe od 2002 do 2004 roku [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_448" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">448</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ], znaczy pre- / pooperacyjnego bólu miednicy i pilny / wyniki częstotliwości były 21,61 ± 8,6 / 9,22 ± 6,6, a średni pre- / pooperacyjnego bólu wizualnej skali analogowej ( VAPS) zdobywa wynosiły 6,5 ± 2,9 / 2,4 ± 1,1. </span><span style="margin: 0px; padding: 0px;">Średni okres obserwacji wynosił 86 ± 9,8 miesięcy. </span><span style="margin: 0px; padding: 0px;">Sakralna neuromodulacja pokazał odpowiednią dla poprawy objawów BPS ogniotrwałych. </span><span style="margin: 0px; padding: 0px;">Stopa reoperacji wyniósł 25%.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Neuralgia sromowych</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Sromowych nerwobóle oznacza uraz nerwów obwodowych i jako takie powinny reagować na neuromodulacji przez wszczepione generatorów impulsów. </span><span style="margin: 0px; padding: 0px;">Jednakże, ważne jest, że stymulacja odbierane w tym samym miejscu co odczuwanego bólu. </span><span style="margin: 0px; padding: 0px;">Stymulacja rdzenia kręgowego (SCS) może być skuteczne dla piersiowo-lędźwiowego aferentnych.</span><span style="margin: 0px; padding: 0px;">Jednak, trudno jest uzyskać odpowiednią stymulację z SCS do krzyżowego nerwów tym sromowych. </span><span style="margin: 0px; padding: 0px;">Istnieje ograniczone doświadczenie ze stymulacją korzenia sakralnej, jak i stymulacji wynikowym sromowego nerwobóle powinny być podejmowane tylko w wyspecjalizowanych ośrodkach oraz w ośrodkach, które mogą zapewnić opiekę multidyscyplinarnego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_449-452" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">449-452</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przewlekłe Anal Pain Syndrome</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Sakralna neuromodulacja i przezskórnej stymulacji nerwu piszczelowego w bólu miednicy. </span><span style="margin: 0px; padding: 0px;">W dużej grupie 170 pacjentów z funkcjonalną odbytu ból od św Hospital (Harrow, Middlesex, Wielka Brytania) Stymulacja nerwu krzyżowego stosowano u 3 chorych (2 ulepszany) podczas biofeedback był najczęściej używanym modalność o największej skuteczności leczenia w pacjenci z zaburzeniami defecatory (29 pacjentów, 17 ulepszając) [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_396" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">396</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Krzyżowy neuromodulacja donoszono być dość korzystna w dwóch badaniach niekontrolowanych, polepsza się około połowy pacjentów [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_453" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">453</span></a><span style="margin: 0px; padding: 0px;"> , </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_454" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">454</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Sakralna neuromodulacja może być wyborem u pacjentów z KPP, którzy nie odpowiedzieli na terapię biofeedback i narkotyków. </span><span style="margin: 0px; padding: 0px;">Stymulacja mniej inwazyjna przezskórna nerwu piszczelowego (PTNS) badano u 12 kobiet z CPP trwająca co najmniej 6 miesięcy i wykazały poprawę w bólu, jakości życia i życia seksualnego [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_455" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">455</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ].</span><span style="margin: 0px; padding: 0px;">Żadna grupa "pozorne" SNM lub kontroli PTNS użyto albo cytowane badania, co ogranicza ich wartość jako istotny efekt placebo nie można wykluczyć.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_3_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.3.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Bloki nerwowe</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Bloki nerwowe do leczenia bólu są zazwyczaj przeprowadzane przez specjalistów w bólu medycyny jako część szerszego planu zarządzania [ </span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_51" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">51</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Mogą one mieć znaczenie diagnostyczne lub terapeutyczne. </span><span style="margin: 0px; padding: 0px;">Podręczniki zostały napisane na ten temat i praktyków korzystanie z nich powinien być przeszkolony w zakresie właściwego doboru pacjentów, wskazania, ryzyka i korzyści. </span><span style="margin: 0px; padding: 0px;">Wiele takich interwencje wymagają również zrozumienie i doświadczenie w stosowaniu technik obrazowania wykonać bloki dokładnie. </span><span style="margin: 0px; padding: 0px;">Bloki diagnostyczne mogą być trudne do interpretacji z powodu skomplikowanych mechanizmów leżących u podstaw bolesny stan lub zespół. </span><span style="margin: 0px; padding: 0px;">Trwały, ale ograniczone świadczenie może prowadzić do większej liczby procedur stałych (na przykład, procedury o częstotliwości radiowej).</span><span style="margin: 0px; padding: 0px;">Jest słaba baza dowodowa tych interwencji przewlekłego bólu niezłośliwych.</span></span></div> <div class="bodytekst_bold" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Neuralgia sromowych</span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Rola iniekcji może być podzielona na dwie części. </span><span style="margin: 0px; padding: 0px;">Po pierwsze, zastrzyk znieczuleniu miejscowym i sterydów na widok uszkodzenia nerwów może powodować działania terapeutycznego. </span><span style="margin: 0px; padding: 0px;">Możliwe przyczyny tego są związane z faktem, że sterydy mogą zmniejszyć stan zapalny i obrzęk w miejscu podrażnienie nerwów, ale również dlatego, że sterydy mogą blokować kanały sodowe i zmniejszenia nadwrażliwości uruchamianych nerwu [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_456" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">456</span></a><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> ]. </span><span style="margin: 0px; padding: 0px;">Drugą korzyścią jest możliwość diagnostyki. </span><span style="margin: 0px; padding: 0px;">Jak już wskazano, że gdy nerwu sromowego jest rannych istnieje kilka miejsc, gdzie może się to zdarzyć.</span><span style="margin: 0px; padding: 0px;">Różnica blok nerwu sromowego pomaga przekazywać informacje w odniesieniu do miejsca, w którym może zostać uwięziony nerw [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_229-239" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">229-239</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <div class="bodytekst_inspringen_eerste" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: -18px 0px 0px; outline: 0px; padding: 0px 0px 20px; text-indent: 80px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Infiltracja w ischeal kręgosłupa wymaga użycia stymulator nerwów / lokalizatorem. </span><span style="margin: 0px; padding: 0px;">Zarówno silnik (skurcz odbytu) i sensoryczne punkty końcowe mogą być odnotowane. </span><span style="margin: 0px; padding: 0px;">Punkt końcowy anatomiczne mogą być lokalizowane przez RTG, CT, wskazówek lub wykorzystanie USA. </span><span style="margin: 0px; padding: 0px;">US unika się promieniowania, przy czym prowadzenie CT wiąże znaczące ilości promieniowania. </span><span style="margin: 0px; padding: 0px;">Obecnie fluoroskopii jest prawdopodobnie technika obrazowania najczęściej stosowany, ponieważ jest ona łatwo dostępna dla większości anestezjologów, które wykonują bloku. </span><span style="margin: 0px; padding: 0px;">Obecnie infiltracji sromowego nerwu w kanale Alcock odbywało się przede wszystkim przy zastosowaniu CT. </span><span style="margin: 0px; padding: 0px;">A także wtryskiwanie wokół nerwu sromowego specyficzne bloków innych związanych z nerwami miednicy mogą być wykonane. </span><span style="margin: 0px; padding: 0px;">Impulsowo stymulacji częstotliwości radiowej również sugerowano w leczeniu [ </span></span><a href="https://uroweb.org/guideline/chronic-pelvic-pain/#note_457" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgb(0, 160, 227); background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"><span style="margin: 0px; padding: 0px;">457</span></a><span style="margin: 0px; padding: 0px;"> ].</span></div> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">. 5.4</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Podsumowanie dowodów oraz zaleceń: Zarządzanie</span></span></span></h2> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie PPS</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Fenotypowo skierowane leczenie może poprawić sukces leczenia.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 3</div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Alfa-blokery mają umiarkowaną skuteczność leczenia dotyczące całkowitej pain-, voiding- i QoL wynikami w PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">antybiotykoterapii ma umiarkowany wpływ na całkowitą pain-, voiding- i QoL wynikami w PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">NLPZ mają umiarkowane ogólnych efektów leczenia na PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Fitoterapia ma jakiś korzystny wpływ na ból i ogólnej pozytywnej odpowiedzi na leczenie w PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Pentozan polisiarczan poprawia ogólną ocenę i wynik JŻ PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie ma wystarczających danych dotyczących skuteczności środków zwiotczających w PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Pregabaliny nie jest skuteczny w leczeniu PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">BTX wstrzyknięcie do miednicy może mieć niewielki wpływ na PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Stymulacja tylny nerw piszczelowy prawdopodobnie skuteczne w leczeniu PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie ma wystarczających danych na poparcie stosowania innych zabiegów chirurgicznych, takich jak przezcewkowej nacięcie szyi pęcherza moczowego, przezcewkowej resekcji gruczołu krokowego lub radykalnej prostatektomii u chorych z PPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Behawioralnej, przeznaczone do PPS może poprawić bólu i QoL.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta multimodalnych i fenotypowo skierowane możliwości leczenia PPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Pojedyncze stosowanie antybiotykoterapii (chinolony lub tetracykliny) zaleca się u pacjentów wcześniej nieleczonych przez minimum 6 tygodni trwającego PPS <1 font="" roku.=""></1></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Alfa-adrenergiczne są wskazane w przypadku pacjentów w czasie trwania PPS <1 font="" roku.=""></1></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wysoka dawka polisiarczanu pentozan jest zalecane w PPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">NLPZ są zalecane do stosowania w PPS, ale długoterminowe skutki uboczne muszą być brane pod uwagę.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dla PPS ze znacznym cierpienia psychicznego, zalecane jest leczenie psychologiczne koncentrują się na PPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> </tbody></table> <div class="bodytekst_italic_onder_tabel_1e_regel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">PPS = zespół bólowy prostaty; </span><span style="margin: 0px; padding: 0px;">NLPZ = niesteroidowe leki przeciwzapalne.</span></span></div> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie BPS</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Brak wystarczającej ilości danych dla długotrwałego stosowania kortykosterydów.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Istnieją ograniczone dane dotyczące skuteczności cymetydyny w BPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Amitryptylina jest skuteczny w leczeniu bólu i objawów związanych BPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oral pentosanpolysulphate sodu jest skuteczny w leczeniu bólu i objawów związanych BPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oral pentosanpolysulphate sodu oraz heparynę podskórnie jest skuteczny w leczeniu bólu i objawów związanych z BPS, szczególnie w niskich początkowo reagujących na pentosanpolysulphate sama sodu.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dopęcherzowego lidokainę oraz wodorowęglan sodu jest skuteczny w krótkim okresie.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dopęcherzowe pentosanpolysulphate sodu jest skuteczny w oparciu o ograniczoną ilość danych i może poprawić leczenie doustne.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Istnieją ograniczone dane dotyczące skuteczności dopęcherzowego heparyny.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dopęcherzowe siarczan chondroityny, może być skuteczne.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Brak wystarczającej ilości danych dla stosowania jako rozciągnięcie pęcherza interwencji terapeutycznej.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Hydrodistension Plus BTX-A jest lepszy hydrodistension sam.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Dopęcherzowe BCG nie jest skuteczny w BPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przezcewkowa (koagulacja i laser) mogą być skuteczne w rodzaju BPS 3C.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Krzyżowy neuromodulacja mogą być skuteczne w BPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">stymulacja nerwów sromowych (PNS) jest lepszy od SNM w leczeniu BPS.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Unikanie jakiegoś jedzenia i picia może zmniejszyć objawy.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wynik dla cystektomii dla BPS jest zmienna.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferują podtyp fenotyp zorientowane terapię BPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Multimodalne techniki behawioralne, fizyczne i psychologiczne powinny być zawsze traktowane obok doustnych lub inwazyjnych zabiegów BPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podawać amitriptilinę do stosowania w BPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta oralny pentosanpolysulphate sodu do leczenia BPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Leczenie lekiem doustnym pentosanpolysulphate sodu powiększonej heparyny podskórnie zalecany jest szczególnie w niskich reagujących na pentosanpolysulphate sama sodu.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podawać śródpęcherzowego lidokainy plusa wodorowęglanu sodu przed więcej metod inwazyjnych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podawać śródpęcherzowego pentosanpolysulphate sód, zanim w monoterapii lub w połączeniu z doustnym pentosanpolysulphate sodu bardziej inwazyjnego leczenia.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podawać zastrzyk podśluzówkowe BTX-A plus hydrodistension jeśli dopęcherzowego zakropleniu terapie zawiodły.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wszystko ablative chirurgii narządu powinna być ostatecznością tylko dla doświadczonych i BPS doświadczonych chirurgów.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta śródpęcherzowego kwas hialuronowy przed środkami bardziej inwazyjnych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta śródpęcherzowego siarczan chondroityny, zanim środki bardziej inwazyjnych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta przezcewkowa (lub koagulację lub laser) uszkodzenia pęcherza moczowego, ale w rodzaju BPS 3 C tylko.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta neuromodulacja przed bardziej inwazyjnych zabiegów.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferujemy porady dietetyczne.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta śródpęcherzowego heparyny przed bardziej inwazyjnych środków, w monoterapii lub w leczeniu skojarzonym.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta śródpęcherzowego ściany pęcherza moczowego i zastrzyk trójkątny BTX-A, jeśli dopęcherzowego zakropleniu terapie zawiodły.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Kortykosteroidy nie są zalecane do długotrwałego leczenia.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Pęcherz rozdęcie nie jest zalecana jako leczenie BPS.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> </tbody></table> <div class="bodytekst_italic_onder_tabel_1e_regel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">DMSO sulfotlenek = dimetylu; </span><span style="margin: 0px; padding: 0px;">BPS syndrome = ból pęcherza; </span><span style="margin: 0px; padding: 0px;">BTX-A = botulinowa Toksyna;</span></span></div> <div class="bodytekst_italic_onder_tabel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: -15px 0px 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">BCG = Bacillus Calmette Guérin.</span></div> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.3.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie zespołem bólowym moszny</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Mikrochirurgiczne odnerwienie powrózka nasiennego jest skuteczną terapią dla zespołu bólowego moszny.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Vasovasostomy jest skuteczny w bólu po wazektomii,</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Orchiektomii jest ostatecznością w leczeniu zespół bólowy moszny.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> 4</div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Start z ogólnych metod leczenia przewlekłego bólu miednicy.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Informują o ryzyku wystąpienia bólu po wazektomii, gdy pacjenci poradnictwo planowanego na wazektomii.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Aby zmniejszyć ryzyko wystąpienia bólu moszny, otwarty zamiast laparoskopowego leczenia przepuklin pachwinowych jest zalecane.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zaleca się, by w czasie naprawy przepukliny pachwinowej wszystkie nerwów powrózka nasiennego zostały zidentyfikowane.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">W przypadku pacjentów leczonych chirurgicznie, zaleca się mikrochirurgiczne odnerwienie powrózka nasiennego.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zalecamy wycięcie jądra nie powinny być wykonywane, chyba że wszystkie inne terapie, w tym oceny zarządzania ból, nie powiodły się.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_4" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.4.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie zespołem bólowym cewki moczowej</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Nie ma specyficznego leczenia zespołu bólowego cewki moczowej.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">4</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">U pacjentów ze znacznym niebezpieczeństwie związanym z pęcherza lub cewki moczowej objawy, psychologiczny</span></div> <div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Leczenie może być wart używając w celu zmniejszenia stresu, a tym samym poprawić funkcjonowanie i QoL.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">4</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Start z ogólnych metod leczenia przewlekłego bólu miednicy.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zaleca się, aby pacjenci z zespołem bólowym cewki moczowej są traktowane w multidyscyplinarnym i multimodalnego programu.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Gdy pacjenci są w trudnej sytuacji, zaleca się odnosić je do bólu istotne leczenia psychologicznego w celu poprawy funkcjonowania i jakości życia.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_5" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.5.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie ginekologicznych aspektów przewlekłego bólu miednicy</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">opcje terapeutyczne, w tym farmakoterapii i chirurgii, można skutecznie leczyć endometriozę.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Leczenie psychologiczne (CBT lub podtrzymujące psychoterapii) może poprawić bólu i funkcje seksualne i emocjonalne w zespołach bólowych pochwy i sromu.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wszystkie pozostałe warunki ginekologiczne (w tym bolesne miesiączkowanie, położnicze szkody, wypadanie narządów miednicy i ginekologiczne) przerzutów raka można leczyć skutecznie stosując farmakoterapię.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zapewnienie możliwości terapeutyczne, takie jak terapia hormonalna lub operacji w ściśle określonych stanach chorobowych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zapewnienie interdyscyplinarnego podejścia do leczenia bólu w utrzymujących się stanów chorobowych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_6" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.6.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie zespołem bólowym odbytu</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów na ból odbytu funkcjonalnej</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Biofeedback jest preferowaną metodą leczenia przewlekłego zespołu bólowego anal.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Electrogalvanic stymulacja jest mniej skuteczny niż biologicznego sprzężenia zwrotnego.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Toksyna botulinowa jest skuteczne.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Przezskórna stymulacja nerwów piszczelowej jest skuteczny w bólu odbytu.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Sakralna neuromodulacja jest skuteczny w bólu odbytu.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wdychania salbutamolu jest skuteczny w przerywanym przewlekłym zespołem bólowym anal.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zalecenia dotyczące funkcjonalnego bólu odbytu</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Biofeedback leczenia zaleca się u chorych z bólem miednicy i dyssynergic defekacji.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta toksyny botulinowej A i electrogalvanic stymulacji w przewlekłym zespołem bólowym anal.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta przezskórnej stymulacji nerwu piszczelowego w przewlekłym zespołem bólowym anal.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta sakralną neuromodulacji w przewlekłym zespołem bólowym anal.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta wziewnych salbutamol w przerywanym syndrom chronicznego bólu odbytu.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">do</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_7" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.7.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie sromowego nerwobóle</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Istnieje wiele możliwości leczenia o różnym poziomie dowodów.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">3</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Wytyczne neuropatycznego bólu są dobrze znane. </span><span style="margin: 0px; padding: 0px;">Standardowe podejście do zarządzania bólu neuropatycznego powinny być wykorzystywane.</span></span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_8" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.8.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie Seksuologicznego aspektów w CPP</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Miednicy mięśni fizjoterapia może przynieść ulgę w bólu i zmniejszenia dolegliwości seksualnych.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">2b</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Oferta behawioralne strategie dla pacjenta i jego / jej partnera, aby poradzić sobie z dysfunkcji seksualnych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Trening mięśni dna miednicy jest zalecany w celu poprawy jakości życia i funkcji seksualnych.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">b</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_9" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.9.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie dysfunkcji miednicy podłogi</span></span></span></div> <table class="tabel_zwart-wit" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 1px solid rgb(102, 102, 102); box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Podsumowanie dowodów</span></div> </th><th class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(240, 240, 240); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">LE</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Powięziowy leczenie jest skuteczne.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1b</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Biofeedback poprawia wyniki leczenia myofascial.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Punkt wyzwalania uwalniania jest skuteczne w leczeniu bólu mięśni i, o którym mowa.</span></div> </td><td class="Celstijl_1" style="-webkit-font-smoothing: antialiased; background: rgb(255, 255, 255); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">1a</span></div> </td></tr> </tbody></table> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Zastosuj MFR traktowanie jako leczenie pierwszego rzutu.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">U chorych na nadczynność dna miednicy, biofeedback jest zalecana jako leczenie uzupełniające do ćwiczeń mięśni.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Gdy-powięziowych punktów spustowych stwierdzono, zaleca się leczenie przez ciśnienie lub igłowania.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <div class="kop3_witregel" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; line-height: 18px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="5_4_10" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">5.4.10.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Zarządzanie przewlekłej / non-ostrego bólu moczowo-płciowego przez opioidy</span></span></span></div> <table class="tabel_blauw" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border-collapse: collapse; border-spacing: 0px; border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px 0px 20px; max-width: 100%; outline: 0px; padding: 0px; table-layout: auto; vertical-align: baseline; width: 693px;"><thead style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">zalecenia</span></div> </th><th class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 1.2rem; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 500; line-height: 1.4667rem; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekstbold_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: 16px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: 18px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">GR</span></div> </th></tr> </thead><tbody style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Wszystkie inne uzasadnione zabiegi muszą być wypróbowane i nie powiodło się.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Decyzja wszcząć długotrwałemu leczeniu opioidami powinno być wykonane przez odpowiednio wyszkolonego specjalistę w porozumieniu z innym lekarzem (w tym pacjenta i lekarza rodzinnego).</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> <tr style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="93%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">Jeżeli istnieje podejrzenie, historii lub narkomanii, psychiatry lub psychologa mają interes w leczeniu bólu i narkomanii powinny być zaangażowane.</span></div> </td><td class="Celstijl_1_tint_PMS" style="-webkit-font-smoothing: antialiased; background: rgb(197, 218, 241); border: 1px solid rgb(102, 102, 102); box-sizing: border-box; font-family: inherit; font-size: 13px; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 3px 5px; vertical-align: top;" width="7%"><div class="tabel_bodytekst_9pt" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;">ZA</span></div> </td></tr> </tbody></table> <div id="share-post" style="background-color: white; border: 0px; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; line-height: 28px; margin: 20px 0px 0px; overflow: hidden; padding: 0px; vertical-align: baseline; width: 779.094px;"> <a class="facebook" href="https://www.blogger.com/share-post.g?blogID=5719139140166014270&postID=2413648506540314639&target=facebook" style="background-color: #436fc9; border: 0px; color: white; display: block; float: left; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; height: 32px; line-height: 32px; margin: 0px 10px 25px 0px; outline: none; padding: 0px 10px 0px 0px; text-decoration: none; transition: all 0.25s; vertical-align: baseline;" target="_blank" title="Udostępnij w usłudze Facebook"></a></div> <div style="-webkit-text-stroke-width: 0px; background-color: white; border: 0px; clear: both; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: 28px; margin: 0px; orphans: auto; padding: 0px; text-align: left; text-indent: 0px; text-transform: none; vertical-align: baseline; white-space: normal; widows: 1; word-spacing: 0px;"> </div> <br /> <h1 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 30px; font-stretch: inherit; font-weight: 500; line-height: 30px; margin: 0px 0px 20px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">6.</span></span><span style="margin: 0px; padding: 0px;"> OCENA wyników leczenia</span></h1> <h2 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 17px; font-stretch: inherit; font-weight: 500; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span style="border: 0px; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Ocena leczenia</span></span></span></h2> <div class="separator" style="background-color: white; border: 0px; clear: both; color: #585858; font-family: Helvetica, Arial, sans-serif; font-size: 16px; font-stretch: inherit; line-height: 28px; margin: 0px; padding: 0px; text-align: center; vertical-align: baseline;"> </div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">U pacjentów z przewlekłym bólu trzewnego, wizyta lekarza jest bardzo ważne, ponieważ mogą zadawać pytania, rozmawiać o tym, jak proces się dzieje i mieć trochę czasu z opiekunem, który rozumie naturę ich bólu. </span><span style="margin: 0px; padding: 0px;">Pierwsza ocena powinna nastąpić po około sześciu tygodni, aby zobaczyć, czy leczenie było udane, czy nie. </span><span style="margin: 0px; padding: 0px;">Gdy konieczne zmiany dokonywane są oceny, a następne planowane jest.</span></span></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <br style="margin: 0px; padding: 0px;" /></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.1.1.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Leczenie nie było skuteczne</span></span></span></h3> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="6_1_1_1" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">6.1.1.1.</span></span><span style="margin: 0px; padding: 0px;"> Leczenie Alternatywne</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W przypadkach, gdy leczenie zainicjowanych nie mają wystarczająco dużo efekt, alternatywne podejście jest zalecane.</span><span style="margin: 0px; padding: 0px;">Pierwszą rzeczą do zrobienia jest dokładna ocena pacjentów i świadczeniodawców przylgnięcia do leczenia, które zostało rozpoczęte. </span><span style="margin: 0px; padding: 0px;">Poprosić pacjenta, jeżeli podjęły leku według recepty, czy są jakieś skutki uboczne, a jeśli nie, gdzie wszelkie zmiany w bólu i funkcji. </span><span style="margin: 0px; padding: 0px;">Dostosowanie dawki leków lub systemów może pomóc. </span><span style="margin: 0px; padding: 0px;">Kolejną ważną rzeczą jest, aby zapoznać się z doniesieniami innych opiekunów, takich jak fizjoterapeuty i psychologa. </span><span style="margin: 0px; padding: 0px;">Czy leczenie zostało następnie do końca, jaka była opinia terapeuty na temat zmian, które zostały zaobserwowane. </span><span style="margin: 0px; padding: 0px;">W przypadkach, gdy sesje zostały zakończone przez pacjentów, poprosić pacjenta, dlaczego zrobili tę decyzję. </span><span style="margin: 0px; padding: 0px;">Sprawdź, czy pacjent zrozumiał ideę terapii, które zostało przerwane.</span></span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="6_1_1_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">6.1.1.2.</span></span><span style="margin: 0px; padding: 0px;"> Skierowanie do kolejnej koperty opieki</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Jeśli pacjenci i lekarze doszli do wniosku, że żadna z podanych terapii wykazał wystarczająco skuteczne, a następnie skierowanie do kolejnej koperty opieki jest zalecane. </span><span style="margin: 0px; padding: 0px;">Niestety terminologia stosowana do opisu poziomu przyrody i specjalizacji centra zapewnienie specjalistycznej opieki dla pacjentów ból trzewny nie jest standaryzowany kraju opiera.</span><span style="margin: 0px; padding: 0px;">To nie ułatwia proste schematy skierowania. </span><span style="margin: 0px; padding: 0px;">Zaleca się, aby pacjenci odnoszą się do ośrodka, który pracuje z wielodyscyplinarny zespół i uznanym w kraju jako specjalizuje się w bólu miednicy. </span><span style="margin: 0px; padding: 0px;">Takie centrum będzie ponownie ocenić, co zostało zrobione i kiedy będzie dostępny, zapewniają specjalistyczną opiekę.</span></span></div> <h4 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 20px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <a href="https://www.blogger.com/null" name="6_1_1_3" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;">6.1.1.3.</span></span><span style="margin: 0px; padding: 0px;"> Self-zarządzania i wspólna troska</span></h4> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">Pacjenci, którzy znajdują się w obliczu KPP, dla których nie ma konkretnych możliwości leczenia dostępne, będzie musiał żyć ze swoim bólem. </span><span style="margin: 0px; padding: 0px;">Będą musiały zarządzać ich ból, co oznacza, że ​​będą musieli znaleźć sposób na radzenie sobie ze skutkami ich ból w codziennych czynnościach życiowych we wszystkich dziedzinach życia. </span><span style="margin: 0px; padding: 0px;">programy samopomocy może poinformowani i mogą być pomocne. </span><span style="margin: 0px; padding: 0px;">Ten pacjent może również korzystać ze wspólnych opieki, co oznacza, że ​​opiekun jest dostępna dla wspierania strategii samo-zarządzania. </span><span style="margin: 0px; padding: 0px;">Wraz z tym opiekunem pacjent może zoptymalizować i wykorzystywać strategie zarządzania.</span></span></div> <h3 style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; font-style: italic; font-weight: 400; line-height: 30px; margin: 0px 0px 0px 80px; outline: 0px; padding: 0px; position: relative; text-rendering: optimizeLegibility; vertical-align: baseline;"> <span class="kop3_bolditalic" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 700; line-height: inherit; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"><a href="https://www.blogger.com/null" name="6_1_2" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; color: #2cace1; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: inherit; line-height: inherit; margin: 0px; outline: none; padding: 0px; text-decoration: none; transition: opacity 0.3s, color 0.3s; vertical-align: baseline;"></a><span class="list" style="-webkit-font-smoothing: antialiased; background: 0px 0px; border: 0px; box-sizing: border-box; display: inline-block; font-family: inherit; font-size: inherit; font-stretch: inherit; font-style: inherit; font-variant: inherit; font-weight: 400; line-height: inherit; margin: 0px 0px 0px -80px; outline: 0px; padding: 0px; vertical-align: baseline; width: 80px;"><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">6.1.2.</span></span></span><span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;"> Leczenie jest skuteczne</span></span></span></h3> <div class="bodytekst" style="-webkit-font-smoothing: antialiased; background: 0px 0px rgb(245, 245, 245); border: 0px; box-sizing: border-box; color: #2c2b2b; font-family: Roboto, 'Helvetica Neue', Helvetica, Arial, sans-serif; font-size: 15px; font-stretch: inherit; line-height: 18px; margin: 0px; outline: 0px; padding: 0px 0px 20px; vertical-align: baseline;"> <span style="margin: 0px; padding: 0px;"><span style="margin: 0px; padding: 0px;">W przypadkach, gdy leczenie jest skuteczne opiekun może zwrócić uwagę na profilaktykę awaryjne. </span><span style="margin: 0px; padding: 0px;">Jeśli pacjenci znowu czuje ten sam ból pomaga rozpocząć na wczesnym etapie ze strategiami samorządność, że nauczył się podczas poprzedniego leczenia. </span><span style="margin: 0px; padding: 0px;">Dzięki temu będą mieli największe szanse na zapobieganie rozwojowi zespołów bólowych miednicy ponownie.</span></span></div>

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