{"paper_id":"48eb54c4-2438-40c6-a95b-396a239eb7c6","body_text":"Zusammenfassung\nHintergrund\nDer chronische Unterbauchschmerz der Frau stellt in der gynäkologischen Praxis ein schwieriges diagnostisches und therapeutisches Problem dar, das im Umgang mit den betroffenen Frauen eine stete Herausforderung ist.\nGynäkologische Ursachen\nMögliche gynäkologische Ursachen und Befunde sind Endometriose, Adhäsionen bzw. die „pelvic inflammatory disease“ (PID), pelvine Varikosis und das „ovarian retention syndrome/ovarian remnant syndrome“. Andere somatische Ursachen sind das Reizdarmsyndrom, das „bladder pain syndrome“ bzw. die interstitielle Zystitis sowie Erkrankungen des muskuloskeletalen Systems und des Bindegewebes.\nPsychosoziale Ursachen\nGesicherte psychosoziale Ursachen sind eine hohe Komorbidität mit psychologischen Faktoren wie Angststörungen, Substanzabhängigkeit oder depressiven Störungen, wobei eine eindeutige Zuordnung zu sozialen Faktoren nicht nachgewiesen ist. Auch ein Zusammenhang mit körperlichem und sexuellem Missbrauch kann nicht abschließend bewertet werden.\nDiagnostik und Therapie\nIn der Diagnostik sind die Anamnese, gynäkologische Untersuchung und Durchführung einer Laparoskopie als wichtige Schritte zu nennen. Multidisziplinäre Therapieansätze sind als Erfolg versprechend anzusehen. Die psychosomatische Grundversorgung soll von Beginn an in das Behandlungskonzept integriert werden. Auch eine Psychotherapie ist frühzeitig einzuleiten.\nAbstract\nBackground\nChronic pelvic pain in women represents a difficult diagnostic and therapeutic problem in the gynecological practice which is always a challenge when dealing with affected women.\nGynecological causes\nPossible gynecological causes are endometriosis, adhesions and/or pelvic inflammatory disease (PID), pelvic varicosis and ovarian retention syndrome/ovarian remnant syndrome. Other somatic causes are irritable bowel syndrome, bladder pain syndrome, interstitial cystitis and fibromyalgia.\nPsychosocial factors\nPsychosocial causes contributing to chronic pelvic pain are a high comorbidity with psychological factors, such as anxiety disorders and substance abuse or depression but the influence of social factors is less certain. The association with physical and sexual abuse also remains unclear.\nDiagnostics and therapy\nImportant diagnostic steps are recording the patient history, a gynecological examination and laparoscopy. Multidisciplinary therapeutic approaches are considered to be very promising. Basic psychosomatic care and psychotherapy should be integrated into the therapeutic concept at an early stage.\nAccess this article\nWe’re sorry, something doesn't seem to be working properly.\nPlease try refreshing the page. 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J Psychosom Obstet Gynaecol 30:262–268\nZhu X, Hamilton KD, McNicol ED (2011) Acupuncture for pain in endometriosis. Cochrane Database Syst Rev:CD007864. DOI 10.1002/14651858.CD007864\nEinhaltung ethischer Richtlinien\nInteressenkonflikt. F. Siedentopf und M. Sillem geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.\nAuthor information\nAuthors and Affiliations\nCorresponding author\nRights and permissions\nAbout this article\nCite this article\nSiedentopf, F., Sillem, M. Chronischer Unterbauchschmerz der Frau. Schmerz 28, 300–304 (2014). https://doi.org/10.1007/s00482-014-1408-4\nPublished:\nIssue date:\nDOI: https://doi.org/10.1007/s00482-014-1408-4","source_license":"CC0","license_restricted":false}