{"paper_id":"a6aee46e-b6a5-4688-8777-da1336fade29","body_text":"Abstract\nChronic pelvic pain (CPP) is defined as intermittent or constant pain in the lower abdomen, pelvis, anterior abdominal wall, lower back, or buttocks that has a duration of at least 6 months and is associated with limitations on the ability to attend to daily living activities. Females who suffer from CPP may have several etiologies for their pain; hence, the evaluation should identify specific peripheral causes of pain and differentiate them from centralized pain syndromes, given that the treatments can differ substantially. It is important to recognize that as many as 55% of women presenting with CPP will have no well-defined etiology following completion of all investigations (Whitaker et al., PloS One 11:e0151950, 2016). The socioeconomic CPP cost is considerable, with an estimated direct healthcare cost of $880 million per year in the United States, besides $2 billion direct and indirect costs annually (Ahangari, Pain Physician 17:E141–7, 2014). Of these women, 15% report missing work, and 45% note experiencing reduced productivity.\nThis chapter provides a comprehensive summary of chronic pelvic pain management in older women for the generalist and facilitates appropriate investigation and management.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nReferences\nAgostinho L, Cruz R, Osorio F, Alves J, Setubal A, Guerra A. MRI for adenomyosis: a pictorial review. Insights Imaging. 2017;8(6):549–56.\nAhangari A. Prevalence of chronic pelvic pain among women: an updated review. Pain Physician. 2014;17(2):E141–7.\nAnderson RU, Wise D, Sawyer T, Nathanson BH, Nevin SJ. Equal improvement in men and women in the treatment of urologic chronic pelvic pain syndrome using a multi-modal protocol with an internal myofascial trigger point wand. Appl Psychophysiol Biofeedback. 2016;41(2):215–24.\nBC Centre for Disease Control. STI in British Columbia: annual surveillance report 20122014.\nCamilleri M. Diagnosis and treatment of irritable bowel syndrome: a review. JAMA. 2021;325(9):865–77.\nChapron C, Querleu D, Bruhat MA, Madelenat P, Fernandez H, Pierre F, et al. Surgical complications of diagnostic and operative gynaecological laparoscopy: a series of 29,966 cases. Hum Reprod. 1998;13(4):867–72.\nChronic Pelvic Pain. ACOG practice bulletin, number 218. Obstet Gynecol. 2020;135(3):e98–e109.\nCollins SA, Joshi G, Quiroz LH, Steinberg AC, Nihira MA. Pain management strategies for urogynecologic surgery: a review. Female Pelvic Med Reconstr Surg. 2014;20(6):310–5.\nHartmann D, Sarton J. Chronic pelvic floor dysfunction. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):977–90.\nHindocha A, Beere L, Dias S, Watson A, Ahmad G. Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews. Cochrane Database Syst Rev. 2015;1:CD011254.\nKhilnani NM, Meissner MH, Learman LA, Gibson KD, Daniels JP, Winokur RS, et al. Research priorities in pelvic venous disorders in women: recommendations from a multidisciplinary research consensus panel. J Vasc Interv Radiol. 2019;30(6):781–9.\nKim JH, Han E. Endometriosis and female pelvic pain. Semin Reprod Med. 2018;36(2):143–51.\nKirby AC, Luber KM, Menefee SA. An update on the current and future demand for care of pelvic floor disorders in the United States. Am J Obstet Gynecol. 2013;209(6):584:e1–5.\nLevy G, Dehaene A, Laurent N, Lernout M, Collinet P, Lucot JP, et al. An update on adenomyosis. Diagn Interv Imaging. 2013;94(1):3–25.\nLoving S, Thomsen T, Jaszczak P, Nordling J. Female chronic pelvic pain is highly prevalent in Denmark. A cross-sectional population-based study with randomly selected participants. Scand J Pain. 2014;5(2):93–101.\nMathias S, Kuppermann M, Liberman R, Lipschutz R, Steege J. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol. 1996;87:321–7.\nMeister MR, Sutcliffe S, Ghetti C, Chu CM, Spitznagle T, Warren DK, et al. Development of a standardized, reproducible screening examination for assessment of pelvic floor myofascial pain. Am J Obstet Gynecol. 2019;220(3):255.e1–9.\nMitchell C, Prabhu M. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment. Infect Dis Clin N Am. 2013;27(4):793–809.\nNickel JC, Shoskes D, Irvine-Bird K. Clinical phenotyping of women with interstitial cystitis/painful bladder syndrome: a key to classification and potentially improved management. J Urol. 2009;182(1):155–60.\nPape J, Falconi G, De Mattos Lourenco TR, Doumouchtsis SK, Betschart C. Variations in bladder pain syndrome/interstitial cystitis (IC) definitions, pathogenesis, diagnostics and treatment: a systematic review and evaluation of national and international guidelines. Int Urogynecol J. 2019;30(11):1795–805.\nPhillips D, Deipolyi AR, Hesketh RL, Midia M, Oklu R. Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management. J Vasc Interv Radiol. 2014;25(5):725–33.\nRossi FH, Rodrigues TO, Izukawa NM, Kambara AM. Best practices in diagnosis and treatment of chronic iliac vein obstruction. J Vasc Brasileiro. 2020;19:e20190134.\nRourke W, Khan SA, Ahmed K, Masood S, Dasgupta P, Khan MS. Painful bladder syndrome/interstitial cystitis: aetiology, evaluation and management. Archivio italiano di urologia, andrologia: organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2014;86(2):126–31.\nSharma D, Dahiya K, Duhan N, Bansal R. Diagnostic laparoscopy in chronic pelvic pain. Arch Gynecol Obstet. 2011;283(2):295–7.\nShobeiri SA, White D, Quiroz LH, Nihira MA. Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison. Int Urogynecol J. 2012;23(8):1047–53.\nSpeer LM, Mushkbar S, Erbele T. Chronic pelvic pain in women. Am Fam Physician. 2016;93(5):380–7.\nSpringer KW, Sheridan J, Kuo D, Carnes M. The long-term health outcomes of childhood abuse. An overview and a call to action. J Gen Intern Med. 2003;18(10):864–70.\nTrent M, Bass D, Ness RB, Haggerty C. Recurrent PID, subsequent STI, and reproductive health outcomes: findings from the PID evaluation and clinical health (PEACH) study. Sex Transm Dis. 2011;38(9):879–81.\nVannuccini S, Petraglia F. Recent advances in understanding and managing adenomyosis. F1000Research. 2019:8.\nVercellini P, Vigan’o P, Somigliana E, Daguati R, Abbiati A, Fedele L. Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynecol. 2006;20:465–77.\nVincent K. Chronic pelvic pain in women. Postgrad Med J. 2009;85(999):24–9.\nWhitaker LH, Reid J, Choa A, McFee S, Seretny M, Wilson J, et al. An exploratory study into objective and reported characteristics of neuropathic pain in women with chronic pelvic pain. PLoS One. 2016;11(4):e0151950.\nZondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, et al. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract. 2001;51(468):541–7.\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2023 Springer Nature Switzerland AG\nAbout this entry\nCite this entry\nJavadian, P., Momeni, M., Nihira, M.A. (2023). Management of Pelvic Pain in Older Women. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-031-14881-1_51\nDownload citation\nDOI: https://doi.org/10.1007/978-3-031-14881-1_51\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-031-14880-4\nOnline ISBN: 978-3-031-14881-1\neBook Packages: MedicineReference Module Medicine","source_license":"CC0","license_restricted":false}