{"paper_id":"cb92a182-ef53-423f-a79a-c58e405fd126","body_text":"Abstract\nChronic pelvic pain (CPP) is defined as intermittent or constant pain in the lower abdomen or pelvis for at least 6 months in duration, with subsequent impact on the ability to attend to daily living activities. Gynecologists have traditionally focused on the organ-specific approach or viscera to explain or identify the pain source. 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. CPP is fairly common, with an estimated prevalence of 3.8 % in the adult female population. It is the impetus for 10 % of gynecologic referrals, 12 % of hysterectomies, and 40 % of laparoscopic procedures. The socioeconomic CPP cost is considerable, with estimated direct health care cost of $880 million per year in the United States, besides $2 billion dollars direct and indirect costs annually. Of these women, 15 % report missing work, and 45 % note experiencing reduced productivity.\nThis chapter will provide a comprehensive summary of chronic pelvic pain management in older women for the generalist and to facilitate appropriate investigation and management\nReferences\nBC Centre for Disease Control 2014. STI in British Columbia: Annual Surveillance Report 2012. http://www.bccdc.ca/util/about/annreport/default.htm\nBrawn J, Morotti M, Zondervan K, Becker C, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update. 2014;20:737–47.\nCollins S, Joshi G, Quiroz L, Steinberg A, Nihira M. Pain management strategies for urogynecologic surgery: a review. Female Pelvic Med Reconstr Surg. 2014;20:310–5.\nFlor H, Fydrich T, Turk D. Efficacy of multidisciplinary pain treatment centers: ameta-analytic review. Pain. 1992;49:221–30.\nHanno P, Burks D, Clemens J, Dmochowski R, Erickson D, Fitzgerald M, Forrest J, Gordon B, Gray M, Mayer R, Newman D, Nyberg LJ, Payne C, Wesselmann U, Faraday M. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162–70.\nHartmann D, Sarton J. Chronic pelvic floor dysfunction. Best Pract Res Clin Obstet Gynaecol. 2014;28:977–90.\nHeilbrun ME, Nygaard IE, Lockhart ME, Richter HE, Brown MB, Kenton KS, Rahn DD, Thomas JV, Weidner AC, Nager CW, Delancey JO. Correlation between levator ani muscle injuries on magnetic resonance imaging and fecal incontinence, pelvic organ prolapse, and urinary incontinence in primiparous women. Am J Obstet Gynecol. 2010;202:488.e1–6.\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.\nKirby A, Luber K, Menefee S. An update on the current and future demand for care of pelvic floor disorders in the United States. Am J Obstet Gynecol. 2013;209:584.e1–5.\nLevy G, Dehaene A, Laurent N, Lernout M, Collinet P, Lucot J, Lions C, Poncelet E. An update on adenomyosis. Diagn Interv Imag. 2013;94:3–25.\nLongstreth G. Irritable bowel syndrome and chronic pelvic pain. Obstet Gynecol Surv. 1994;49:505–7.\nMatheis A, Martens U, Kruse J, Enck P. Irritable bowel syndrome and chronic pelvic pain: a singular or two different clinical syndrome? World J Gastroenterol. 2007;13:3446–55.\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.\nMitchell C, Prabhu M. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment. Infect Dis Clin North Am. 2013;27:793–809.\nNascimento A, Mitchell D, Holland G. Ovarian veins: magnetic resonance imaging findings in an asymptomatic population. J Magn Reson Imag. 2002;15:551–6.\nNickel J, 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;182:155–60.\nPhillips D, Deipolyi A, Hesketh R, Midia M, Oklu R. Pelvic congestion syndrome: etiology of pain, diagnosis, and clinical management. J Vasc Interv Radiol. 2014;25:725–33.\nRourke W, Khan S, Ahmed K, Masood S, Dasgupta P, Khan M. Painful bladder syndrome/interstitial cystitis: aetiology, evaluation and management. Arch Ital Urol Androl. 2014;86:126–31.\nShobeiri S, White D, Quiroz L, Nihira M. Anterior and posterior compartment 3D endovaginal ultrasound anatomy based on direct histologic comparison. Int Urogynecol J. 2012;23:1047–53.\nSlocumb J. Neurological factors in chronic pelvic pain: trigger points and the abdominal pelvic pain syndrome. Am J Obstet Gynecol. 1984;149:536–43.\nToday’s Research on Aging. 2009. HIV/AIDS and older adults in the United States. Available: http://acl.gov/NewsRoom/Publications/docs/Seniors_and_HIV_AIDS.pdf\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;85:24–9.\nZondervan K, Yudkin P, Vessey M, Jenkinson C, Dawes M, Barlow D. The community prevalence of chronic pelvic pain in women and associated illness behaviour. Br J Gen Pract. 2001;51:541–7.\nAuthor information\nAuthors and Affiliations\nCorresponding authors\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2016 Springer International Publishing Switzerland\nAbout this entry\nCite this entry\nJavadian, P., Nihira, M.A. (2016). Management of Pelvic Pain in Older Women. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-17002-2_51-1\nDownload citation\nDOI: https://doi.org/10.1007/978-3-319-17002-2_51-1\nReceived:\nAccepted:\nPublished:\nPublisher Name: Springer, Cham\nOnline ISBN: 978-3-319-17002-2\neBook Packages: Living Reference MedicineReference Module Medicine","source_license":"CC0","license_restricted":false}