{"paper_id":"e229277d-e4e6-4ad7-8146-cb3785d859d7","body_text":"EDITORIAL\nChronic pelvic pain in urogynecological practice\nPeter L. Dwyer\nPublished online: 24 February 2011\n# The International Urogynecological Association 2011\nIn this issue of the International Urogynecology Journal\nthere is a focus on chronic pain in urogynecological\npractice. Kavvadias et al. performed a literature review of\ndefinitions and assessment of chronic pelvic pain in the\nurogynecological patient, and there are a number of original\nmanuscripts relating to chronic pelvic pain conditions\nincluding interstitial cystitis and pain after sling surgery.\nWe believe that this is timely as referral of women with\nchronic pelvic pain is a common occurrence for all of us.\nSome of these women will have pain which is related to the\nlower urinary tract with urinary frequency, urgency, and\ndifficult or painful micturiction and possibly have a\nprovisional diagnosis of interstitial cystitis or urethral\nsyndrome. Others may have predominantly genital or\ncolorectal pain which may be constant or intermittent, or\nrelated to coitus or defecation. The pain may have\ndeveloped spontaneously or following your or somebody\nelse’s surgery. Many of these women may have been\ndiagnosed as having pudendal neuropathy or entrapment,\npelvic congestion syndrome, fibromyalgia, vulva vestibulitis,\nand irritable bowel syndrome. Women with chronic pelvic\npain frequently have dysfunctional sexual symptoms as well\nas emotional and psychosocial problems, and sometimes\nchildhood sexual or physical abuse.\nIn women with chronic pelvic pain where there is no\nclearly defined pathology, accurate diagnosis is difficult as\nthe underlying aetiology is unclear. There is a lack of\ndiagnostic investigations for many pelvic conditions and\ntreatment strategies are often unsuccessful. These patients\nhave frequently seen multiple doctors and finally in\ndesperation referred to you, a urogynecologist or urologist\nbecause of associated urinary symptoms. Not surprising,\nmedical ligation is common in this group of patients\nespecially if considered to be surgically related. This tends\nto perpetuate the pain and complicate management.\nTherefore, considering the importance of chronic pain in\nurogynecology, we would encourage good innovative\nresearch and prospective trials, and the submission of\noriginal articles and reviews in this area to the International\nUrogynecology Journal .\nP . L. Dwyer (*)\nDepartment of Urogynecology, Mercy Hospital for Women,\nUniversity of Melbourne,\nMelbourne, Australia\ne-mail: pdwyer@connexus.net.au\nInt Urogynecol J (2011) 22:381\nDOI 10.1007/s00192-011-1369-4","source_license":"CC0","license_restricted":false}