Systematic Review of Therapies for Noncyclic Chronic Pelvic Pain in Women

Amanda Yunker, Yunker A, Sathe NA, Nila A Sathe, William M. Reynolds, William Stuart Reynolds, Frances E. Likis, Andrews J, Jeff Andrews
Obstetrical & gynecological survey · 2012 · vol. 67(7) , pp. 417–425 · doi:10.1097/ogx.0b013e31825cecb3 · PMID:22926248 · W2314555581
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This systematic review found that current literature on therapies for chronic pelvic pain in women is of poor quality and inconclusive, with both surgical and nonsurgical interventions showing some pain improvement but no clear superiority.

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Abstract

We synthesized the literature (articles published between 1990 and May 2011) on the treatment of noncyclic and mixed cyclic/noncyclic chronic pelvic pain (CPP) in adult women. Two reviewers assessed studies against predetermined inclusion/exclusion criteria, extracted data regarding participant and intervention characteristics and outcomes, and assigned overall quality and strength of evidence ratings. Of 2081 studies, 21 addressed surgical or nonsurgical interventions. Definitions of CPP and participant characteristics varied across studies, and most studies were of poor quality, which precluded data synthesis. Although surgical and nonsurgical approaches both improved pain, neither was more effective when directly compared in 3 studies. Laparoscopic adhesiolysis or laparoscopic uterosacral nerve ablation did not further improve pain scores over diagnostic laparoscopy. The evidence to conclude that surgical intervention is either effective or ineffective or that one technique is superior to another is insufficient. Most studies on nonsurgical approaches evaluated hormonal therapies in endometriosis-associated CPP and were not placebo controlled. Few studies addressed nonhormonal or nonpharmacologic approaches. Harms reporting was limited. Overall, no nonsurgical treatment was more or less effective than another, except for the clear negative effect of raloxifene. In general, the literature addressing therapies for CPP in women is of poor quality and inconclusive. Improved characterizations of the targeted condition and interventions in CPP research, including a uniform definition and standardized evaluation, are necessary to inform treatment choices. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader should be able to assess the effects of surgical and nonsurgical interventions on the outcomes of pain status, functional status, satisfaction with care, and quality of life; to evaluate the effectiveness of interventions for noncyclic chronic pelvic pain; and to categorize areas of future research need.

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Condition tags

chronic_pelvic_painendometriosis

MeSH descriptors

Pain Management Pelvic Pain Analgesics Analgesics Chronic Disease Estrogens Estrogens Female Humans Hysterectomy Laparoscopy Neuromuscular Agents Neuromuscular Agents Pain Management Pain Measurement Pelvic Pain Progestins Progestins Treatment Outcome

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (48)

Cited by (20)

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