Etiology and Management of Chronic Pelvic Pain Syndromes

Lori Reisner
In: Journal of Pharmaceutical Care in Pain & Symptom Control · 1997 · vol. 5(4) , pp. 31–48 · doi:10.1300/j088v05n04_03 · W1987724290
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This review discusses the heterogeneous etiology, diagnosis, and empiric management of chronic pelvic pain, emphasizing a step-wise conservative and psychosocial approach due to limited pharmacological evidence.

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Abstract

Chronic pelvic pain constitutes a major reason for gynecological visits, representing a constellation of symptoms for which no definitive treatments exist. History and examination must include both physical and emotional spheres. Presenting symptoms and diagnoses are heterogeneous for the pelvis and abdomen, with multiple treatments yielding minimal relief. Few well-controlled studies of pharmacological therapies exist, and treatments are still empiric. Step-wise conservative treatment is warranted when the source of the pain is known or associated with a high level of suspicion. Pharmacological therapy should begin with agents appropriate for the level of pain and disability, and escalation of regimens done only when rational and genuinely therapeutic courses have failed. Psychosocial impact of the pain must be considered, and adjunctive treatment offered to minimize the impact of the pain on the patient's quality of daily living.

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chronic_pelvic_pain

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