Exploration d’une douleur pelvienne : approche collégiale « gynécologue-gastroentérologue » appliquée aux formes chroniques

G Roseau, Piétro Santulli, Louis Marcellin, Charles Chapron
In: Acta Endoscopica · 2014 · vol. 44(5) , pp. 281–291 · doi:10.1007/s10190-014-0409-6 · W202725754
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-13 ⓘ

This paper explores chronic pelvic pain by reviewing literature on the neuroanatomy of gastrointestinal pain, endometriosis, visceral sensation, and the prevalence of pelvic pain and endometriosis in various patient populations.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This paper describes a collaborative clinical approach between gynecologists and gastroenterologists for exploring chronic pelvic pain, with a focus on visceral pain mechanisms and diagnostic context drawn from prior literature on lower gastrointestinal pain disorders, chronic pelvic pain epidemiology, and symptom characterization. It emphasizes relationships among pelvic pain, anatomic localization (including deep infiltrating endometriosis in cited studies), and the challenge of correlating patient symptom descriptions with objective findings, while acknowledging that diagnostic experience and standardized tools have limitations. The key finding is that a multidisciplinary “collegial” framework is presented as a structured way to interpret chronic pelvic pain by integrating gynecologic and gastrointestinal perspectives and mechanisms of peripheral/central sensitization. This paper is centrally about endometriosis — it discusses and cites endometriosis repeatedly to frame how chronic pelvic pain is analyzed across pelvic and digestive mechanisms, particularly in deep infiltrating endometriosis.

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Références Vermeulen W, De Man JG, Pelckmans PA, De Winter BY. Neuroanatomy of lower gastrointestinal pain disorders. World J Gastroenterol 2014;20:1005–20. Stratton P, Berkley KJ. Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications. Hum Reprod 2011;17:327–46. Procacci P, Zoppi M, Maresca M. Clinical approach to visceral sensation. Prog Brain Res 1986;67:21–8. Cervero F. Visceral pain: mechanisms of peripheral and central sensitization. Ann Med 1995;27:235–9. Giamberardino MA. Recent and forgotten aspects of visceral pain. Eur J Pain 1999;3:77–92. Jamieson D, Steege J. The prevalence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol 1996;87:55–8. Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol 1999;106:1149–55. Greene R, Stratton P, Cleary SD, Ballweg ML, Sinaii N. Diagnostic experience among 4,334 women reporting surgically diagnosed endometriosis. Fertil Steril 2009;91:32–9. Saha S, Midtling E, Roberson E, Nair VA, Wald A, Reichelderfer M. Dysmenorrhea in women with Crohn’s disease: a case-control study. Inflamm Bowel Dis 2013;19:1463–9. Hurd WW. Criteria that indicate endometriosis is the cause of chronic pelvic pain. Obstet Gynecol 1998;92:1029–32. Nicolai MP, Fidder HH, Bekker MD, Putter H, Pelger RC, Elzevier HW. Pelvic floor complaints in gastroenterology practice: results of a survey in the Netherlands. Frontline Gastroenterol 2012;3:166–71. Biberoglu KO, Behrman SJ. Dosage aspects of danazol therapy in endometriosis: short-term and long-term effectiveness. Am J Obstet Gynecol 1981;139:645–54. Fauconnier A, Staraci S, Huchon C, Roman H, Panel P, Descamps P. Comparison of patient- and physician-based descriptions of symptoms of endometriosis: a qualitative study. Hum Reprod 2013;28:2686–94. Koninckx PR, Meuleman C, Demeyere S, Lesaffre E, Cornillie FJ. Suggestive evidence that pelvic endometriosis is a progressive disease, whereas deeply infiltrating endometriosis is associated with pelvic pain. Fertil Steril 1991;55:759–65. Chapron C, Barakat H, Fritel X, Dubuisson JB, Bréart G, Fauconnier A. Presurgical diagnosis of posterior deep infiltrating endometriosis based on a standardized questionnaire. Hum Reprod 2005;20:507–13. Fauconnier A, Chapron C, Dubuisson JB, Vieira M, Dousset B, Breart G. Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis. Fertil Steril 2002;78:719–26. Roman H, Ness J, Suciu N, Bridoux V, Gourcerol G, Leroi AM, et al. Are digestive symptoms in women presenting with pelvic endometriosis specific to lesion localizations? A preliminary prospective study. Hum Reprod 2012;27:3440–9. Dessole M, Melis GB, Angioni S. Endometriosis in adolescence. Obstet Gynecol Int 2012;2012:869–191 Steenberg CK, Tanbo TG, Qvigstad E. Endometriosis in adolescence: predictive markers and management. Acta Obstet Gynecol Scand. 2013;92:491–5. Kontorvadis A, Chryssikopoulos A, Hassiakos D, Liapis A, Zourlas PA. The diagnostic value of laparoscopy in 2,365 patients with acute and chronic pelvic pain. Int J Gynaecol Obstet 1996;52:243–8. Peters AA, van Dorst E, Jellis B, van Zuuren E, Hermans J, Trimbos JB. A randomized clinical trial to compare two differents approaches in women with chronic pelvic pain. Obstet Gynecol 1991;77:740–4. Cunanan RG, Courey NG, Lippes J. Laparoscopic findings in patients with pelvic pain. Am J Obstet Gynecol 1983;146:589–91. Kresch AJ, Seifer D, Sachs LB, Barrese I, Laparoscopic findings in patients with pelvic pain. Am J Obstet Gynecol 1983;146:589–91. Author information Authors and Affiliations Corresponding author About this article Cite this article Roseau, G., Santulli, P., Marcellin, L. et al. Exploration d’une douleur pelvienne : approche collégiale « gynécologue-gastroentérologue » appliquée aux formes chroniques. Acta Endosc 44, 281–291 (2014). https://doi.org/10.1007/s10190-014-0409-6 Published: Issue date: DOI: https://doi.org/10.1007/s10190-014-0409-6

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