Nongynecologic somatic pathology in women with chronic pelvic pain and negative laparoscopy
Observational
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⤵ 40 in-corpus citations
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This study identified nongynecologic somatic pathology in 47% of women with chronic pelvic pain and negative laparoscopy, with myofascial pain being most common and 75% of those diagnosed showing long-term improvement.
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Abstract
One hundred eighty-three women with chronic pelvic pain were referred to a multidisciplinary chronic pelvic pain clinic after negative laparoscopy. One hundred twenty-two of them completed a thorough medical and psychologic evaluation and were followed for a minimum of six months after completion of therapy. Occult somatic pathology was diagnosed in 57 women (47%), including 19 in whom coexistent psychopathology was diagnosed. Myofascial pain was the most common somatic diagnosis, followed by atypical cyclic pain (dysmenorrhea or mittelschmerz); gastroenterologic, urologic and infectious diseases; and pelvic vascular congestion. No plausible somatic etiology was apparent in the remaining 65 (53%) of the 122 referrals. Nongynecologic somatic pathology accounted for 34 (29%) and gynecologic pathology for 23 (19%) of the referrals, only 6 (5%) of whom ultimately required hysterectomy. Women with a somatic diagnosis were found to be significantly older than the remainder of the referral population. Long-term symptomatic improvement or resolution of pain was obtained in 43 (75%) of the 57 patients with somatic diagnoses. Coexistent psychopathology was found to correlate with a poorer long-term prognosis. Our findings underscore the importance of a multidisciplinary approach to evaluating and treating chronic pelvic pain in women and confirm that hysterectomy is indicated in this setting only rarely.
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Cited by (32)
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- Endometriosis and other causes of pelvic pain in perspective 2021
- Pelvic Pain in the Transgender Man 2020
- Chronic Urogenital and Pelvic Pain 2019
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- No. 164-Consensus Guidelines for the Management of Chronic Pelvic Pain 2018
- No 164 - Directive clinique de consensus pour la prise en charge de la douleur pelvienne chronique 2018
- Office management of pelvic pain and dyspareunia 2016
- Gynecology 2016
- History of abuse and its relationship to pain experience and depression in women with chronic pelvic pain 2014
- Musculoskeletal causes of chronic pelvic pain: what a gynecologist should know 2013
- Systematic review of therapies for noncyclic chronic pelvic pain in women 2012
- Physical therapy management of female chronic pelvic pain: Anatomic considerations 2012
- Chronic Pelvic Pain Unrelated to Endometriosis 2012
- Importance of pelvic muscle tenderness evaluation in women with chronic pelvic pain 2009
- Physical therapy evaluation of patients with chronic pelvic pain: a controlled study 2008
- Gynecological Pain, Endometriosis, Visceral Disease, and the Viscero-Somatic Connection 2008
- Impact of diagnostic laparoscopy on the management of chronic pelvic pain 2006
- Consensus statement for the management of chronic pelvic pain and endometriosis: proceedings of an expert-panel consensus process 2002
- Hernia and Chronic Pelvic Pain in Women 2001
- Chronic pelvic pain: clinical dilemma or clinician's nightmare 2000
- Clinical knots Chronic pelvic pain: clinical dilemma or clinician's nightmare 2000
- Dolor pélvico crónico: enfoque multidisciplinario 2000
- Clinical outcome in female patients with pelvic pain and normal pelvic US findings 2000
- Chronic pelvic pain as a somatoform disorder 1999
- Indications for hysterectomy: have they changed? 1997
- The role of laparoscopy in the evaluation of chronic pelvic pain: pitfalls with a negative laparoscopy 1996
- Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates 1996
- The effectiveness of hysterectomy for chronic pelvic pain 1995
- Irritable bowel syndrome and chronic pelvic pain 1994
- Combined hysteroscopic and laparoscopic findings in patients with chronic pelvic pain 1994
- Surgical management of chronic pelvic pain 1993
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- openalex
- last seen: 2026-06-10T17:14:06.276822+00:00
- pubmed
- last seen: 2026-10-08T21:05:10.907216+00:00
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