Chronic Pelvic Pain Syndrome among women - challenge in diagnostics and management. Current literature review

In: Journal of Education, Health and Sport · 2024 · vol. 55 , pp. 170–184 · doi:10.12775/jehs.2024.55.011 · W4391317221
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This review summarizes the challenges in diagnosing and managing Chronic Pelvic Pain Syndrome in women, highlighting its complex, multifactorial nature and the need for multidisciplinary treatment approaches.

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This article is a narrative literature review that examines chronic pelvic pain syndrome (CPPS) in women, focusing on diagnostic and management challenges using epidemiologic findings and prior studies describing symptom patterns and treatment approaches. It characterizes CPPS as intermittent or constant lower abdominal/pelvic pain lasting at least 6 months, noting that prevalence is reported at 5.7–26.6% among reproductive-age women while only about one-third seek medical care, and it highlights that multifactorial symptom overlap (pelvic floor, urinary, and gastrointestinal dysfunction) complicates diagnosis and delays appropriate management. The review concludes that the most successful treatment strategies emphasize multidisciplinary collaboration across gynecology, gastroenterology, mental health, and physiotherapy, while stating that the pathophysiology has not been comprehensively studied and more research on multimodal strategies is needed. Relevance to endometriosis: the paper is included as a CPPS review in a corpus that specifically covers gynecologic pain conditions, and it cites endometriosis-oriented medical management studies within its reference list (e.g., dienogest vs combined oral contraceptive for endometriosis-associated pain and other endometriosis hormone-therapy trials), though its main focus is CPPS broadly rather than endometriosis or adenomyosis specifically.

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Abstract

Introduction and purpose: Chronic Pelvic Pain Syndrome (CPPS) is characterized as intermittent or constant pain located in the lower abdomen or pelvis, persisting continuously for at least 6 months [1]. Reports on the prevalence of chronic pelvic pain indicate the occurrence of this condition at a level of 5.7–26.6% in women of reproductive age. However, only a third of women suffering from chronic pelvic pain, seek medical care [2]. Clinical picture of CPPS consists of various patterns and symptoms, often as the intersection of the multiple systems, which additionally complicates and delays the diagnostic process. The aim of this review is to summarize existing literature about the diagnostics and management of Chronic Pelvic Pain Syndrome among women and create an awareness about the challenges which this condition poses for healthcare professionals. A brief description of the state of knowledge: Chronic Pelvic Pain Syndrome is a multifaceted condition and the pathophysiology of it has not yet been comprehensively studied. Clinical picture often involves dysfunctions in pelvic floor, urinary tract, or gastrointestinal system. Treatment involves a multidisciplinary approach including non-pharmacological and pharmacological interventions. Summary (conclusions): Chronic Pelvic Pain is a complex condition involving symptoms affecting the psychological, gastrointestinal, musculoskeletal systems. The most successful treatment approach emphasizes the role of collaboration among a diverse team of specialists such as gynecologists, gastroenterologists, psychiatrists, psychologists, and physiotherapists. More research focused on multimodal strategies in management of the CPP is needed to match patients most effectively with the most suitable combination of treatment and reduce the systemic consequences of chronic pain.
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Introduction

and purpose: Chronic Pelvic Pain Syndrome (CPPS) is characterized as intermittent or constant pain located in the lower abdomen or pelvis, persisting continuously for at least 6 months [1]. Reports on the prevalence of chronic pelvic pain indicate the occurrence of this condition at a level of 5.7–26.6% in women of reproductive age. However, only a third of women suffering from chronic pelvic pain, seek medical care [2]. Clinical picture of CPPS consists of various patterns and symptoms, often as the intersection of the multiple systems, which additionally complicates and delays the diagnostic process. The aim of this review is to summarize existing literature about the diagnostics and management of Chronic Pelvic Pain Syndrome among women and create an awareness about the challenges which this condition poses for healthcare professionals. A brief description of the state of knowledge: Chronic Pelvic Pain Syndrome is a multifaceted condition and the pathophysiology of it has not yet been comprehensively studied. Clinical picture often involves dysfunctions in pelvic floor, urinary tract, or gastrointestinal system. Treatment involves a multidisciplinary approach including non-pharmacological and pharmacological interventions. Summary (conclusions): Chronic Pelvic Pain is a complex condition involving symptoms affecting the psychological, gastrointestinal, musculoskeletal systems. The most successful treatment approach emphasizes the role of collaboration among a diverse team of specialists such as gynecologists, gastroenterologists, psychiatrists, psychologists, and physiotherapists. More research focused on multimodal strategies in management of the CPP is needed to match patients most effectively with the most suitable combination of treatment and reduce the systemic consequences of chronic pain.

References

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Urology. 2017;106:50-54. doi:10.1016/j.urology.2017.02.053 Downloads Published How to Cite Issue Section License Copyright (c) 2024 Zuzanna Zielińska, Karolina Nowak, Zuzanna Olejarz, Zuzanna Drygała, Julia Wyrwał, Magdalena Słowik, Karolina Nowak, Maria Nieć, Katarzyna Gierlach , Martyna Krasuska This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Stats Number of views and downloads: 980 Number of citations: 0

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