Optimizing Outcomes: Perioperative Strategies for Patients With Chronic Pelvic Pain

A Oshinowo, Rükset Attar, R A Thompson, Innie Chen, Michael S. Kinson
In: Clinical Obstetrics & Gynecology · 2026 · doi:10.1097/grf.0000000000001042 · PMID:42474257 · W7169782157
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This paper addresses perioperative management challenges for chronic pelvic pain, emphasizing comprehensive preoperative screening of risk factors like central sensitization and comorbidities to optimize surgical recovery outcomes.

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This paper examines the perioperative management challenges faced by patients with chronic pelvic pain, noting that such individuals often experience heightened anxiety and severe postoperative pain flares. The authors argue that comprehensive preoperative screening is essential to evaluate risk factors like central sensitization, substance use, and concurrent chronic overlapping pain conditions. By identifying these specific risk profiles, clinicians can better manage patient expectations and provide targeted strategies to optimize surgical recovery outcomes. This paper is centrally about endometriosis — specifically, it addresses the broader category of chronic pelvic pain in which endometriosis is a primary etiology, focusing on optimizing perioperative care for this patient population.

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Abstract

Chronic pelvic pain (CPP) severely impacts quality of life, presenting distinct perioperative management challenges. Patients face heightened anxiety, severe postoperative pain, prolonged recovery from fear of movement, and persistent pain amplified by concurrent chronic overlapping pain conditions (COPCs). While data on preoperative pain's precise impact remains limited, surgery often triggers severe flares. Consequently, comprehensive preoperative screening is crucial. Evaluating risk factors-including central sensitization, substance use, smoking, COPCs, specific pain generators, and psychological comorbidities-allows clinicians to manage expectations effectively. Ultimately, this targeted risk assessment equips patients with the necessary strategies and tools to optimize their surgical recovery.
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Optimizing Outcomes: Perioperative Strategies for Patients With Chronic Pelvic Pain - Adeoti E. Oshinowo* - Rukset Attar† - Rebecca Thompson* - Innie Chen‡ - Michael S. Kinson§ Chronic pelvic pain (CPP) severely impacts quality of life, presenting distinct perioperative management challenges. Patients face heightened anxiety, severe postoperative pain, prolonged recovery from fear of movement, and persistent pain amplified by concurrent chronic overlapping pain conditions (COPCs). While data on preoperative pain’s precise impact remains limited, surgery often triggers severe flares. Consequently, comprehensive preoperative screening is crucial. Evaluating risk factors—including central sensitization, substance use, smoking, COPCs, specific pain generators, and psychological comorbidities—allows clinicians to manage expectations effectively. Ultimately, this targeted risk assessment equips patients with the necessary strategies and tools to optimize their surgical recovery.

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