Chronic Pelvic Pain

Janesh Gupta
In: Dewhurst's Textbook of Obstetrics & Gynaecology · 2018 · pp. 744–752 · doi:10.1002/9781119211457.ch54 · W4231589320
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This chapter outlines a classification of causes for chronic pelvic pain, a common post-surgical condition, emphasizing clinical assessment, potential multidisciplinary approaches, and the diagnostic role of laparoscopy.

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Abstract

Chronic pelvic pain (CPP) may develop after any surgical procedure, and is a common feature after abdominal and pelvic surgery, with a prevalence varying between 10 and 40%. Pelvic congestion syndrome (PCS) is still being assessed as a potential cause for CPP. This chapter tabulates a classification of causes of CPP that should be borne in mind while undertaking the clinical assessment. Observing how a patient walks into the consulting room can provide a clue to the diagnosis. When no diagnosis can be reached, a treatment goal should be established. Some women are relieved by the fact that there is no sinister pathology and do not want further investigations and treatment, whereas pain relief is of paramount importance for others. A multidisciplinary team approach should evaluate such cases, especially in liaison with a chronic pain team. Laparoscopy has commonly been undertaken as the primary investigation for CPP.

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chronic_pelvic_pain

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