Chronic Pelvic Pain

Fred M. Howard
In: Obstetrics & Gynecology · 2003 · vol. 101(3) , pp. 594–611 · doi:10.1097/00006250-200303000-00029 · W4246643944
article OA: closed CC0 ⤵ 4 in-corpus citations
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Chronic pelvic pain, a common and significant disorder affecting 3.8% of women, involves multiple systems and requires a comprehensive evaluation and treatment approach.

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Abstract

In Brief Chronic pelvic pain is a common and significant disorder of women. It is estimated to have a prevalence of 3.8% in women. Often the etiology of chronic pelvic pain is not clear, as there are many disorders of the reproductive tract, gastrointestinal system, urological organs, musculoskeletal system, and psychoneurological system that may be associated with chronic pelvic pain. The history and physical examination are crucial in evaluating a woman with chronic pelvic pain and must address all of the possible systems potentially involved in chronic pelvic pain, not just the reproductive system. Laboratory and imaging studies should be selectively utilized, as should laparoscopy. Conscious laparoscopic pain mapping has been proposed as a way to improve information derived from laparoscopic evaluations. Treatment of chronic pelvic pain may consist of two approaches. One is to treat chronic pain itself as a diagnosis, and the other is to treat diseases or disorders that might be a cause of or a contributor to chronic pelvic pain. These two approaches are not mutually exclusive, and in many patients effective therapy is best achieved by using both approaches. Treatment of chronic pain as well as treatment of four of the more common disorders associated with chronic pelvic pain (endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis) are discussed in this review. Chronic pelvic pain is a common and significant syndrome that may involve disorders of the reproductive, gastrointestinal, urological, musculoskeletal, and psychoneurological systems.

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Condition tags

endometriosischronic_pelvic_paininterstitial_cystitisirritable_bowel_syndrome

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