Doctors and the Female Pelvic Pain Patient

In clinical practice, many women with chronic pelvic pain (CPP) turn out not to have any identifiable pathology despite having undergone multiple investigations. There is no consensus as to the best management for women in this group, and the majority will already have had an invasive procedure such as laparoscopy. When specific pathology is found, there is the further problem that it can often be coincidental. Although a multidisciplinary approach to diagnosis and care has been advocated as best practice, it is costly and not practical in most units in the United Kingdom, and many other countries, owing to a lack of specialists in this area and to resource limitations. As a consequence we see many of these patients undergoing a cycle of repeated consultations over many years with no effective management plan. The outcomes for both patient and medical practitioners in this area are often less than satisfactory.