Chronic Pelvic Pain in Women: Evaluation and Management in Primary Care

In: Comprehensive Therapy · 2005 · vol. 31(1) , pp. 028–039 · doi:10.1385/comp:31:1:028 · PMID:15793322 · W2075194443
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Chronic pelvic pain in women is a common, challenging disorder often requiring comprehensive evaluations and multidisciplinary management for effective treatment.

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This review paper addresses chronic pelvic pain (CPP) in women, describing its prevalence and proposing an evaluation and management framework applicable in primary care. It emphasizes that CPP may arise from pelvic organs or from referred sites, and argues that comprehensive history and physical examination should consider gynecological, urological, gastrointestinal, psychiatric, myofascial, and neuromuscular contributors, with management potentially involving specialist input, psychologists, and multiple visits. The key recommendations are to approach CPP as a chronic disease and use combined strategies such as lifestyle modification, appropriate laboratory testing and imaging (including transvaginal ultrasound), and laparoscopy when needed to identify serious disease or provide reassurance, noting that some surgical procedures and pain relief measures can benefit selected patients. This paper is centrally about endometriosis only insofar as it discusses endometriosis-associated pelvic pain within a broader CPP evaluation and management context, including cited diagnostic and treatment evidence (e.g., suspected endometriosis and presacral neurectomy in endometriosis-related dysmenorrhea).

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Abstract

Chronic pelvic pain (CPP) in women is a common disorder, affecting as many as 15% of adult women, and often provides both a diagnostic and therapeutic challenge. Pain in CPP may originate directly from pelvic organs, or may be referred from more distant tissue sites. A comprehensive medical history and physical examination should include special attention to gynecological, urological, gastrointestinal, psychiatric, myofascial, and neuromuscular systems. The effective management of CPP may involve comprehensive evaluations by specialists, psychologists, and multiple office visits. Physicians should address CPP as a chronic disease. Combining lifestyle modification with other traditional treatments produces better outcomes. Laboratory tests, transvaginal ultrasound, and laparoscopy may identify serious disease or provide significant reassurance to patient. Specific surgical procedures for various conditions and pain relief measures are beneficial in selected patients. A sensitive physician who is willing to spend adequate time and coordinate care with specialists can markedly diminish the suffering of these patients.
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Abstract

Chronic pelvic pain (CPP) in women is a common disorder, affecting as many as 15% of adult women, and often provides both a diagnostic and therapeutic challenge. Pain in CPP may originate directly from pelvic organs, or maybe referred from more distant tissue sites. A comprehensive medical history and physical examination should include special attention to gynecological, urological, gastrointestinal, psychiatric, myofascial, and neuromuscular systems. The effective management of CPP may involve comprehensive evaluations by specialists, psychologists, and multiple office visits. Physicians should address CPP as a chronic disease. Combining lifestyle modification with other traditional treatments produces better outcomes. Laboratory tests, transvaginal ultrasound, and laparoscopy may identify serious disease or provide significant reassurance to patient. Specific surgical procedures for various conditions and pain relief measures are beneficial in selected patients. A sensitive physician who is willing to spend adequate time and coordinate care with specialists can markedly diminish the suffering of these patients. Similar content being viewed by others

References

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Evidence-based management of chronic pelvic pain. Clin Obstet Gynecol 1998;41(2):422–435. Author information Authors and Affiliations Corresponding author Additional information The authors have stated that they do not have a significant financial interest or other relationship with any product manufacturer or provider of services discussed in this article. The authors also do not discuss the use of off-label products, which includes unlabeled, unapproved, or investigative products or devices. About this article Cite this article Samraj, G.P.N., Kuritzky, L. & Curry, R.W. Chronic pelvic pain in women Evaluation and management in primary care . Compr Ther 31, 28–39 (2005). https://doi.org/10.1385/COMP:31:1:028 Received: Accepted: Issue date: DOI: https://doi.org/10.1385/COMP:31:1:028

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