Chronic Pelvic Pain

Fred M Howard
Obstetrics and gynecology · 2003 · vol. 101(3) , pp. 594–611 · doi:10.1016/s0029-7844(02)02723-0 · PMID:12636968 · W2019470966
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This review discusses the evaluation and treatment of chronic pelvic pain in women, which often has unclear etiology and may involve multiple organ systems.

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Abstract

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.

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Condition tags

mesh:D017699endometriosischronic_pelvic_paininterstitial_cystitisirritable_bowel_syndrome

MeSH descriptors

Medical History Taking Pelvic Pain Pelvic Pain Chronic Disease Diagnosis, Differential Female Humans Pain Measurement Pelvic Pain Pelvic Pain Pelvic Pain Physical Examination

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References (100)

Cited by (50)

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License: CC0 · commercial use OK