Assessing pelvic pain in women

Pelvic pain is a common presenting symptom, but, despite the high prevalence of this condition in the community, many women have never had their symptoms evaluated or diagnosed. In many cases, the examination and work up reveal no specific cause for pelvic pain, and these patients frequently end up in a pain clinic or the office of a psychiatrist. Pelvic pain can arise from the reproductive organs, the bowel, the urinary tract, the spinal nerves, or it may be musculoskeletal in origin. The causes of acute onset pelvic pain are it different to those of long standing pain in the pelvis. Often the cause of pelvic pain becomes evident after a thorough clinical evaluation of the patient. The distinctive advantage of laparoscopy is that a definitive diagnosis can be made, and treatments such as diathermy to endometriosis, removal of cysts and division of adhesions, can usually be undertaken at the same time. Many women are content to live with mild pelvic pain provided that the cause is known and the condition is neither harmful nor progressive. (author abstract)