Chronic Pelvic Pain: An Overview

Jai Kishan Goel, Siddharth Goel
In: Journal of South Asian Federation of Obstetrics and Gynaecology · 2013 · vol. 5(3) , pp. 147–153 · doi:10.5005/jp-journals-10006-1249 · W2331716146
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This overview discusses chronic pelvic pain as a multidimensional syndrome requiring comprehensive evaluation of gastrointestinal, urological, gynecological, psychological, and musculoskeletal sources and personalized patient management.

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Abstract

ABSTRACT Chronic pelvic pain (CPP) is not a disease but a complex multidimensional syndrome. Although any one disorder may be the cause of CPP, pain can also be the end result of several medical conditions, with each contributing to the generation of pain and requiring management. Women with chronic pelvic pain are often disappointed with the quality of their medical consultations and want their clinician, a personalized care, empathetic and take their symptoms seriously, provide an explanation as to the cause of their pain syndrome and be reassuring. Gastrointestinal, urological, gynecological, psychological, and musculoskeletal sources should be considered in evaluating women with chronic pelvic pain. A complete history, physical examination and counseling can take 45 to 90 minutes to women with CPP. Laboratory testing is of limited value in evaluating women with CPP and, however, pelvic ultrasound is highly sensitive for identifying pelvic masses and determining the origin of the mass. Diagnostic laparoscopy is recommended, if GI, GU and myofascial and neuropathic causes are ruled out or treated and the results of the psychological evaluation are negative. However in 30% of the cases, no cause is ever determined and it presents a therapeutic challenge to the clinician. Success in treating women with chronic pelvic pain is greatly facilitated by earning their trust and confidence. To decide on the best therapeutic plan for an individual patient, the physician and patient should have a thorough discussion of her preferences and values regarding testing, medical versus surgical treatment and childbearing plans. For many patients, the optimal approach involves a combination of treatments. How to cite this article Goel JK, Goel S. Chronic Pelvic Pain: An Overview. J South Asian Feder Obst Gynae 2013;5(3): 147-153.

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