Chronic pelvic pain and endometriosis

Joseph S. Sanfilippo, Jessica Papillon‐Smith, M. Jonathon Solnik
In: Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition · 2019 · pp. 214–228 · doi:10.1201/9781315147659-18 · W2477689187
Review OA: closed CC0 ⤵ 2 in-corpus citations
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-06 ⓘ

This review discusses the evaluation and management of chronic pelvic pain in adolescents, highlighting endometriosis as a common cause and outlining diagnostic and surgical approaches.

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Abstract

Endometriosis is a chronic inflammatory condition defined by endometrial stroma and glands found outside of the uterine cavity. The initial evaluation of any adolescent with either acute or chronic pelvic pain should be directed toward excluding organic pathology. Both acute and chronic pelvic pain can be associated with trigger points in the abdomen, vagina, or sacral area. In a systematic review published in 2013, approximately two-thirds of adolescent girls with chronic pelvic pain or dysmenorrhea were found to have laparoscopic evidence of endometriosis. In many circumstances, bimanual exam may not even be necessary, but palpation or inspection of the anus may help elucidate the presence of pelvic floor spasm, and a rectal, rather than a rectovaginal, examination may be useful for patients with suspected deep infiltrating endometriosis. Surgical management of endometriosis is indicated for pain refractory to medical management, advanced disease with involvement of the bowel, ureters, or nerves, and associated subfertility.

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Condition tags

endometriosisdie_deep_infiltratingchronic_pelvic_paindysmenorrhea

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (17)

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License: CC0 · commercial use OK