Epidemiology of Chronic Pelvic Pain

In: Encyclopedia of Pain · 2013 · pp. 1150–1157 · doi:10.1007/978-3-642-28753-4_1333 · W4235541688
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Chronic pelvic pain (CPP) is defined as recurrent or constant pain in the lower abdomen lasting at least six months, with various proposed definitions existing.

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This encyclopedia chapter reviews how chronic pelvic pain (CPP) is defined for research, contrasting commonly used criteria (lower abdominal/pelvic pain lasting at least 6 months) with definitions used when no obvious pathology is identified (CPPWOP) and newer descriptions. It highlights that many definitions assume a causal link between pelvic pathology and pain, which the authors note may not always hold, and it points to proposed alternative definitions from major clinical bodies. The text emphasizes implications for research comparability, while the provided excerpt is primarily definitional rather than presenting new epidemiologic estimates. Relevance to endometriosis: the chapter cites endometriosis-related menstrual symptoms (e.g., a study on menstrual symptoms in women with pelvic endometriosis) within its broader discussion of CPP epidemiology, though the paper’s main focus is cross-cutting definitions and research framing for chronic pelvic pain.

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Definition The most commonly used definition of chronic pelvic pain (CPP) for research purposes is “Recurrent or constant pain in the lower abdominal region that has lasted for at least 6 months.” The International Association for the Study of Pain (1986) defines CPP without obvious pathology (CPPWOP) as “chronic or recurrent pelvic pain that cannot be sufficiently explained by an apparent physical cause.” The definition assumes a causal link between pelvic pathology and pain, which clinical experience and the published literature would suggest is not always the case. Since then, two further definitions have been suggested. The American College of Obstetricians and Gynecologists (2004) has proposed a definition of CPP as “non-cyclical pain of at least 6 months’ duration that appears in locations such as the pelvis, anterior abdominal wall, lower back, or buttocks, and that is serious enough to... Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only References American College of Obstetricians and Gynecologists. (2004). ACOG Practice Bulletin No.51. Chronic pelvic pain. Obstetrics and Gynecology, 103, 589–605. Campbell, F., & Collett, B. J. (1994). Chronic pelvic pain. British Journal of Anaesthesia, 73(5), 571–573. Choung, R. S., Herrick, L. M., Locke, G. R., Zinsmeister, A. R., & Talley, N. J. (2010). Irritable bowel syndrome and chronic pelvic pain a population-based study. Journal of Clinical Gastroenterology, 44(10), 696–701. Garcia-Perez, H., Harlow, S. D., Erdmann, C. A., & Denman, C. (2010). Pelvic pain and associated characteristics among women in Northern Mexico. International Perspectives on Sexual and Reproductive Health, 36(2), 90–98. Grace, V. M., & Zondervan, K. T. (2004). Chronic pelvic pain in New Zealand: Prevalence, pain severity diagnoses and use of health services. 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Whorwell, P. J., McCallum, M., Creed, F. H., & Roberts, C. T. (1986). Non-colonic features of irritable bowel syndrome. Gut, 27, 37–40. Williams, R. E., Hartmann, K. E., & Steege, J. F. (2004). Documenting the current definitions of chronic pelvic pain: Implications for research. Obstetrics and Gynecology, 103(4), 686–691. Zondervan, K. T. (1999). Epidemiology of chronic pelvic pain. Oxford University DPhil thesis. Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (1998). The prevalence of chronic pelvic pain in women in the United Kingdom: A systematic review. British Journal of Obstetrics and Gynaecology, 105, 93–99. Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (1999a). Prevalence and incidence of chronic pelvic pain in primary care: Evidence from a national general practice database. British Journal of Obstetrics and Gynaecology, 106, 1149–1155. Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (1999b). Patterns of diagnosis and referral in women consulting for chronic pelvic pain in UK primary care. British Journal of Obstetrics and Gynaecology, 106, 1156–1161. Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Jenkinson, C. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (2001a). The community prevalence of chronic pelvic pain in women and associated illness behaviour. British Journal of General Practice, 51, 541–547. Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Jenkinson, C. P., Dawes, M. G., Barlow, D. H., & Kennedy, S. H. (2001b). Chronic pelvic pain in the community: Symptoms, investigations and diagnoses. American Journal of Obstetrics and Gynecology, 184(6), 1149–1155. Zondervan, K. T., Cardon, L. R., Kennedy, S. H., Martin, N. G., & Treloar, S. E. (2005). Multivariate genetic analysis of chronic pelvic pain and associated phenotypes. Behavior Genetics, 35(2), 177–188. Zondervan, K. T., Moore, J., Kennedy, S. H. (2006). Issues in investigating the aetiology of chronic pelvic pain. Response to Latthe P, Mignini L, Gray R, Hills R, Khan K. Factors predisposing women to chronic pelvic pain: Systematic review. BMJ, 332(7544), 749–755. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2013 Springer-Verlag Berlin Heidelberg About this entry Cite this entry Broderick, A., Kennedy, S., Zondervan, K. (2013). Epidemiology of Chronic Pelvic Pain. In: Gebhart, G.F., Schmidt, R.F. (eds) Encyclopedia of Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28753-4_1333 Download citation DOI: https://doi.org/10.1007/978-3-642-28753-4_1333 Publisher Name: Springer, Berlin, Heidelberg Print ISBN: 978-3-642-28752-7 Online ISBN: 978-3-642-28753-4 eBook Packages: Biomedical and Life SciencesReference Module Biomedical and Life Sciences

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