La douleur pelvienne chronique chez la femme : prise en charge initiale

Charlotte Maillard, Amandine Gerday, Jean-Luc Squifflet, Mathieu Luyckx, Frédérique Dessy, Pascale Jadoul
In: Louvain médical, Vol. 143, no./, p. 47-52 (2024) · 2024 · W7126356308
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This paper describes chronic pelvic pain in women as a multifactorial condition resulting from nociceptive signaling dysregulation and central sensitization, necessitating a comprehensive, biopsychosocial, and multidisciplinary initial management approach.

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This 2024 paper discusses chronic pelvic pain in women and the elements of initial management, framing the condition as commonly multifactorial with potential visceral, neuro-musculoskeletal, and psychosocial contributors. It defines chronic pelvic pain as lasting more than six months, often linked with negative cognitive/behavioral/sexual/emotional consequences and symptoms suggestive of urinary, sexual, bowel, myofascial, or gynecologic dysfunction, and it emphasizes a nociplastic pain model driven by dysregulated nociceptive signaling and central sensitization. The authors highlight the need for comprehensive initial assessment, early establishment of a therapeutic relationship, and an approach that is biopsychosocial and multidisciplinary, tailored to the complaint. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

La douleur pelvienne chronique (DPC) est une pathologie fréquente et représente un défi clinique majeur en raison de ses étiologies souvent multifactorielles, incluant des causes viscérales, neuro-musculosquelettiques et psychosociales. Elle est définie comme « une douleur perçue comme provenant des organes ou des structures de la région pelvienne ou abdominale basse persistant depuis plus de 6 mois, s’accompagnant fréquemment de répercussions négatives sur les plans cognitif, comportemental, sexuel et émotionnel, ainsi que de symptômes suggérant des dysfonctionnements au niveau du système urinaire inférieur, de la fonction sexuelle, intestinale, myofasciale ou gynécologique ». La DPC est désormais perçue comme le résultat d’un dérèglement des signaux nociceptifs et d’une sensibilisation centrale. Cette douleur nociplastique est principalement due à un dysfonctionnement du traitement sensoriel par le système nerveux central. Une évaluation initiale complète est nécessaire en adoptant une relation thérapeutique d’emblée. La gestion optimale de la DPC repose sur une approche biopsychosociale et nécessite une prise en charge multidisciplinaire et adaptée à ce type de plaintes.
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La douleur pelvienne chronique chez la femme : prise en charge initiale (2024) Louvain médical — Vol. 143, p. 47-52 (2024) (2024) Louvain médical — Vol. 143, p. 47-52 (2024) Open Access - Adobe PDF - 228.52 KB - Authors - Author Maillard, Charlotte UCLouvain - Author Gerday, Amandine UCLouvain - Author Squifflet, Jean-Luc UCLouvain - Author Luyckx, Mathieu UCLouvain - Author Dessy, Frédérique UCLouvain - Author Jadoul, Pascale UCLouvain - Abstract - (en) Chronic pelvic pain in women: initial management Chronic pelvic pain (CPP) is a common complaint and a major clinical challenge due to its often multifactorial etiology, including visceral, neuro-musculoskeletal, and psychosocial causes. It is defined as “pain perceived as originating from organs or structures of the pelvic or lower abdominal region that persists for more than 6 months, often accompanied by negative cognitive, behavioral, sexual, and emotional consequences, as well as symptoms suggestive of lower urinary, sexual, bowel, myofascial, or gynecologic dysfunction”. CPP is now considered to be the result of dysregulation of nociceptive signals and central sensitization. This nociplastic pain is mainly due to a dysfunction of sensory processing by the central nervous system. A comp rehensive initial assessment is required and a therapeutic relationship should be established from the outset. Optimal management of CPP is based on a biopsychosocial approach and requires a multidisciplinary approach tailored to this type of complaint. - Affiliations - APA - Chicago - FWB Maillard, C., Gerday, A., Squifflet, J.-L., Luyckx, M., Dessy, F., & Jadoul, P. (2024). La douleur pelvienne chronique chez la femme : prise en charge initiale. Louvain médical, 143, 47-52. https://hdl.handle.net/2078.5/245604 (Original work published 2024)

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