If Everything Else Fails

In: Management of Chronic Pelvic Pain · 2021 · pp. 223–232 · doi:10.1017/9781108877084.022 · W3134777361
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Pelvic pain arises from complex anatomical structures and can be challenging to diagnose, often requiring thorough reevaluation of patient history and medical records, with pelvic floor dysfunction frequently contributing.

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Abstract

Pelvic pain is one of the most difficult human conditions to diagnose and treat. The pelvis is composed of a complicated network of somatic and visceral nerves; connective tissues; as well as reproductive, urinary, and gastrointestinal organs. Pain in the pelvis can thus be from any of these areas. In order to diagnose and treat patient correctly it is very important to have a knowledge of all nongynecologic and gynecologic conditions leading to pelvic pain. Despite this knowledge, diagnosis may still be very difficult. Often very reexamining history and medical records may be helpful. In many patients pelvic floor is a main contributing factor to pelvic pain.
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Management of Chronic Pelvic Pain Buy print or eBook [Opens in a new window] A Practical Manual - Management of Chronic Pelvic Pain - Management of Chronic Pelvic Pain - Copyright page - Contents - Contributors - Foreword - Chapter 1 Introduction to Chronic Pelvic Pain - Chapter 2 Neurobiological Basis of Pelvic Pain - Chapter 3 History and Evaluation of Patients with Chronic Pelvic Pain - Chapter 4 Psychological Assessment of a Female Patient with Chronic Pelvic Pain - Chapter 5 Musculoskeletal Assessment for Patients with Pelvic Pain - Chapter 6 Pharmacological Management of Patients with Pelvic Pain - Chapter 7 Evidence for Surgery for Pelvic Pain - Chapter 8 Pelvic Pain Arising from Endometriosis - Chapter 9 Bladder Pain Syndrome - Chapter 10 Pelvic Pain Arising from Pelvic Congestion Syndrome - Chapter 11 Irritable Bowel Syndrome - Chapter 12 Vulvodynia - Chapter 13 Pelvic Pain Arising from Adhesive Disease - Chapter 14 Pelvic Pain Arising from Ovarian Remnant Syndrome - Chapter 15 Pudendal Neuralgia - Chapter 16 Other Peripheral Pelvic Neuralgias - Chapter 17 Chronic Pain After Gynecological Surgery - Chapter 18 Pain Arising from Pelvic Mesh Implants - Chapter 19 Treatment of Sexual Dysfunction Arising from Chronic Pelvic Pain - Chapter 20 Physical Therapy Interventions for Musculoskeletal Impairments in Pelvic Pain - Chapter 21 If Everything Else Fails - Index - References Published online by Cambridge University Press: 08 March 2021 Edited by Book contents - Management of Chronic Pelvic Pain - Management of Chronic Pelvic Pain - Copyright page - Contents - Contributors - Foreword - Chapter 1 Introduction to Chronic Pelvic Pain - Chapter 2 Neurobiological Basis of Pelvic Pain - Chapter 3 History and Evaluation of Patients with Chronic Pelvic Pain - Chapter 4 Psychological Assessment of a Female Patient with Chronic Pelvic Pain - Chapter 5 Musculoskeletal Assessment for Patients with Pelvic Pain - Chapter 6 Pharmacological Management of Patients with Pelvic Pain - Chapter 7 Evidence for Surgery for Pelvic Pain - Chapter 8 Pelvic Pain Arising from Endometriosis - Chapter 9 Bladder Pain Syndrome - Chapter 10 Pelvic Pain Arising from Pelvic Congestion Syndrome - Chapter 11 Irritable Bowel Syndrome - Chapter 12 Vulvodynia - Chapter 13 Pelvic Pain Arising from Adhesive Disease - Chapter 14 Pelvic Pain Arising from Ovarian Remnant Syndrome - Chapter 15 Pudendal Neuralgia - Chapter 16 Other Peripheral Pelvic Neuralgias - Chapter 17 Chronic Pain After Gynecological Surgery - Chapter 18 Pain Arising from Pelvic Mesh Implants - Chapter 19 Treatment of Sexual Dysfunction Arising from Chronic Pelvic Pain - Chapter 20 Physical Therapy Interventions for Musculoskeletal Impairments in Pelvic Pain - Chapter 21 If Everything Else Fails - Index - References Pelvic pain is one of the most difficult human conditions to diagnose and treat. The pelvis is composed of a complicated network of somatic and visceral nerves; connective tissues; as well as reproductive, urinary, and gastrointestinal organs. Pain in the pelvis can thus be from any of these areas. In order to diagnose and treat patient correctly it is very important to have a knowledge of all nongynecologic and gynecologic conditions leading to pelvic pain. Despite this knowledge, diagnosis may still be very difficult. Often very reexamining history and medical records may be helpful. In many patients pelvic floor is a main contributing factor to pelvic pain. - Type - Chapter - Information - Management of Chronic Pelvic PainA Practical Manual, pp. 223 - 232Publisher: Cambridge University PressPrint publication year: 2021 Mathias, SD, Kuppermann, M, Liberman, RF, Lipschutz, RC, Steege, JF. Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet. Gynecol. 1996;87:321–7.CrossRefGoogle ScholarPubMed Chung, MK, Chung, RP, Gordon, D. Interstitial cystitis and endometriosis in patients with chronic pelvic pain: the ‘Evil Twins’ syndrome. JSLS. 2005;9:25–9.Google Scholar Gyang, A, Hartman, M, Lamvu, G. Musculoskeletal causes of chronic pelvic pain. Obstet. Gynecol. 2013;121:645–50.Google Scholar Reig, E, Abejón, D, Del Pozo, C, Insausti, J, Contreras, R. Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain. Pain Pract. 2005;5:103–10.Google Scholar Stovall, TG, Ling, FW, Crawford, DA. Hysterectomy for chronic pelvic pain of presumed uterine etiology. Obstet. Gynecol. 1990;75:676–9.Google ScholarPubMed Hillis, SD, Marchbanks, PA, Peterson, HB. The effectiveness of hysterectomy for chronic pelvic pain. Obstet. Gynecol. 1995;86:941–5.Google ScholarPubMed Hartmann, KE, Ma, C, Lamvu, GM, Langenberg, PW, Steege, JF, Kjerulff, KH. Quality of life and sexual function after hysterectomy in women with preoperative pain and depression. Obstet. Gynecol. 2004;104:701–9.CrossRefGoogle ScholarPubMed Janicki, TI. Chronic pelvic pain as a form of complex regional pain syndrome. Clin Obstet Gynecol. 2003;46:797–803.CrossRefGoogle ScholarPubMed Correll, GE, Maleki, J, Gracely, EJ, Muir, JJ, Harbut, RE. Subanesthetic ketamine infusion therapy: a retrospective analysis of a novel therapeutic approach to complex regional pain syndrome. Pain Med. 2004;5:263–275. DOI: 10.1111/j.1526-4637.2004.04043.x.Google Scholar Rubin, JJ. Psychosomatic pain: new insights and management strategies. South Med J. 2005;98:1092–1099, 1138.CrossRefGoogle ScholarPubMed Mahran, A, Baaklini, G, Hassani, D, et al. Sacral neuromodulation treating chronic pelvic pain: a meta-analysis and systematic review of the literature. Int Urogynecol J. 2019;30:339–52.Google Scholar Song, JJ, Popescu, A, Bell, RL. Present and potential use of spinal cord stimulation to control chronic pain. Pain Physician. 2014;3:235–46.Google Scholar Till, SR, Wahl, HN, As-Sanie, S. The role of nonpharmacologic therapies in management of chronic pelvic pain: what to do when surgery fails. Curr Opin Obstet Gynecol. 2017;4:231–9.Google Scholar Dunkley, CR, Brotto, LA. Psychological treatment for provoked vestibulodynia: integration of mindfulness-based and cognitive behavioral therapies. J Clin Psychol. 2016;7:637–50.Google Scholar Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - If Everything Else Fails - - Book: Management of Chronic Pelvic Pain - Online publication: 08 March 2021 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - If Everything Else Fails - - Book: Management of Chronic Pelvic Pain - Online publication: 08 March 2021 To save content items to your account, please confirm that you agree to abide by our usage policies. 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