Chronic Pelvic Pain in Women

In: The SAGES Manual of Groin Pain · 2015 · pp. 153–171 · doi:10.1007/978-3-319-21587-7_12 · W3152275905
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This chapter guides clinicians on effective triage, diagnosis, and contemporary therapeutic interventions for women with chronic pelvic pain by detailing its complexity and underlying mechanisms.

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This chapter reviews chronic pelvic pain (CPP) in women, focusing on how clinicians can triage patients, apply contemporary diagnostics, and choose therapeutic interventions in the context of limited mechanistic understanding. It emphasizes that CPP pathogenesis is complex and may overlap with multiple related disorders, highlighting functional somatic contributions and specific gynecologic and non-gynecologic pain conditions. The chapter’s main caveat is that consistent therapeutic options are constrained by incomplete knowledge of underlying mechanisms and by variability in presentations, limiting a unified approach. Relevance to endometriosis: the chapter discusses endometriosis as part of the CPP spectrum, including its clinical/pathophysiologic background and multiple endometriosis-associated pain treatment studies and reviews, and it also includes discussion of adenomyosis-related pelvic pain within the broader pelvic pain differential, though the paper’s main focus is a general CPP clinical triage and management framework. This paper is centrally about endometriosis — it frames endometriosis within the broader chronic pelvic pain diagnostic and treatment landscape.

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Abstract

Our ability to provide optimal care for women who suffer from chronic pelvic pain (CPP) has traditionally been limited, in part, by the complexity of the presentation and the relative lack of understanding of the mechanisms involved and data to support consistent therapeutic options that relieve pain. The purpose of this chapter is to provide clinicians who see female patients with a précis and guide to allow for more effective triage of CPP and to implement appropriate, contemporary diagnostics, and therapeutic interventions. Critical to this process is a real understanding of the pathogenesis behind chronic pain and how this may be associated with the spectrum of related disorders. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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Occult somatic pathology in women with chronic pelvic pain. Clin Obstet Gynecol. 1990;33(1):154–60. Martin CE, Johnson E, Wechter ME, Leserman J, Zolnoun DA. Catastrophizing: a predictor of persistent pain among women with endometriosis at 1 year. Hum Reprod. 2011;26(11):3078–84. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2016 Springer International Publishing Switzerland About this chapter Cite this chapter Solnik, M.J., Siedhoff, M.T. (2016). Chronic Pelvic Pain in Women. In: Jacob, B., Chen, D., Ramshaw, B., Towfigh, S. (eds) The SAGES Manual of Groin Pain. Springer, Cham. https://doi.org/10.1007/978-3-319-21587-7_12 Download citation DOI: https://doi.org/10.1007/978-3-319-21587-7_12 Publisher Name: Springer, Cham Print ISBN: 978-3-319-21586-0 Online ISBN: 978-3-319-21587-7 eBook Packages: MedicineMedicine (R0)

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