Beyond the Basics: Cutting-Edge Approaches to Chronic Pelvic Pain Evaluation

Jorge F. Carrillo, Mario Castellanos, Mario E. Castellanos
Clinical Obstetrics and Gynecology · 2026 · doi:10.1097/grf.0000000000001048 · PMID:42559970 · W7197030614
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This review outlines a multidisciplinary, biopsychosocial framework for chronic pelvic pain evaluation using updated FIGO-IPPS definitions and the R U MOVVING SOMe classification to identify overlapping pain generators and central sensitization.

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This review advocates for a multidisciplinary, biopsychosocial framework to evaluate chronic pelvic pain, addressing it as a global epidemic. The authors introduce an updated FIGO-IPPS definition that lowers the diagnostic threshold to three months of pain and prioritizes functional impairment alongside the R U MOVVING SOMe classification system. This approach integrates trauma-informed care, specialized examinations, and patient-reported outcomes to systematically identify overlapping pain generators and central sensitization. Relevance to endometriosis: listed as one indication for GnRH antagonists, though the paper's main focus is uterine fibroids.

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Abstract

This review explores transitioning toward a multidisciplinary, biopsychosocial framework for evaluating chronic pelvic pain (CPP), considered a global epidemic. The manuscript introduces the updated FIGO-IPPS CPP definition, which lowers the diagnostic threshold to pain typically lasting 3 months or more and prioritizes functional impairment. Central to this definition is the R U MOVVING SOMe classification system, enabling systematic identification of overlapping pain generators and central sensitization. The authors advocate for a cutting-edge methodology integrating trauma-informed care (TIC), specialized musculoskeletal and neurological examinations, and validated Patient-Reported Outcomes (PROs). This framework provides clinicians a standardized pathway to optimize diagnostic accuracy and treatment.
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Beyond the Basics: Cutting-Edge Approaches to Chronic Pelvic Pain Evaluation - Jorge Carrillo*,† - Mario Castellanos*,† This review explores transitioning toward a multidisciplinary, biopsychosocial framework for evaluating chronic pelvic pain (CPP), considered a global epidemic. The manuscript introduces the updated FIGO-IPPS CPP definition, which lowers the diagnostic threshold to pain typically lasting 3 months or more and prioritizes functional impairment. Central to this definition is the R U MOVVING SOMe classification system, enabling systematic identification of overlapping pain generators and central sensitization. The authors advocate for a cutting-edge methodology integrating trauma-informed care (TIC), specialized musculoskeletal and neurological examinations, and validated Patient-Reported Outcomes (PROs). This framework provides clinicians a standardized pathway to optimize diagnostic accuracy and treatment.

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