Chronic pelvic pain in women : illness, disease and medical attitudes

The aim of this study was i) to describe the clinical investigation, treatment and management of chronic pelvic pain in women, ii) to place medical attitudes to the problem in a socio-cultural context, iii) to design simple tools to optimise investigation and treatment and to test whether the introduction of such tools was beneficial. A longitudinal observational study was conducted to describe the clinical characteristics of women referred to the Princess Anne Hospital suffering from chronic pelvic pain. An attitude questionnaire was developed and sent to practising gynaecologists who were members and fellows of the Royal College of Obstetricians and Gynaecologists. Based on the results of the longitudinal observational study simple tools were designed and introduced to practising gynaecologists at the Princess Anne Hospital. Written evaluation studies were undertaken to test whether the tools and intervention programme were beneficial and the observation study was repeated to assess improvements in patient outcome. The longitudinal observational study identified factors predictive of higher levels of pain at follow-up. Detailed statistical modelling demonstrated associations between endometriosis, an initial ... (continues)