Pelvic Pain

Molly Heublein
In: Common Cases in Women's Primary Care Clinics · 2024 · pp. 47–59 · doi:10.1007/978-3-031-48569-5_4 · W4394990766
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Chronic pelvic pain diagnosis and treatment require considering multiple organ systems, with a focus on individual symptoms and functional recovery for better outcomes.

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This chapter discusses chronic pelvic pain as a common but often difficult diagnostic and treatment problem in primary care, emphasizing that clinicians should consider multiple pelvic organ systems rather than assuming gynecologic causes. It argues for an approach centered on identifying contributors across reproductive, genitourinary, musculoskeletal, gastrointestinal, and central pain pathways, and for treatment goals aimed at functional recovery based on individual symptom profiles. A key limitation is that it presents a general framework rather than new original data, so it does not provide specific, condition-specific evidence. Relevance to endometriosis: the chapter includes references to endometriosis pathogenesis and adenomyosis evaluation/management, though its main focus is a broad, multisystem framework for chronic pelvic pain.

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Abstract Chronic pelvic pain is a common medical concern which can be difficult for clinicians to diagnose and treat. It is important to consider the contribution of all relevant organ systems in the pelvis—reproductive organs, genitourinary, musculoskeletal, gastroenterology, and central pain—to determine the etiology, as a majority of chronic pelvic pain is not due to gynecologic causes. Focusing the treatment on individual patient symptoms with a goal toward functional recovery can improve outcomes and is an approach primary care providers can easily initiate. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others Suggested Reading Lamvu G, Carrillo J, Ouyang C, Rapkin A. Chronic pelvic pain in women: a review. JAMA. 2021;325(23):2381–91. https://doi.org/10.1001/jama.2021.2631. Chronic pelvic pain: ACOG practice bulletin, number 218. Obstet Gynecol. 2020;135(3):e98–e109. https://doi.org/10.1097/AOG.0000000000003716. Ferries-Rowe E, Corey E, Archer JS. Primary dysmenorrhea: diagnosis and therapy. Obstet Gynecol. 2020;136(5):1047–58. https://doi.org/10.1097/AOG.0000000000004096. Klemmt PAB, Starzinski-Powitz A. Molecular and cellular pathogenesis of endometriosis. Curr Womens Health Rev. 2018;14(2):106–16. https://doi.org/10.2174/1573404813666170306163448. PMID: 29861704; PMCID: PMC5925869 Kho KA, Chen JS, Halvorson LM. Diagnosis, evaluation, and treatment of adenomyosis. JAMA. 2021;326(2):177–8. https://doi.org/10.1001/jama.2020.26436. Vannuccini S, Petraglia F. Recent advances in understanding and managing adenomyosis. F1000Res. 2019;8:F1000 Faculty Rev-283. https://doi.org/10.12688/f1000research.17242.1. PMID: 30918629; PMCID: PMC6419978 Torres-Cueco R, Nohales-Alfonso F. Vulvodynia-it is time to accept a new understanding from a neurobiological perspective. Int J Environ Res Public Health. 2021;18(12):6639. https://doi.org/10.3390/ijerph18126639. PMID: 34205495; PMCID: PMC8296499 Bresler L, Westbay LC, Fitzgerald CM. Bladder pain syndrome in women. JAMA. 2019;322(24):2435–6. https://doi.org/10.1001/jama.2019.16927. Schwartz ES, Gebhart GF. Visceral pain. Curr Top Behav Neurosci. 2014;20:171–97. https://doi.org/10.1007/7854_2014_315. As-Sanie S, Harris RE, Harte SE, Tu FF, Neshewat G, Clauw DJ. Increased pressure pain sensitivity in women with chronic pelvic pain. Obstet Gynecol. 2013;122(5):1047–55. https://doi.org/10.1097/AOG.0b013e3182a7e1f5. PMID: 24104772; PMCID: PMC3897295 Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2024 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Heublein, M. (2024). Pelvic Pain. In: Mahmoudi, M. (eds) Common Cases in Women's Primary Care Clinics. Springer, Cham. https://doi.org/10.1007/978-3-031-48569-5_4 Download citation DOI: https://doi.org/10.1007/978-3-031-48569-5_4 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-48568-8 Online ISBN: 978-3-031-48569-5 eBook Packages: MedicineMedicine (R0)

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