Urogenital and Pelvic Pain

Abstract Urogenital and pelvic pains are common and may have urologic, gynecologic, gastrointestinal, vascular, musculoskeletal, or neurologic origins. In the evaluation and treatment of these pains, it must be kept in mind that these sites of pain generation are private places associated with bodily functions that are associated with strong emotions: sexual function, defecation, and urination. After infection, ischemia, inflammation, obstruction, or neoplasm has been ruled out as likely etiologies, one is often left with simply a descriptive diagnosis coupled to an empiric treatment. Common diagnoses of chronic urogenital painful disorders include interstitial cystitis, prostatitis, endometriosis, and chronic pelvic pain without obvious pathology. The cost of these disorders to the US health system rivals that of chronic low back pain or asthma. These disorders are three to four times more prevalent in women than in men and difficult to diagnose due to the complex innervation of the pelvis: primary neural afferents travel by sympathetic, pelvic, and pudendal nerve pathways. Pain types may be generally categorized as neuropathic or as somatic or visceral nociceptive pains. Treatments are similar to those for other parts of the body but due to psychosocial modifiers are often more difficult to assess. Pain management is generally multimodal and commonly includes pharmacotherapy (antidepressants, muscle relaxants, anticonvulsants, opiates), surgery (laparoscopic versus open), and interventional procedures (spinal cord stimulations, sympathetic blocks). Other options include yoga, biofeedback, and physical therapy. Similar content being viewed by others Suggested Reading Cheong Y, Stones WR. Chronic pelvic pain: aetiology and therapy. Best Pract Res Clin Obstet Gynaecol. 2006;20(5):695–711. Hanno PM, Burks DA, Clemens JQ, Dmochowski RR, Erickson D, FitzGerald MP, et al. American urological association guidelines: diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol 2011; 185(6):2162–70. Howard FM. Chronic pelvic pain. Obstet Gynecol. 2003;101(3):594–611. Konkle KS, Clemens JQ. New paradigms in understanding chronic pelvic pain syndrome. Curr Urol Rep. 2011;12:278–83. Nickel JC, Shoskes D, Irvine-Bird K. Clinical phenotyping of women with intestitial cystitis/painful bladder syndrome: a key to classification and potentially improved management. J Urol. 2009;182:155–60. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2018 Springer International Publishing AG About this chapter Cite this chapter Udoji, M.A., Ness, T.J. (2018). Urogenital and Pelvic Pain. In: Cheng, J., Rosenquist, R. (eds) Fundamentals of Pain Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-64922-1_30 Download citation DOI: https://doi.org/10.1007/978-3-319-64922-1_30 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-64920-7 Online ISBN: 978-3-319-64922-1 eBook Packages: MedicineMedicine (R0)