Chronic Pelvic Pain

Chronic pelvic pain (CPP) is defined as nonmalignant pain in lower abdominal and pelvic structures that has persisted for more than 6 months. Although CPP mostly occurs in women, it can also affect men. In the United States, the prevalence of CPP in women age 18 to 50 is estimated to be 1 in 7. In the United Kingdom, the annual prevalence of CPP in primary care settings is around 3.8% in women age 15 to 73 years. About 10% of referrals to gynecologists are for pelvic pain; 20% of the referrals undergo hysterectomies and 40% undergo laparoscopic surgeries. The pain can be somatic, visceral, or neurogenic, making the differential diagnosis challenging. A detailed, comprehensive evaluation is necessary to diagnose CPP. Often, even after a thorough evaluation, the etiology remains unclear. Multisystem involvement requires specialist referral. CPP can be psychologically and physically debilitating, and, along with disease-specific treatments, often requires a multidisciplinary approach for optimal pain management.