Chronic pelvic pain: an integrated approach to diagnosis and treatment

Obstet Gynecol Surv. 2003 Sep;58(9):615-23. doi: 10.1097/01.OGX.0000083225.90017.01.

Abstract

Chronic pelvic pain affects upward of 15% of women and is a frustrating condition for both patients and physicians. Chronic pelvic pain is not a disease, but a syndrome that results from a complex interaction between neurologic, musculoskeletal, and endocrine systems that is further influenced by behavioral and psychologic factors. Traditional approaches to this disorder have been surgical, although long-term success rates have been disappointing. Placebo response to surgery is common, and many conditions that contribute to the pain cannot be identified or treated with a surgical approach. Many patients will require a combination of both pharmacologic and nonpharmacologic treatments in addition to various types of invasive procedures. It is now recognized that many disorders contribute to the chronic pelvic pain symptom complex; thus, an integrated multidisciplinary approach to diagnosis and treatment is essential to achieve the greatest success.

Target audience: Obstetricians & Gynecologists, Family Physicians.

Learning objectives: After completion of this article, the reader will be able to describe the pathophysiology of chronic pelvic pain, to outline the evaluation of a patient with chronic pelvic pain, and to explain the treatment options for patients with chronic pelvic pain.

Publication types

  • Review

MeSH terms

  • Analgesics / administration & dosage
  • Chronic Disease
  • Female
  • Humans
  • Laparoscopy
  • Pelvic Pain / diagnosis*
  • Pelvic Pain / etiology
  • Pelvic Pain / therapy*
  • Urinary Bladder Diseases / diagnosis
  • Urinary Bladder Diseases / physiopathology

Substances

  • Analgesics