Management of chronic pelvic pain

Minerva Ginecol. 2010 Oct;62(5):447-65.

Abstract

Chronic pelvic pain (CPP) is a common complaint of women presenting for gynecologic and primary care. Evaluation of CPP requires obtaining a careful history including not only obstetrical and gynecologic information but also screening for gastrointestinal, urologic, musculoskeletal, and neurological disorders. A detailed physical examination is also necessary. Management of CPP depends largely on the cause. Gynecologic causes include endometriosis, pelvic inflammatory disease, adhesive disease, pelvic congestion syndrome, ovarian retention syndrome, ovarian remnant syndrome, adenomyosis, and leiomyomas. Some non-gynecologic causes are interstitial cystitis/painful bladder syndrome, irritable bowel syndrome, pelvic floor tension myalgia, and abdominal myofascial pain syndrome. Treatments may be directed toward specific causes or may be targeted to general pain management. The most effective therapy may involve using both approaches. The diagnosis and treatment of each of the above disorders, and the management of CPP itself, is discussed.

Publication types

  • Review

MeSH terms

  • Abdominal Wall
  • Chronic Disease
  • Cystitis, Interstitial / complications
  • Female
  • Genital Diseases, Female / complications
  • Humans
  • Irritable Bowel Syndrome / complications
  • Musculoskeletal Diseases / complications
  • Myofascial Pain Syndromes / complications
  • Pelvic Floor
  • Pelvic Pain / diagnosis*
  • Pelvic Pain / etiology
  • Pelvic Pain / therapy*