Chronic pelvic pain

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Contents 1 Women and Pelvic pain 2 Chronic Pelvic Pain in Female Adolescents 2.1 Etiology 3 References 4 See also 5 External links

[edit] Women and Pelvic pain

Pelvic and perineal pain
Classifications and external resources

ICD-10	R10..2

Most women (and some men), sometime in their lives experience pelvic pain (when the condition persists for longer than 3 mths, it is called chronic pelvic pain (CPP)). This is a poorly understood condition that likely represents abnormal neurological function, either in the peripheral nervous system or central nervous system. Mainly different etiologies have been proposed for CPP, but a major problem is that virtually none of them have been validated. Commonly proposed etiologies include:

• endometriosis (very controversial)
• infection or post-infectious neurological hypersensitivity
• exaggerated bladder, bowel, or uterine pain sensitivity (also known as visceral pain)
• ovarian cysts, uterine leiomyoma - often found in asymptomatic patients as well, however
• less common emergencies: ovarian torsion - sudden loss of circulation to the ovary, appendicitis - infection of one part of the intestine, with right lower abdominal pain, ectopic pregnancy - where an early pregnancy grows outside of the uterus, and can cause sudden, heavy intra-abdominal bleeding
• pelvic girdle pain = SPD or DSP

Women with symptoms of pain may want to see a gynecologist if problems don't go away after a few days, and workup should begin with a careful history and examination, followed by a pregnancy test. Some women may also need bloodwork or additional imaging studies, and a handful may also benefit from having surgical evaluation using small telescopes (laparoscopy). Many women will also benefit from a consultation with a physical therapist, a trial of anti-inflammatory medications, hormonal therapy, or even neurological agents.

This is a condition that although common, direly needs to be studied more closely.

[edit] Chronic Pelvic Pain in Female Adolescents

As girls enter gynecologic maturity, pelvic or abdominal pain becomes a frequent complaint.

Chronic pelvic pain (CPP) accounts for 10% of all visits to gynecologists. In addition, CPP is the reason for 20 - 30% of all laparoscopies in adults.

[edit] Etiology

• Gynecologic Etiologies
  • Dysmenorrhea
  • Endometriosis
  • Müllerian abnormalities
  • Pelvic Inflammatory Disease
  • Ovarian Abnormalities

• Abdominal Etiologies

[edit] References

• Milburn A, Reiter R, Rhomberg A: Multi-disciplinary approach to chronic pain. Obstet Gynecol Clin 1993;20:643 - 661.
• Stovall DW: Endometriosis associated pelvic pain: Evidence for an association between the stage of disease and a history of chronic pelvic pain. Fertil Steril 1997;68:13 - 17.
• Schroeder B, Sanfillippo JS: Chronic Pelvic Pain and Recurrent Abdominal Pain in Female Adolescents. Pediatr Clin North Am 1999;46:566 - 567.
• Elisabeth Thibaud, Hyams JS: Clinical aspects of recurrent abdominal pain. Pediatric and Adolescent GynecologyPediatr Ann 2001;30:17–21.

[edit] See also

Abdominal adhesions

[edit] External links

• International Pelvic Pain Society
• American Pain Society
• Advanced Gynecology Studies
• Evanston Northwestern Healthcare Division of Endoscopic Surgery and Chronic Pelvic Pain
• University of Michigan Pelvic Pain Program
• University of North Carolina Pelvic Pain Program
• Endometriosis Research Center
• (http://www.endometriosis.org endometriosis.org)
• Endometriosis Association