Chronic pelvic pain

Jump to: navigation, search

WikiDoc Resources for Chronic pelvic pain

Articles

Most recent articles on Chronic pelvic pain

Most cited articles on Chronic pelvic pain

Review articles on Chronic pelvic pain

Articles on Chronic pelvic pain in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Chronic pelvic pain

Images of Chronic pelvic pain

Photos of Chronic pelvic pain

Podcasts & MP3s on Chronic pelvic pain

Videos on Chronic pelvic pain

Evidence Based Medicine

Cochrane Collaboration on Chronic pelvic pain

Bandolier on Chronic pelvic pain

TRIP on Chronic pelvic pain

Clinical Trials

Ongoing Trials on Chronic pelvic pain at Clinical Trials.gov

Trial results on Chronic pelvic pain

Clinical Trials on Chronic pelvic pain at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Chronic pelvic pain

NICE Guidance on Chronic pelvic pain

NHS PRODIGY Guidance

FDA on Chronic pelvic pain

CDC on Chronic pelvic pain

Books

Books on Chronic pelvic pain

News

Chronic pelvic pain in the news

Be alerted to news on Chronic pelvic pain

News trends on Chronic pelvic pain

Commentary

Blogs on Chronic pelvic pain

Definitions

Definitions of Chronic pelvic pain

Patient Resources / Community

Patient resources on Chronic pelvic pain

Discussion groups on Chronic pelvic pain

Patient Handouts on Chronic pelvic pain

Directions to Hospitals Treating Chronic pelvic pain

Risk calculators and risk factors for Chronic pelvic pain

Healthcare Provider Resources

Symptoms of Chronic pelvic pain

Causes & Risk Factors for Chronic pelvic pain

Diagnostic studies for Chronic pelvic pain

Treatment of Chronic pelvic pain

Continuing Medical Education (CME)

CME Programs on Chronic pelvic pain

International

Chronic pelvic pain en Espanol

Chronic pelvic pain en Francais

Business

Chronic pelvic pain in the Marketplace

Patents on Chronic pelvic pain

Experimental / Informatics

List of terms related to Chronic pelvic pain

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Most women (and some men), at some time in their lives, experience pelvic pain. When the condition persists for longer than 3 months, 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. Many different etiologies have been proposed for CPP, but a major problem is that virtually none of them have been validated.

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.

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.

Causes

Common Causes

Commonly proposed etiologies include: [1] [2]

  • Endometriosis (very controversial)[3] Deeply Infiltrative Endometriosis may be more important
  • 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)

Causes by Organ System

Cardiovascular Pelvic vein thrombosis
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect No underlying causes
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic Anal fissure, Appendicitis, Colitis, Colonic polyps, Constipation, Diarrhea, Diverticulitis, Gastrointestinal cancers, Hemorrhoids, Internal hernia, Irritable bowel syndrome, Proctitis, Reproductive tract cancers, Strangulated hernia, Ulcerative colitis
Genetic No underlying causes
Hematologic Porphyria
Iatrogenic Ovarian remnant
Infectious Disease UTI
Musculoskeletal / Ortho Coccydynia, Low back pain, Muscle spasm, Pelvic girdle malrotation, Tension in the pelvic floor muscles
Neurologic Nerve entrapment in pelvis, Peripheral neuropathy in pelvis, Post herpetic neuralgia, Post infectious neurological hypersensitivity, Pudendal nerve neuralgia
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic Adenomyosis, Adhesions in the pelvic area, Cervical polyps, Chronic vulvovaginitis, Dysmenorrhea, Ectopic pregnancy, Endometrial polyps, Endometriosis, Fibroids, Miscarriage, Mittelschmerz pain, Mullerian abnormalities, Ovarian cysts, Ovarian torsion, Pelvic congestion syndrome, Pelvic inflammatory disease, Pelvic relaxation, Placental abruption, Retroverted uterus, Uterine leiomyoma, Vulvodynia
Oncologic Colon cancer, Neuromas, Pelvic tumor, Testicular tumors
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric Chronic stress, Depression
Pulmonary No underlying causes
Renal / Electrolyte Loin pain hematuria syndrome
Rheum / Immune / Allergy Fibromyalgia
Sexual Clitorodynia, Epididymo-orchitis, Sexual abuse
Trauma Physical abuse
Urologic Chronic bacterial prostatitis, Chronic bladder irritation, Chronic non bacterial prostatitis, Chronic pelvic pain syndrome, Chronic urethritis, Epididymal cysts, Hydrocele, Interstitial cystitis, Urinary tract calculi, Varicocele
Dental No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


References

  1. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X
  3. Stout AL, Steege JF, Dodson WC, Hughes CL (1991). "Relationship of laparoscopic findings to self-report of pelvic pain". Am J Obstet Gynecol. 164 (1 Pt 1): 73–9. PMID 1824741.

Additional Resources

Related Chapters

External Links


Linked-in.jpg