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Annals of Agricultural and... Jun 2016Chronic pelvic pain (CPP) affects about 10-40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months. (Review)
Review
INTRODUCTION
Chronic pelvic pain (CPP) affects about 10-40% of women presenting to a physician, and is characterised by pain within the minor pelvis persisting for over 6 months.
MATERIALS AND METHOD
The Medline database was searched using the key words 'chronic pelvic pain' and 'pelvic congestion syndrome', published in English during the past 15 years. The condition markedly deteriorates the quality of life of the affected. Its aetiology has not been fully described and elucidated, although organic, functional and psychosomatic factors are implicated. Pain associated with parametrial varices was defined as pelvis congestion syndrome (PCS). Since the aetiology of CPP is complex, multi-directional diagnostic procedures are required.
RESULTS
The main diagnostic methods employed are imaging examinations (ultrasound, computer tomography, magnetic resonance). Advances in interventional radiology considerably contributed to the CPP treatment. Currently, embolization of parametrial vessels is one of the most effective methods to relieve pain associated with pelvic congestion syndrome.
CONCLUSIONS
Due to the complex aetiology of chronic pelvic pain, the most beneficial effects are obtained when the therapy is based on cooperation of the gynaecologist, physiotherapist, psychologist and interventional radiologist.
Topics: Chronic Pain; Humans; Pelvic Pain
PubMed: 27294622
DOI: 10.5604/12321966.1203880 -
Obstetrics and Gynecology Clinics of... Sep 2014Individuals with pelvic pain commonly present with complaints of pain located anywhere below the umbilicus radiating to the top of their thighs or genital region. The... (Review)
Review
Individuals with pelvic pain commonly present with complaints of pain located anywhere below the umbilicus radiating to the top of their thighs or genital region. The somatovisceral convergence that occurs within the pelvic region exemplifies why examination of not only the organs but also the muscles, connective tissues (fascia), and neurologic input to the region should be performed for women with pelvic pain. The susceptibility of the pelvic floor musculature to the development of myofascial pain has been attributed to unique functional demands of this muscle. Conservative interventions should be considered to address the impairments found on physical examination.
Topics: Chronic Pain; Electric Stimulation Therapy; Humans; Lower Urinary Tract Symptoms; Myofascial Pain Syndromes; Pain Measurement; Pelvic Floor; Pelvic Pain; Physical Examination; Physical Therapy Modalities; Treatment Outcome
PubMed: 25155122
DOI: 10.1016/j.ogc.2014.04.003 -
Seminars in Reproductive Medicine Mar 2018
Topics: Chronic Pain; Female; Humans; Pelvic Pain
PubMed: 30566974
DOI: 10.1055/s-0038-1676086 -
Therapeutische Umschau. Revue... 2019Chronic pelvic pain Chronic pelvic pain syndrome (CPPS) is a condition that may occur in combination with endometriosis and has a prevalence of 1 - 11 %. After... (Review)
Review
Chronic pelvic pain Chronic pelvic pain syndrome (CPPS) is a condition that may occur in combination with endometriosis and has a prevalence of 1 - 11 %. After persistence of pain of more than three months CPPS is likely. After exclusion of inflammatory, traumatic and other conditions the diagnosis may be considered. Symptoms include painful sensations in the pelvic area, tingling feelings, burning sensations, micturition and voiding disorders, overactive bladder including frequency and urgency, painful micturitions and stool passage as well of just the presence of "something being there" with or without pain. Treatment options depend on the leading symptom. As for the pain, the WHO scheme of pain treatment should be considered including anti-inflammatory pain medication. Additionally, physiotherapy, psychotherapy, anticholinergics, alpha-blockers, phytotherapy and physical therapy, acupuncture and local or systemic hormonal therapies may be indicated.
Topics: Adrenergic alpha-Antagonists; Chronic Disease; Chronic Pain; Female; Humans; Pelvic Pain
PubMed: 31113315
DOI: 10.1024/0040-5930/a001039 -
Obstetrics and Gynecology Clinics of... Jun 2022For well selected patients with chronic pelvic pain (CPP), 74% to 95% of women will report complete or significant improvement in pain after hysterectomy. A thoughtful... (Review)
Review
For well selected patients with chronic pelvic pain (CPP), 74% to 95% of women will report complete or significant improvement in pain after hysterectomy. A thoughtful history, examination, and review of imaging can improve success by linking pain complaints to discrete pathology, menstrual activity, or uterine tenderness. All patients with CPP should be evaluated for chronic overlapping pain conditions (COPCs) (eg, irritable bowel syndrome (IBS), fibromyalgia) and risk factors for persistent pain or chronic postsurgical pain (eg, depression, pain catastrophizing, central sensitization), and offered treatment as indicated. There are special considerations for preoperative planning and enhanced recovery for patients with chronic pain.
Topics: Chronic Disease; Chronic Pain; Female; Humans; Hysterectomy; Irritable Bowel Syndrome; Pelvic Pain
PubMed: 35636807
DOI: 10.1016/j.ogc.2022.02.008 -
Gastroenterology Clinics of North... Mar 2022Endometriosis, affecting 5-10% of reproductive-age women, is a common contributor to dysmenorrhea and chronic pelvic pain. Diagnosis requires laparoscopic tissue biopsy,... (Review)
Review
Endometriosis, affecting 5-10% of reproductive-age women, is a common contributor to dysmenorrhea and chronic pelvic pain. Diagnosis requires laparoscopic tissue biopsy, but careful pelvic examination, and/or imaging with either ultrasound or MRI, may identify patients who should receive empiric first-line therapy. The presence of dyschezia, particularly with cyclical exacerbation, should raise suspicion for bowel or rectovaginal septum involvement, and a greater need for surgical management. Treatment of dysmenorrhea includes hormonal suppression of the menstrual cycle, and/or analgesics; more severe cases with strong pain and disability may require earlier surgical intervention to excise disease while preserving fertility desires.
Topics: Dysmenorrhea; Dyspareunia; Endometriosis; Female; Gastroenterologists; Humans; Laparoscopy; Pelvic Pain
PubMed: 35135662
DOI: 10.1016/j.gtc.2021.10.012 -
European Journal of Obstetrics,... Sep 2023Bladder pain syndrome (BPS) is a poorly understood condition. In pregnancy, lower urinary tract symptoms and pain are common, but the possibility of BPS is rarely... (Review)
Review
Bladder pain syndrome (BPS) is a poorly understood condition. In pregnancy, lower urinary tract symptoms and pain are common, but the possibility of BPS is rarely considered and almost never explored. The consequences of BPS on pregnancy and vice versa are poorly understood, and management options appear to be limited. This article reviews the current evidence to allow us to better counsel, investigate, diagnose and manage patients with suspected or known BPS who fall pregnant or who are considering pregnancy. MEDLINE, EMBASE and PubMed were searched for a combination of mesh terms of keywords: 'cystitis', 'interstitial', 'bladder', 'pain' and 'pregnancy'. Relevant articles were identified, reviewed and further relevant articles identified from the references. CONCLUSION: BPS symptoms are very common in pregnancy, with limited data suggesting significant negative effects on the woman and pregnancy. There are safe options for investigation, diagnosis and management in pregnancy. There is a need to raise awareness of the impact of BPS symptoms in pregnancy and the available options for diagnoses and management, improving patient experience and outcomes. PATIENT SUMMARY: Patients with BPS or symptoms akin to BPS need not be abandoned in pregnancy. There is data to support them in making decisions around investigation and management in pregnancy.
Topics: Female; Humans; Cystitis, Interstitial; Urinary Bladder; Pelvic Pain; Lower Urinary Tract Symptoms
PubMed: 37421744
DOI: 10.1016/j.ejogrb.2023.06.017 -
Current Pain and Headache Reports Feb 2021Chronic pelvic pain (CPP) is a complex condition that can be multifactorial, disabling, and difficult to treat. It is important to understand the various diagnoses and... (Review)
Review
PURPOSE OF REVIEW
Chronic pelvic pain (CPP) is a complex condition that can be multifactorial, disabling, and difficult to treat. It is important to understand the various diagnoses and pathways that can be involved and have an understanding of the available treatment options.
RECENT FINDINGS
There is a complex innervation of the pelvic region which makes its treatment very challenging. There are pathophysiological similarities of CPP to disease states like complex regional pain syndrome and sympathetically driven pain. CPP is poorly understood and includes psychological, psychosocial, cultural, and economic influences. Treatment options vary, but neuromodulation does remain a centerpiece and can include sacral stimulation, SCS, DRG stimulation, and PNS.
Topics: Chronic Pain; Humans; Pain Management; Pelvic Pain; Transcutaneous Electric Nerve Stimulation; Treatment Outcome
PubMed: 33534006
DOI: 10.1007/s11916-020-00927-y -
Journal of Obstetrics and Gynaecology... Mar 2016Cutaneous allodynia (pain from a non-painful stimulus) is a sign that can be observed among women with chronic pelvic pain. Dysmenorrhea is recognized as a common cause...
OBJECTIVE
Cutaneous allodynia (pain from a non-painful stimulus) is a sign that can be observed among women with chronic pelvic pain. Dysmenorrhea is recognized as a common cause of chronic pelvic pain in women. This study was conducted to explore the frequency of allodynia and the relationship between allodynia and severe dysmenorrhea.
METHODS
We enrolled women in this study if they had experienced chronic pelvic pain for more than six months. Women provided information regarding their chronic pelvic pain and menstrual function, specifically the severity of their menstrual pain. In addition to a gynaecological assessment, women were tested for allodynia and pain pressure thresholds.
RESULTS
Abdominal allodynia was present in 62.1% of 181 women who participated. Women with allodynia had a significantly greater rate of severe dysmenorrhea and significantly greater duration of severe dysmenorrhea. Pain pressure thresholds were demonstrated to decrease significantly in relation to increasing duration of severe dysmenorrhea.
CONCLUSION
There is a greater frequency of chronic pain among women with a history of severe dysmenorrhea. Women who experienced prolonged severe dysmenorrhea were shown to have a progressive increase in pain sensitivity (reflected in reduced pain pressure thresholds). These findings support efforts to manage dysmenorrhea early in a woman's life with approaches to suppress menstrual function.
Topics: Adult; Chronic Pain; Cohort Studies; Dysmenorrhea; Female; Humans; Hyperalgesia; Middle Aged; Pain Threshold; Pelvic Pain
PubMed: 27106198
DOI: 10.1016/j.jogc.2016.02.001 -
FP Essentials Apr 2022Chronic pelvic pain (CPP) is defined as at least 6 months of pain originating from the lower abdomen or pelvis that is not associated with pregnancy. Symptoms include...
Chronic pelvic pain (CPP) is defined as at least 6 months of pain originating from the lower abdomen or pelvis that is not associated with pregnancy. Symptoms include abdominal bloating, low back pain, and dyspareunia. CPP is considered a symptom and not a diagnosis. The etiology may involve a specific organ or condition (eg, endometriosis, adhesions). The most common associated conditions are endometriosis, interstitial cystitis, irritable bowel syndrome, and depression. The history and physical examination are essential in the evaluation. A comprehensive history that encompasses the gynecologic, obstetric, surgical, and psychosocial histories is key. The psychosocial history should include screening for depression, anxiety, posttraumatic stress disorder, and physical and sexual abuse because of their association with CPP. The physical examination should include musculoskeletal, abdominal, and gynecologic examinations. The choice of laboratory tests and imaging studies should be guided by the history and physical examination findings. Management is multimodal and involves management of associated conditions, pharmacotherapy, surgeries and procedures, physical therapy, and behavior and lifestyle therapies. The multidisciplinary care team typically consists of the primary care physician, subspecialty physicians (eg, gynecology, pain management, psychiatry, gastroenterology, urology), a physical therapist, and a behavioral health subspecialist.
Topics: Chronic Pain; Cystitis, Interstitial; Endometriosis; Female; Humans; Male; Pelvic Pain; Pelvis
PubMed: 35420402
DOI: No ID Found