Assessing chronic pelvic pain
O'Connell CB - Chronic pelvic pain is a fairly common yet poorly understood syndrome. The differential diagnosis can be quite challenging and includes genitourinary, musculoskeletal, neurologic, and psychiatric disorders. The most common causes include endometriosis, pelvic-floor disorders (tension, prolapse, and levator ani spasm), pelvic congestion syndrome (varicosities around the uterus and/or ovaries), inflammatory disorders (chronic infection, inflammatory bowel disease), interstitial cystitis or bladder cancer, and psychological disorders (depression, somatization disorders, and personality disorders). Other possible causes include herniated disks, abdominal migraine, abdominal epilepsy, tuberculous salpingitis, and fibromyalgia...Chronic pelvic pain is thought to occur in up to one out of seven women, and in many cases, no cause is found. A multifaceted and multidisciplinary approach while maintaining support and good rapport with the patient is paramount. [more...]
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