Kosin Med J.  2012 Jun;27(1):11-16. 10.7180/kmj.2012.27.1.11.

Recent Trends in Chronic Pelvic Pain Diagnosis

Affiliations
  • 1Department of Obstetrics and Gynecology, College of Medicine, Wonkwang University, Gyeonggi, Korea.
  • 2Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea. hykyale@yahoo.com

Abstract

Chronic pelvic pain is a common and significant disorder of women. It is estimated to have a prevalence of 3.8% in women. The etiology of chronic pelvic pain in women is poorly understood. Although a specific diagnosis is not found in the majority of cases, some common diagnoses include endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis. The initial history and physical examination can narrow the diagnostic possibilities, guide any subsequent evaluation, and rule out malignancy or significant systemic disease. If the initial evaluation does not reveal a specific diagnosis, a limited laboratory and ultrasound evaluation can clarify the diagnosis, as well as rule out serious disease and reassure the patient. Laboratory and imaging studies should be selectively utilized, as should laparoscopy. Conscious laparoscopic pain mapping has been proposed as a way to improve information derived from laparoscopic evaluations.

Keyword

Chronic pelvic pain; Diagnosis; Etiology

MeSH Terms

Cystitis, Interstitial
Endometriosis
Female
Humans
Irritable Bowel Syndrome
Laparoscopy
Pelvic Pain
Physical Examination
Prevalence

Reference

1. ACOG Committee on Practice Bulletins-Gynecology. ACOG Practice Bulletin No. 51. Chronic pelvic pain. Obstet Gynecol. 2004. 103:589–605.
2. Zondervan KT, Yudkin PL, Vessey MP, Dawes MG, Barlow DH, Kennedy SH. Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol. 1999. 106:1149–1155.
Article
3. Mathias SD, Kuppermann M, Liberman RF, Lipschutz RC, Steege JF. Chronic pelvic pain: prevalence, healthrelated quality of life, and economic correlates. Obstet Gynecol. 1996. 87:321–327.
Article
4. Howard FM. Chronic pelvic pain. Obstet Gynecol. 2003. 101:594–611.
Article
5. Royal College of Obstetricians and Gynaecologists. Guideline No. 41: The initial management of chronic pelvic pain. 2005. London, U.K.: RCOG.
6. Zondervan KT, Yudkin PL, Vessey MP, Jenkinson CP, Dawes MG, Barlow DH, et al. Chronic pelvic pain in the community-symptoms, investigations, and diagnoses. Am J Obstet Gynecol. 2001. 184:1149–1155.
Article
7. Bordman R, Jackson B. Below the belt: approach to chronic pelvic pain. Can Fam Physician. 2006. 52:1556–1562.
8. Price J, Farmer G, Harris J, Hope T, Kennedy S, Mayou R. Attitudes of women with chronic pelvic pain to the gynaecological consultation: a qualitative study. BJOG. 2006. 113:446–452.
Article
9. Pelvic pain assessment form. The International Pevic Pain Society, Research Committee. 2002 Nov 19. Birmingham, Alabama: www.pelvicpain.org/pdf/FRM_Pain_Questionnaire.pdf.
10. Mens JM, Vleeming A, Stoeckart R, Stam HJ, Snijders CJ. Understanding peripartum pelvic pain: Implications of a patient survey. Spine (Phila Pa 1976). 1996. 21:1363–1369.
11. Jensen MP, Karoly P. Turk DC, Melzack R, editors. Self-report scales and procedures for assessing pain in adults. Handbook of pain assessment. 1992. New York: Guilford Press;135–151.
12. Dulemba JF. Spilled gallstones causing pelvic pain. J Am Assoc Gynecol Laparosc. 1996. 3:309–311.
Article
13. Pfeifer ME, Hansen KA, Tho SP, Hines RS, Plouffe L Jr. Ovarian cholelithiasis after laparoscopic cholecystectomy associated with chronic pelvic pain. Fertil Steril. 1996. 66:1031–1032.
Article
14. Sexton DJ, Heskestad L, Lambeth WR, McCallum R, Levin LS, Corey GR. Postoperative pubic osteomyelitis misdiagnosed as osteitis pubis-report of 4 cases and review. Clin Infect Dis. 1993. 17:695–700.
Article
15. Barbieri RL. Stenosis of the external cervical os: An association with endometriosis in women with chronic pelvic pain. Fertil Steril. 1998. 70:571–573.
Article
16. Walling MK, Reiter RC, O'Hara MW, Milburn AK, Lilly G, Vincent SD. Abuse history and chronic pain in women: I. Prevalences of sexual abuse and physical abuse. Obstet Gynecol. 1994. 84:193–199.
17. Tu FF, As-Sanie S, Steege JF. Musculoskeletal causes of chronic pelvic pain: a systematic review of diagnosis: part 1. Obstet Gynecol Surv. 2005. 60:379–385.
Article
18. Howard F. Rose BD, editor. Evaluation of chronic pelvic pain in women. UpToDate. 2007. Waltham, MA: UpToDate.
19. Howard FM. The role of laparoscopy in the evaluation of chronic pelvic pain: Pitfalls with a negative laparoscopy. J Am Assoc Gynecol Laparosc. 1996. 4:85–94.
Article
20. Palter SF, Olive DL. Office microlaparoscopy under local anesthesia for chronic pelvic pain. J Am Assoc Gynecol Laparosc. 1996. 3:359–364.
Article
21. Howard FM, El-Minawi AM, Sanchez RA. Conscious pain mapping by laparoscopy in women with chronic pelvic pain. Obstet Gynecol. 2000. 96:934–939.
Article
Full Text Links
  • KMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr