chronic%20pelvic%20pain
CHRONIC PELVIC PAIN
Chronic pelvic pain (CPP) is a persistent, distressing, & severe pain of >6 month duration.
It occurs intermittently, cyclically, or situationally.
Localized to the pelvis, anterior abdominal wall at or below the umbilicus, the lumbosacral back, or the buttocks.
It is severe enough to cause functional disability or need medical care.
In women, CPP is not restricted to intercourse or menstruation & is not associated w/ pregnancy.
It is a symptom w/ a number of contributory factors & not a diagnosis; pathophysiology is complex & not well understood.
It is assumed that in the development of chronic pain, the nervous system is affected among others by inflammatory & chemical mediators & hormones.
A complex problem that is both multifactorial & multidimensional
  1. ACOG Committee on Practice Bulletins--Gynecology. ACOG practice bulletin no. 51. Chronic pelvic pain. Obstet Gynecol. 2004 Mar;103(3):589-605. https://www.clinicalkey.com. Accessed 13 Mar 2015. PMID: 14990428
  2. Engeler D, Baranowski AP, Borovicka J, et al. Guidelines on chronic pelvic pain. European Association of Urology (EAU). http://uroweb.org. 2014. Accessed 06 Nov 2014.
  3. Engeler DS, Baranowski AP, Dinis-Oliveira P, et al; European Association of Urology. The 2013 EAU guidelines on chronic pelvic pain: is management of chronic pelvic pain a habit, a philosophy, or a science? 10 years of development. Eur Urol. 2013 Sep;64(3):431-439. doi: 10.1016/j.eururo.2013.04.035. Accessed 06 Nov 2014. PMID: 23684447
  4. Jarrell JF, Vilos GA, Allaire C, et al; Chronic Pelvic Pain Working Group; Society of Obstetricians and Gynaecologists of Canada. Consensus guidelines for the management of chronic pelvic pain. J Obstet Gynaecol Can. 2005 Aug;27(8):781-826. http://sogc.org. Accessed 13 Mar 2015. PMID: 16287011
  5. Jarrell JF, Vilos GA, Allaire C, et al; Chronic Pelvic Pain Working Group; Society of Obstetricians and Gynaecologists of Canada. Consensus guidelines for the management of chronic pelvic pain. J Obstet Gynaecol Can. 2005 Sep;27(9):869-910. http://sogc.org. Accessed 13 Mar 2015. PMID: 19830953
  6. Ortiz DD. Chronic pelvic pain in women. Am Fam Physician. 2008 Jun 1;77(11):1535-1542. http://www.aafp.org. Accessed 13 Mar 2015. PMID: 18581833
  7. Royal College of Obstetricians & Gynaecologists (RCOG). The initial management of chronic pelvic pain. Green-top guideline no. 41. RCOG. https://www.rcog.org.uk. May 2012. Accessed 06 Nov 2014.
  8. Royal College of Obstetricians & Gynaecologists (RCOG). Therapies targeting the nervous system for chronic pelvic pain relief. Scientific impact paper no. 46. RCOG. https://www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip46.pdf. Jan 2015. Accessed 25 Mar 2015.
  9. Siedentopf F on behalf of the International Society of Psychosomatic Obstetrics and Gynaecology (ISPOG) Study Group. ISPOG practice protocol chronic pelvic pain in women. ISPOG. http://www.ispog.org. 17 Dec 2012. Accessed 13 Mar 2015.
  10. Stein SL. Chronic pelvic pain. Gastroenterol Clin North Am. 2013 Dec;42(4):785-800. doi: 10.1016/j.gtc.2013.08.005. Accessed 25 Mar 2015. PMID: 24280400
  11. Rees J, Abrahams M, Doble A, Cooper A; Prostatitis Expert Reference Group (PERG). Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015 Oct;116(4):509-525. doi: 10.1111/bju.13101. Accessed 09 Aug 2016. PMID: 25711488
  12. Engeler D, Baranowski AP, Borovicka J, et al. EAU guidelines on chronic pelvic pain. European Association of Urology (EAU). http://uroweb.org. 2016. Accessed 09 Aug 2016.
  13. Hanno PM, Burks DA, Clemens JQ, et al. American Urological Association (AUA) guideline: diagnosis and treatment of interstitial cystitis/bladder pain syndrome. American Urological Association (AUA). https://www.auanet.org. 2014. Accessed 09 Aug 2016.
Editor's Recommendations
Most Read Articles
Rachel Soon, 5 days ago

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

Stephen Padilla, 6 days ago
Early administration of recombinant human B-type natriuretic peptide (rhBNP) can lower the incidence of reperfusion injury for patients with ST-elevation myocardial infarction (STEMI) who are receiving percutaneous coronary intervention (PCI) treatment, according to a China study.
11 Aug 2019
Intraoperative methylprednisolone does not appear to significantly prevent the incidence of death, cardiac arrest and other injuries in neonates undergoing cardiac surgery with cardiopulmonary bypass, according to a recent study.
3 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.