CTOP

Chronic Pelvic Pain in Gynecology
Specialty	Gynecology
Symptoms	Persistent pelvic pain
Complications	Impact on quality of life, psychological distress
Causes	Multifactorial, including endometriosis, pelvic inflammatory disease, interstitial cystitis
Diagnostic method	Clinical evaluation, imaging, laparoscopy
Treatment	Multidisciplinary approach, medication, physical therapy, surgery

Chronic Pelvic Pain in Gynecology (CPPG) is a complex condition characterized by persistent pain in the pelvic region that lasts for six months or longer. It is a significant health issue affecting women and can have a profound impact on their quality of life. CPPG is often multifactorial, with potential contributions from gynecological, urological, gastrointestinal, musculoskeletal, and psychological factors.

Etiology

The etiology of CPPG is diverse and can include:

• Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside the uterus, causing pain and potentially leading to infertility.
• Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs, often caused by sexually transmitted bacteria.
• Interstitial Cystitis: A chronic condition causing bladder pressure, bladder pain, and sometimes pelvic pain.
• Irritable Bowel Syndrome (IBS): A gastrointestinal disorder that can cause abdominal pain and changes in bowel habits.
• Musculoskeletal issues: Such as pelvic floor dysfunction or myofascial pain.
• Psychological factors: Including stress, anxiety, and depression, which can exacerbate the perception of pain.

Diagnosis

Diagnosing CPPG involves a comprehensive approach:

• Clinical Evaluation: A detailed medical history and physical examination are crucial. The clinician should inquire about the nature, location, and duration of the pain, as well as any associated symptoms.
• Imaging Studies: Ultrasound, MRI, or CT scans may be used to identify structural abnormalities.
• Laparoscopy: A minimally invasive surgical procedure that allows direct visualization of the pelvic organs and can help diagnose conditions like endometriosis.
• Laboratory Tests: To rule out infections or other systemic conditions.

Management

The management of CPPG requires a multidisciplinary approach:

• Pharmacological Treatment: Includes analgesics, hormonal therapies, and neuromodulators.
• Physical Therapy: Focused on the pelvic floor muscles to alleviate pain and improve function.
• Psychological Support: Cognitive-behavioral therapy and other forms of counseling can be beneficial.
• Surgical Intervention: In cases where conservative management fails, surgical options such as laparoscopy may be considered.

Prognosis

The prognosis for CPPG varies depending on the underlying cause and the effectiveness of the treatment plan. Early diagnosis and a comprehensive, individualized treatment approach can improve outcomes and enhance quality of life.

Also see

• Endometriosis
• Pelvic Inflammatory Disease
• Interstitial Cystitis
• Irritable Bowel Syndrome
• Pelvic Floor Dysfunction