Management Of Chronic Pelvic Pain

A practical manual on the treatment of pelvic pain, focusing on the many gynecological and non-gynecological causes of the condition.

Chronic pelvic pain (CPP) involves a list of deviations with persistent pain in the pelvic area as the main factor. Multiple pain syndromes exist for this, and, after assessment, the reason for the chronic symptoms often remains unclear. The exclusion of the origins or reasons for the pain that can be treated curatively is of the greatest importance. When no reasons for the pain can be found, or when the pain cannot be healed, symptomatic treatment will be necessary. The most successful treatment of CPP is a multidisciplinary approach, bringing together doctors, nurses, physical therapists, osteopaths, and psychologists. Chronic pain has an important impact on the quality of life and strong negative consequences on the psychologic and emotional state of the patient. In addition, the success of the (usually long-term) treatment is not easy to predict. Beginning with a general discussion, this book considers pain abnormalities in the most important parts of the small pelvis. It also discusses various treatments of these issues, and delves into the psychological approach to such pain.

This clinical guide offers much-needed assistance in pinpointing the c ause of acute, chronic, and recurring pelvic pain and recommends the m ost effective medical or surgical treatment for the pain and the under lying disorder. The chapters present detailed, methodical guidelines f or the workup of the patient with chronic pelvic pain and for the diag nosis and treatment of the many disorders that cause pelvic discomfort . The section on diagnosis and treatments follows an organ-based appro ach, providing the most efficient, cost-effective way to "rule out" va rious causes of pelvic pain. Appendices include pain maps, pain diarie s, pain scales, and depression scales.

Pain is among the foremost complaints of women seeking gynecological consultation, yet the diagnosis is often limited to endometriosis. Chronic Pelvic Pain discusses how to diagnose a broad scope of underlying conditions presenting in relation to pelvic pain in women and their treatment. Starting with an anatomical review from a pain point of view, several chapters continue to explore specific conditions such as vulvodynia, the often overlooked painful bladder syndrome and pelvic inflammatory disease. Also covered are topics such as sexual dysfunction, psychological aspects of chronic pelvic pain and alternative treatment methods. Practical treatment tips for specific conditions which are readily applicable in everyday practice are provided throughout. Special attention is given to the use of sonography and MRI in diagnostics. With its comprehensive approach, addressing both body and mind, this is essential reading for medical specialists and consultants and specialist medical trainees in gynecology, pain medicine, and family practice.

Chronic pelvic pain (CPP) involves a list of deviations with persistent pain in the pelvic area as the main factor. Multiple pain syndromes exist for this, and, after assessment, the reason for the chronic symptoms often remains unclear. The exclusion of the origins or reasons for the pain that can be treated curatively is of the greatest importance. When no reasons for the pain can be found, or when the pain cannot be healed, symptomatic treatment will be necessary. The most successful treatment of CPP is a multidisciplinary approach, bringing together doctors, nurses, physical therapists, osteopaths, and psychologists. Chronic pain has an important impact on the quality of life and strong negative consequences on the psychologic and emotional state of the patient. In addition, the success of the (usually long-term) treatment is not easy to predict. Beginning with a general discussion, this book considers pain abnormalities in the most important parts of the small pelvis. It also discusses various treatments of these issues, and delves into the psychological approach to such pain.

The number of studies on chronic and recurrent pain bears no relation to the frequency of these complaints in gynecologic practice, nor to the clinical and scientific problems that still need solving in this area. Several factors stand in the way of progress in this field, such as the strongly subjective nature of the complaints, the frequent lack of correlation between them and objective findings, and the complexity of the psychosomatic interac tions involved. Although progress in our knowledge has been much slower than we would have wished, and although we are well aware of these many gaps, it was considered useful to gather in a book what we think we have learned during 3 decades of active interest in pain patients and pain problems in gynecologic practice and 12 years of supervision of a pain clinic in the Department of Obstetrics and Gynecology of Leuven University. As there are many differences between acute pain - clinical as well as experi mental - on the one hand and chronic pain symptoms on the other, it was felt preferable to limit the scope of this book essentially to chronic and recurrent pain in gynecologic practice. When presented with a complaint of lower abdominal and/or low back pain, the gynecologist should constantly be on the lookout for nongynecologic causes, of which the most frequent will be either gastroenterologic or orthopedic and sometimes urologic. I have been fortunate in obtaining the collaboration of Dr.

Based on the gold-standard nondrug, nonsurgical Wise-Anderson Protocol for treating chronic pelvic pain, A Headache in the Pelvis is the definitive resource for anyone suffering from pelvic pain. Pelvic pain afflicts millions of men and women and goes by many names, including pelvic floor dysfunction and prostatitis. David Wise, Ph.D., searched for relief for his pelvic pain for more than 20 years. After researching medical journals and performing outside-the-box self-experimentation, he found a way to resolve his symptoms. He then joined forces with Stanford urologist Dr. Rodney Anderson in the mid-1990s, and together they treated patients and did research on what is now called the Wise-Anderson Protocol. Often incorrectly diagnosed, debilitating, and disruptive, pelvic pain is correlated with psychological distress. Using a holistic treatment integrating physical therapy and meditative relaxation, this book guides you through understanding your pain, why conventional treatments haven't worked, and describes the details of the physical and behavioral protocol that can help to heal the painful pelvic floor. At last, this life-changing protocol offers hope and help to lead a pain-free life.

This text is designed for those clinicians who feel comfortable diagnosing these illnesses and wish to enhance their knowledge base and skill set regarding treatment options. Referrals for pelvic pain are common in urological and gynaecological practice; and may lead to varied diagnoses such as interstitial cystitis/bladder pain syndrome, chronic prostatitis/chronic pelvic pain syndrome, pelvic floor dysfunction, chronic orchialgia, and vulvodynia. To make matters more complex, each of these conditions is frequently associated by co-morbidities. The text is unique in being organized by the multiple and multifaceted therapies that are available, rather than by specific disorders. The text is richly illustrated with multiple diagrams, figures, and tables, making it the “go to” and “how to” reference for patient treatment.

A clinically oriented, multi-disciplinary approach to the diagnosis, treatment, and management of chronic pelvic pain in women -- one of the most common problems encountered in the practice setting. The editors present this challenging and often vexing subject in a user-friendly, highly illustrated text, with chapters on: physiology of pain; pain associated with endometriosis; pain associated with fibroids; surgical management; the role of office based surgery; the role of the psychiatrist in pain management; pelvic pain of urinary origin; pelvic pain of gastrointestinal origin. Designed to be part of everyday practice, this is a must for all clinicians in obstetrics-gynaecology, as well as for any physician involved in the health care of women.

Written with the busy practice in mind, this book delivers clinically focused, evidence-based gynecology guidance in a quick-reference format. It explores etiology, screening, tests, diagnosis, and treatment for a full range of gynecologic health issues. The coverage includes the full range of gynecologic malignancies, reproductive endocrinology and infertility, infectious diseases, urogynecologic problems, gynecologic concerns in children and adolescents, and surgical interventions including minimally invasive surgical procedures. Information is easy to find and absorb owing to the extensive use of full-color diagrams, algorithms, and illustrations. The new edition has been expanded to include aspects of gynecology important in international and resource-poor settings.