Chronic Pelvic Pain Causes

Aka: Chronic Pelvic Pain Causes

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II. Causes: General

  1. Idiopathic in up to 60% of cases
  2. Women with more than one diagnosis contributing to Pelvic Pain: 40%
  3. Gastrointestinal and urinary causes are more common than gynecologic causes
  4. Most common causes
    1. Endometriosis
    2. Intraabdominal Adhesions
    3. Irritable Bowel Syndrome
    4. Interstitial Cystitis

III. Causes: Urinary Tract (5% of Chronic Pelvic Pain)

  1. Urinary Tract Infection (UTI)
  2. Urethral syndrome (Urethritis)
  3. Interstitial Cystitis
    1. Recent evidence suggests very common cause
    2. May be responsible for 33% of Chronic Pelvic Pain
    3. Clemons (2002) Obstet Gynecol 100:337-41 [PubMed]

IV. Causes: Gastrointestinal (20-30% of Chronic Pelvic Pain)

  1. Irritable Bowel Disease
  2. Hernia
  3. Inflammatory Bowel Disease
    1. Crohn's Disease
    2. Ulcerative Colitis

V. Causes: Musculoskeletal

  1. Pelvic Floor Dysfunction
  2. Abdominal wall Trigger Points
    1. Responds to local 0.5% Marcaine injection

VI. Causes: Psychological

  1. Major Depression
  2. Sexual abuse history

VII. Causes: Gynecologic

  1. Endometriosis
  2. Chronic Pelvic Inflammatory Disease
  3. Pelvic Adhesions
  4. Mittelschmerz
  5. Pelvic Relaxation
  6. Ovarian Remnant Syndrome
  7. Pelvic Congestion Syndrome
  8. Cyclic Pelvic or Uterine pain
    1. Primary Dysmenorrhea
    2. Secondary Dysmenorrhea

VIII. References

  1. Speer (2016) Am Fam Physician 93(5):380-7 [PubMed]
  2. Zondervan (1999) Br J Obstet Gynaecol 106(11):1149-55 [PubMed]
  3. Mathias (1996) Obstet Gynecol 87(3): 321-7 [PubMed]

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