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)

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

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