PURPOSE: To review an integrated approach to management of patients with chronic pelvic pain (CPP). EPIDEMDLOGY: CPP is believed to affect 4% to as many as 40% of women who seek primary care, making this symptom at least as common as asthma and back pain. CPP is responsible for 10% of all referrals to gynecologists, 12% of all hysterectomies, and more than 40% of all laparoscopies. REVIEW SUMMARY: Part I of this series discussed the prevalence, etiology, and evaluation of patients presenting with CPP. This article addresses effective treatment or CPP, which requires parallel consideration of 3 factors: addressing underlying conditions that were initially responsible for the pain, ameliorating secondary muscular reactions that may become a continuing source of pain, and optimizing emotional well-being. These goals may be accomplished via pharmacologic and nonpharmacologic methods, including treatments for specific underlying conditions, analgesics, physical therapy, psychotherapy, and surgery when appropriate. Treatment endpoints are minimization of pain and psychologic distress and improvement in functioning-not necessarily cure or determination or a definitive diagnosis. TYPE OF AVAILABLE EVIDENCE: Systematic reviews, randomized-controlled trials, nationally recognized treatment guidelines. GRADE OF AVAILABLE EVIDENCE: Fair. CONCLUSION: CPP is common, burdensome, and costly, taking a toll on women and their families. A multidisciplinary, integrative approach is needed that considers CPP as encompassing a spectrum of potentially coexisting diseases and conditions. With an integrated approach, patients will benefit from a renewed sense of hope that substantial improvement can be achieved even when previous specialists' efforts have not succeeded.
|Original language||English (US)|
|Number of pages||7|
|Journal||Advanced Studies in Medicine|
|State||Published - Jul 1 2005|
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