Gynecological associated disorders and management

Abstract

Background Chronic pelvic pain syndrome is complex and involves multiple organ systems. The gynecological aspects of chronic pelvic pain syndrome can be divided into four different areas: intra‐abdominal, vaginal, pelvic floor muscles and sexual pain. This article provides an overview of gynecological evaluation in patients with chronic pelvic pain and reviews the most common gynecological diagnoses and their management. Methods An extensive review of the literature including guidelines from the International Continence Society, the European Association of Urology, and the International Association for the Study of Pain was performed. Results Gynecological evaluation of patients with chronic pelvic pain begins with a thorough history and physical examination. Laboratory tests, imaging studies and diagnostic procedures can be used as adjuncts to make a diagnosis. Treatment modalities include physical therapy, medications, trigger points injections, and surgery. Conclusion Common gynecological diagnoses of chronic pelvic pain include endometriosis, adenomyosis, vulvodynia, high tone pelvic floor dysfunction, and genitopelvic pain/penetration disorder. Gynecology is one of the many systems that can be associated with chronic pelvic pain. Managing patients with chronic pelvic pain requires a multimodal and multidisciplinary approach.

Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort

“…2 CPP is a common condition and has been estimated to affect 5.7%-26.6% of reproductive aged women with 40% of laparoscopies performed annually for this indication. 1,3,4 The American College of Obstetricians and Gynecologists and the ReVITALize data definitions initiative define chronic pelvic pain as "pain symptoms perceived to originate from pelvic organs/structures typically lasting more than 6 months." 5 CPP is often multifactorial with a broad differential diagnosis; however, adenomyosis is suspected to be a frequent diagnosis within this population.…”

“…Adenomyosis is characterized by ectopic endometrial tissue within the uterine myometrium and is one of many different potential etiologies of chronic pelvic pain (CPP). 1 Signs and symptoms commonly associated with adenomyosis include an enlarged uterus, abnormal uterine bleeding, pelvic pain, and dysmenorrhea, however, these signs and symptoms are not specific to patients with adenomyosis and may be seen in other causes of CPP. 2 CPP is a common condition and has been estimated to affect 5.7%–26.6% of reproductive aged women with 40% of laparoscopies performed annually for this indication.…”