Chronic Pelvic Pain Overview

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is considered the gold standard for investigating chronic pelvic pain?

  • CT scan
  • Transvaginal ultrasound
  • Diagnostic laparoscopy (correct)
  • MRI

Which diagnostic evaluation is NOT typically included in the assessment of chronic pelvic pain?

  • Complete blood count (CBC)
  • Electrocardiogram (ECG) (correct)
  • Vaginal cultures for STDs
  • Urinalysis

Which condition is a leading gynecologic cause of chronic pelvic pain?

  • Chronic urethritis
  • Irritable Bowel Syndrome (IBS)
  • Herniated disk disease
  • Endometriosis (correct)

Which of the following is NOT a pharmacologic treatment for chronic pelvic pain?

<p>Cognitive behavioral therapy (D)</p> Signup and view all the answers

Identify a psychological factor that can contribute to chronic pelvic pain.

<p>Depression (C)</p> Signup and view all the answers

What is a common treatment option for managing endometriosis?

<p>Oral contraceptive pill (C)</p> Signup and view all the answers

Which symptom is NOT typically associated with interstitial cystitis (IC)?

<p>Nausea (D)</p> Signup and view all the answers

What does the term 'nulliparous' refer to in the context of chronic pelvic pain due to endometriosis?

<p>Having never given birth (C)</p> Signup and view all the answers

Which diagnostic procedure is used to identify lesions associated with endometriosis?

<p>Laparoscopy (A)</p> Signup and view all the answers

What is the primary drug of choice for treating interstitial cystitis?

<p>Polysulfate sodium (Elmiron) (A)</p> Signup and view all the answers

Which condition is characterized primarily by dysfunction in pelvic muscles and joints?

<p>Musculoskeletal disorders (A)</p> Signup and view all the answers

What percentage prevalence of postsurgical pain is typical after abdominal and pelvic surgeries?

<p>10 to 40% (B)</p> Signup and view all the answers

Which gastrointestinal disorder is commonly reported in women with IBS?

<p>Constipation (B)</p> Signup and view all the answers

What is considered a defining characteristic of chronic pelvic pain (CPP)?

<p>Pain lasting at least 6 months (D)</p> Signup and view all the answers

Which condition is identified as a common cause of chronic pelvic pain observed during gynecological laparoscopy?

<p>Endometriosis (A)</p> Signup and view all the answers

Which population is at a higher risk for developing chronic pelvic pain?

<p>Survivors of physical and sexual abuse (D)</p> Signup and view all the answers

What percentage of gynecologic laparoscopies performed for benign disease is due to chronic pelvic pain?

<p>40% (C)</p> Signup and view all the answers

Which symptom is NOT commonly associated with pelvic inflammatory disease (PID)?

<p>Severe headaches (C)</p> Signup and view all the answers

What is a frequent psychological impact on individuals with chronic pelvic pain?

<p>Increased risk of hypertension (A)</p> Signup and view all the answers

Which of the following is a common symptom of chronic pelvic inflammatory disease?

<p>Burning upon urination (C)</p> Signup and view all the answers

What term describes the multifaceted nature of the causes of chronic pelvic pain?

<p>Multifactorial (C)</p> Signup and view all the answers

Which of the following is a common pharmacologic treatment for chronic pelvic pain?

<p>Gabapentin (B)</p> Signup and view all the answers

What type of diagnostic evaluation is indicated if endometriosis, adhesions, or chronic PID are suspected?

<p>Laparoscopy (B)</p> Signup and view all the answers

Which complementary and alternative medicine approach is used for managing chronic pelvic pain?

<p>Cognitive behavioral therapy (CBT) (C)</p> Signup and view all the answers

Which of the following is identified as a psychological factor contributing to chronic pelvic pain?

<p>Depression (B)</p> Signup and view all the answers

What is a common urologic cause of chronic pelvic pain?

<p>Chronic urethritis (B)</p> Signup and view all the answers

What is the minimum duration for pain to be classified as chronic pelvic pain?

<p>6 months (A)</p> Signup and view all the answers

Which condition is most commonly diagnosed during gynecological laparoscopy for chronic pelvic pain?

<p>Endometriosis (B)</p> Signup and view all the answers

Which of the following factors is associated with an increased risk of developing chronic pelvic pain?

<p>History of pelvic inflammatory disease (B)</p> Signup and view all the answers

What percentage of gynecologic laparoscopies are considered to be indications for chronic pelvic pain?

<p>40% (C)</p> Signup and view all the answers

Which psychological issue is commonly associated with chronic pelvic pain in patients who have experienced trauma or abuse?

<p>Post-traumatic stress disorder (C)</p> Signup and view all the answers

Which of the following is NOT a typical symptom of pelvic inflammatory disease (PID)?

<p>High blood pressure (C)</p> Signup and view all the answers

What is a significant complication often associated with endometriosis?

<p>Infertility (D)</p> Signup and view all the answers

Which of these systems is NOT typically involved in a patient with chronic pelvic pain?

<p>Dermatological (A)</p> Signup and view all the answers

What is a common hormonal suppression medication used for managing endometriosis?

<p>Zoladex (A)</p> Signup and view all the answers

Which condition is characterized by chronic bladder inflammation and symptoms such as pressure and pain in the pelvic area?

<p>Interstitial cystitis (D)</p> Signup and view all the answers

What type of medication is Dimethylsulfoxide, used in the treatment of interstitial cystitis?

<p>Liquid instilled through a catheter (A)</p> Signup and view all the answers

Chronic pelvic pain in women with irritable bowel syndrome can be accompanied by which symptom?

<p>Bladder discomfort (C)</p> Signup and view all the answers

Which of the following conditions is known to frequently require pelvic physical therapy as a treatment?

<p>Musculoskeletal dysfunction (B)</p> Signup and view all the answers

What is the drug of choice for treating interstitial cystitis?

<p>Elmiron (A)</p> Signup and view all the answers

Which symptom is typically NOT associated with chronic pelvic pain?

<p>Menstrual cramps (A)</p> Signup and view all the answers

What factors may contribute to postsurgical pain following pelvic surgery?

<p>Stretching or compression of pelvic nerves (C)</p> Signup and view all the answers

Which of the following diagnostic tests is often used when endometriosis or chronic PID is suspected?

<p>CT scan (B)</p> Signup and view all the answers

Which pharmacologic treatment is considered first-line for managing chronic pelvic pain?

<p>NSAIDs (C)</p> Signup and view all the answers

Which of the following is a recognized psychological factor that may contribute to chronic pelvic pain?

<p>Depression (C)</p> Signup and view all the answers

Which interventional technique may be indicated for patients suffering from chronic pelvic pain?

<p>Laparoscopy (D)</p> Signup and view all the answers

Identify a gastrointestinal disorder that is frequently associated with chronic pelvic pain.

<p>Irritable Bowel Syndrome (IBS) (A)</p> Signup and view all the answers

Which of the following conditions is considered one of the leading causes of chronic pelvic pain?

<p>Endometriosis (D)</p> Signup and view all the answers

What percentage of gynecologic laparoscopies is performed for benign disease due to chronic pelvic pain?

<p>40% (D)</p> Signup and view all the answers

Which symptom is often associated with pelvic inflammatory disease (PID)?

<p>Foul-smelling vaginal discharge (B)</p> Signup and view all the answers

Which of these factors is not typically associated with chronic pelvic pain?

<p>Menstrual irregularities (B)</p> Signup and view all the answers

What is a common problem that results from endometriosis?

<p>Infertility (D)</p> Signup and view all the answers

Chronic pelvic pain may involve which of the following systems?

<p>All of the above (D)</p> Signup and view all the answers

What is a common treatment approach to control endometriosis?

<p>Hormonal treatment and surgery combined (D)</p> Signup and view all the answers

Which condition is specifically characterized by chronic bladder inflammation?

<p>Interstitial cystitis (B)</p> Signup and view all the answers

Which medication is commonly used as a drug of choice for interstitial cystitis?

<p>Polysulfate sodium (A)</p> Signup and view all the answers

Which of the following is a common symptom of irritable bowel syndrome (IBS) that may contribute to chronic pelvic pain?

<p>Constipation or diarrhea (D)</p> Signup and view all the answers

What is the typical prevalence of postsurgical pain after abdominal and pelvic surgeries?

<p>10-40% (D)</p> Signup and view all the answers

Which pharmacologic treatment is commonly used for hormonal suppression in the management of endometriosis?

<p>Zoladex (A)</p> Signup and view all the answers

Which condition is characterized by pelvic pain not associated with pregnancy or menstruation?

<p>Chronic pelvic pain (C)</p> Signup and view all the answers

What role does physical therapy play in the treatment of chronic pelvic pain?

<p>It is beneficial for musculoskeletal dysfunction. (B)</p> Signup and view all the answers

Which of the following is least likely to be included in the diagnostic evaluation for chronic pelvic pain?

<p>Serum hormone levels (A)</p> Signup and view all the answers

What is the first-line pharmacologic treatment option for managing chronic pelvic pain?

<p>NSAIDs (B)</p> Signup and view all the answers

Which psychological condition is commonly associated with individuals suffering from chronic pelvic pain?

<p>Depression (C)</p> Signup and view all the answers

Which complementary and alternative medicine technique is NOT mentioned as a treatment for chronic pelvic pain?

<p>Aromatherapy (D)</p> Signup and view all the answers

Which of the following conditions is identified as a gastrointestinal cause of chronic pelvic pain?

<p>Irritable bowel syndrome (IBS) (A)</p> Signup and view all the answers

Which of the following factors is most strongly associated with chronic pelvic pain?

<p>History of Pelvic Inflammatory Disease (PID) (D)</p> Signup and view all the answers

What percentage of women with chronic pelvic pain are observed to have endometriosis during gynecological laparoscopy?

<p>71 to 87% (B)</p> Signup and view all the answers

Which of the following is NOT considered a psychosocial factor that can contribute to chronic pelvic pain?

<p>Hypertension (A)</p> Signup and view all the answers

In patients with chronic pelvic pain, which of the following conditions is most likely to cause lower abdominal pain and depression?

<p>Pelvic Inflammatory Disease (PID) (B)</p> Signup and view all the answers

Which symptom is closely associated with endometriosis and can impact a woman's quality of life?

<p>Severe menstrual pain (C)</p> Signup and view all the answers

What is a typical duration for pain to be classified as chronic pelvic pain?

<p>At least 6 months (A)</p> Signup and view all the answers

Which statement best describes a common complication resulting from endometriosis?

<p>Infertility (B)</p> Signup and view all the answers

Which of the following systems is frequently involved in chronic pelvic pain?

<p>Musculoskeletal system (D)</p> Signup and view all the answers

What is the primary goal of hormonal treatment options for managing endometriosis?

<p>To control the disease symptoms (B)</p> Signup and view all the answers

Which drug is specifically indicated as the drug of choice for treating interstitial cystitis?

<p>Elmiron (A)</p> Signup and view all the answers

What type of pain is typically experienced after abdominal surgeries, with a prevalence of 10 to 40%?

<p>Postsurgical pain (C)</p> Signup and view all the answers

In women with irritable bowel syndrome (IBS), which symptom is frequently reported alongside chronic pelvic pain?

<p>Migraine headaches (B)</p> Signup and view all the answers

Which condition is characterized by chronic pain and discomfort around the pelvic area due to musculoskeletal issues?

<p>Musculoskeletal dysfunction (D)</p> Signup and view all the answers

What specific symptom is associated with interstitial cystitis and is not frequently linked to menstruation?

<p>Tenderness in the pelvic area (C)</p> Signup and view all the answers

Which of the following treatments may help alleviate chronic pelvic pain related to musculoskeletal disorders?

<p>Physical therapy (C)</p> Signup and view all the answers

Which pharmacological treatment is NOT typically used for controlling chronic pelvic pain from endometriosis?

<p>Dimethylsulfoxide (D)</p> Signup and view all the answers

Which diagnostic evaluation is commonly included when assessing chronic pelvic pain?

<p>Urinalysis and urine culture (A)</p> Signup and view all the answers

What is a first-line pharmacologic treatment generally recommended for chronic pelvic pain?

<p>NSAIDs (B)</p> Signup and view all the answers

Which physiological condition is considered one of the leading causes of chronic pelvic pain?

<p>Endometriosis (B)</p> Signup and view all the answers

What role does cognitive behavioral therapy (CBT) play in managing chronic pelvic pain?

<p>Psychological support and coping strategies (A)</p> Signup and view all the answers

Which of the following conditions is frequently diagnosed through diagnostic laparoscopy for chronic pelvic pain evaluation?

<p>Adhesions (A)</p> Signup and view all the answers

Which of the following conditions is most commonly diagnosed during gynecological laparoscopy for chronic pelvic pain?

<p>Endometriosis (D)</p> Signup and view all the answers

Which symptom is typically associated with pelvic inflammatory disease (PID)?

<p>Lower abdominal pain (D)</p> Signup and view all the answers

Which subset of patients has an increased risk for developing chronic pelvic pain due to a history of certain events?

<p>Patients with a history of physical and sexual abuse (D)</p> Signup and view all the answers

What is a common psychological impact on individuals with chronic pelvic pain?

<p>Depression (C)</p> Signup and view all the answers

Which condition can lead to chronic pelvic pain and may cause ectopic pregnancy?

<p>Pelvic inflammatory disease (PID) (D)</p> Signup and view all the answers

Which system is NOT typically involved in chronic pelvic pain?

<p>Cardiovascular (D)</p> Signup and view all the answers

What is considered a common risk factor for chronic pelvic pain in women?

<p>Being nulliparous (C)</p> Signup and view all the answers

Which of the following medications are used for hormonal suppression in the treatment of endometriosis?

<p>Implanon (A)</p> Signup and view all the answers

What type of pain might develop following abdominal or pelvic surgery?

<p>Postsurgical pain (B)</p> Signup and view all the answers

Which treatment is specifically recognized for addressing interstitial cystitis?

<p>Polysulfate sodium (B)</p> Signup and view all the answers

What condition is associated with chronic bladder inflammation?

<p>Interstitial cystitis (D)</p> Signup and view all the answers

Which of the following is NOT typically assessed during the evaluation of chronic pelvic pain?

<p>Weight history (D)</p> Signup and view all the answers

Which common gastrointestinal disorder is frequently reported in women with chronic pelvic pain?

<p>Constipation (A)</p> Signup and view all the answers

In the context of chronic pelvic pain, which symptom would most likely indicate musculoskeletal dysfunction?

<p>Joint immobility (C)</p> Signup and view all the answers

Flashcards

Chronic Pelvic Pain Diagnosis

Diagnostic laparoscopy is the gold standard for investigating chronic pelvic pain.

Pelvic Pain Diagnostic Tests

Initial evaluations include STD cultures, urinalysis, urine cultures, CBC, pregnancy tests, and ESR.

Chronic Pelvic Pain Differential Diagnosis

Possible causes include musculoskeletal issues like herniated discs, gastrointestinal problems like IBS, urologic problems, gynecological issues like endometriosis/adhesions, and psychological factors like depression.

Chronic Pelvic Pain Management (Supportive)

Supportive care involves counseling and positive reinforcement to help manage chronic pelvic pain.

Signup and view all the flashcards

Chronic Pelvic Pain First-Line Treatment

NSAIDs are a first-line pharmacologic treatment for chronic pelvic pain, followed by tricyclic antidepressants and anticonvulsants (e.g., gabapentin).

Signup and view all the flashcards

Endometriosis (CPP)

A condition where tissue similar to the lining of the uterus grows outside the uterus, often causing pain.

Signup and view all the flashcards

Endometriosis Diagnosis

Diagnosed through imaging, typically laparoscopy to visualize lesions.

Signup and view all the flashcards

Endometriosis Treatment

Hormonal treatments (e.g., birth control pills, Zoladex) and/or surgery control the symptoms, but no prevention exists.

Signup and view all the flashcards

Interstitial Cystitis (IC)

Chronic inflammation of the bladder causing pain, pressure, and tenderness in the bladder, abdomen, and pelvis.

Signup and view all the flashcards

Interstitial Cystitis Treatment

Polysulfate sodium (Elmiron) is a common drug; newer options, e.g., Dimethylsulfoxide, involve direct instillation.

Signup and view all the flashcards

Chronic Pelvic Pain Causes

Various conditions, including musculoskeletal issues (e.g., sacroiliac joint dysfunction), weak pelvic floor muscles, and postsurgical complications

Signup and view all the flashcards

Postsurgical Pain

Pain lasting longer than expected after surgery, often in abdominal and pelvic areas.

Signup and view all the flashcards

Assessing Chronic Pelvic Pain

Medical history (PQRST), organ system assessment, and identification of associated symptoms are crucial for diagnosis.

Signup and view all the flashcards

Chronic Pelvic Pain (CPP)

Continuous or episodic pain below the belly button lasting 6 months or more, impacting daily life. It's a diagnosis itself, not a symptom.

Signup and view all the flashcards

Risk Factors for CPP

History of pelvic inflammatory disease (PID), constipation, inflammatory bowel disease (IBD), depression/anxiety, physical/sexual abuse are among increased risk factors for chronic pelvic pain.

Signup and view all the flashcards

PID and CPP Link

Pelvic Inflammatory Disease (PID) can lead to chronic pain around the pelvis and lower abdomen, potentially causing depression and insomnia and ectopic pregnancy.

Signup and view all the flashcards

Endometriosis and CPP

Endometriosis is a leading cause of chronic pelvic pain, often diagnosed during gynecological laparoscopy.

Signup and view all the flashcards

Symptoms of PID

Lower abdominal pain, fever, unusual discharge with foul odor from vagina, pain or bleeding during sex, burning upon urination, abnormal bleeding between periods.

Signup and view all the flashcards

Abuse and CPP

History of physical or sexual abuse may long-term increase risks of cardiovascular problems, mental health issues, and some STDs.

Signup and view all the flashcards

Multifactorial Causes of CPP

Chronic pelvic pain often has multiple causes, making it difficult to diagnose.

Signup and view all the flashcards

Gynecological Interventions for CPP

Chronic pelvic pain often leads to gynecological procedures like laparoscopies and some hysterectomies for benign diseases.

Signup and view all the flashcards

What are some risk factors for Chronic Pelvic Pain?

Past pelvic inflammatory disease (PID), constipation, inflammatory bowel disease (IBD), mental health issues like depression/anxiety, and a history of abuse all increase the risk of developing Chronic Pelvic Pain.

Signup and view all the flashcards

PID's impact on pain

Pelvic Inflammatory Disease (PID) can lead to chronic pain in the pelvis and lower abdomen, potentially causing depression, insomnia, and even ectopic pregnancy.

Signup and view all the flashcards

What are some symptoms of PID?

Symptoms of PID include lower abdominal pain, fever, unusual vaginal discharge with foul odor, pain or bleeding during intercourse, burning during urination, and abnormal bleeding between periods.

Signup and view all the flashcards

Multifactorial CPP

Chronic pelvic pain often has multiple causes, making diagnosis challenging.

Signup and view all the flashcards

Gynecological procedures for CPP

Chronic pelvic pain frequently leads to gynecological procedures like laparoscopies and hysterectomies for benign diseases.

Signup and view all the flashcards

Gold standard for CPP investigation

Diagnostic laparoscopy is the most accurate and thorough way to investigate chronic pelvic pain.

Signup and view all the flashcards

First-line treatment for CPP

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the initial recommended medication for managing chronic pelvic pain.

Signup and view all the flashcards

Other CPP management approaches

Besides NSAIDs, additional treatments include tricyclic antidepressants, anticonvulsants like gabapentin, neurostimulation, and interventional procedures such as laparoscopy.

Signup and view all the flashcards

What is the link between PID and CPP?

Pelvic inflammatory disease (PID) can lead to chronic pelvic pain, potentially causing depression, insomnia, and ectopic pregnancy.

Signup and view all the flashcards

Complementary and alternative medicine for CPP

Non-traditional treatments like acupuncture, cognitive behavioral therapy, and cannabis for medical purposes are also used to manage CPP.

Signup and view all the flashcards

What is Chronic Pelvic Pain (CPP)?

Persistent or recurring pain below the belly button, lasting 6 months or more, significantly impacting daily life. It's a diagnosis, not just a symptom.

Signup and view all the flashcards

CPP in Young Women

CPP in women aged 20-30, especially those who haven't had children (nulliparous), is often linked to endometriosis.

Signup and view all the flashcards

Diagnosing Endometriosis

Endometriosis is diagnosed by visually identifying lesions during laparoscopy.

Signup and view all the flashcards

Treating Endometriosis

While no cure exists, a combination of hormonal treatments (e.g., birth control pills, Zoladex) and/or surgery can manage endometriosis.

Signup and view all the flashcards

Treating Interstitial Cystitis

Polysulfate sodium (Elmiron) is a common drug, with newer treatments like Dimethylsulfoxide (liquid instilled through a catheter).

Signup and view all the flashcards

Musculoskeletal Causes of CPP

Pain and discomfort around the pelvis can be caused by conditions like sacroiliac joint dysfunction, symphysis pubis dysfunction, weak pelvic floor muscles, or joint immobility.

Signup and view all the flashcards

What is CPP?

Chronic pelvic pain (CPP) is persistent or recurring pain below the belly button that lasts for 6 months or more and significantly impacts daily life. It's a diagnosis, not just a symptom.

Signup and view all the flashcards

What is Chronic Pelvic Pain?

Pain that's continuous or comes and goes, located below the belly button, and lasts for at least 6 months, seriously impacting daily life. It's a diagnosis, not just a symptom.

Signup and view all the flashcards

What are some risk factors for CPP?

Having a history of pelvic inflammatory disease (PID), constipation, inflammatory bowel disease (IBD), mental health issues like depression/anxiety, and a history of abuse can increase the risk of developing Chronic Pelvic Pain.

Signup and view all the flashcards

What are some common causes of CPP?

Many conditions contribute to Chronic Pelvic Pain, including endometriosis, adhesions, fibroids, pelvic floor disorders, and even problems in the intestines and bladder.

Signup and view all the flashcards

How is endometriosis related to CPP?

Endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus, can cause severe pelvic pain, especially during periods. It's a leading cause of CPP.

Signup and view all the flashcards

Managing Endometriosis

While there's no cure for endometriosis, a combination of hormonal medications (like birth control pills) and surgery can effectively control the symptoms.

Signup and view all the flashcards

Treating IC

Polysulfate sodium (Elmiron) is a common drug for IC. Newer treatments involve direct instillation, usually through a temporary catheter, of Dimethylsulfoxide.

Signup and view all the flashcards

Musculoskeletal & CPP

Conditions affecting muscles and joints, like sacroiliac joint dysfunction or pelvic floor muscle weakness, can cause pelvic pain.

Signup and view all the flashcards

Thorough CPP Assessment

A complete medical history (PQRST of pain), examination of various organ systems, and assessment of associated symptoms are crucial for accurate diagnosis.

Signup and view all the flashcards

How is PID related to CPP?

Pelvic inflammatory disease (PID) can cause chronic pain around the pelvis and lower abdomen. It can also lead to other complications like depression, insomnia, and even ectopic pregnancy.

Signup and view all the flashcards

Interstitial Cystitis (IC) Treatment

Polysulfate sodium (Elmiron) is a common drug for IC. Newer treatments involve direct instillation, usually through a temporary catheter, of Dimethylsulfoxide.

Signup and view all the flashcards

How is Endometriosis linked to CPP?

Endometriosis, a condition where tissue similar to the lining of the uterus grows outside the uterus, can cause severe pelvic pain, especially during periods. It's a leading cause of CPP.

Signup and view all the flashcards

What is the gold standard for investigating CPP?

Diagnostic laparoscopy is a minimally invasive procedure that allows doctors to visualize the pelvic organs, helping diagnose CPP and identifying its cause.

Signup and view all the flashcards

How is CPP managed?

A combination of treatments including medications like NSAIDs, hormonal therapy, and surgery may be used to manage CPP.

Signup and view all the flashcards

What are some new treatments for IC?

Newer treatments for Interstitial Cystitis (IC), like Dimethylsulfoxide (DMSO), involve direct instillation into the bladder, often through a temporary catheter.

Signup and view all the flashcards

Who is most likely to have CPP from endometriosis?

A young woman (20-30 years old) who hasn't had children (nulliparous) is more likely to experience CPP due to endometriosis.

Signup and view all the flashcards

How is endometriosis diagnosed?

Endometriosis is diagnosed by imaging, typically a laparoscopy where a doctor can visually identify lesions.

Signup and view all the flashcards

Can endometriosis be prevented?

There is no way to prevent endometriosis from occurring, but hormonal treatments and/or surgery can control the disease.

Signup and view all the flashcards

What is the main drug for IC?

The main drug used to treat IC is polysulfate sodium (Elmiron).

Signup and view all the flashcards

What are some musculoskeletal causes of CPP?

Common conditions contributing to pelvic pain include sacroiliac joint dysfunction, pubis dysfunction, weak pelvic floor muscles, or joint immobility.

Signup and view all the flashcards

What is key to assessing CPP?

A thorough assessment includes obtaining medical history, examining various organ systems, and assessing associated symptoms.

Signup and view all the flashcards

Study Notes

Chronic Pelvic Pain Definition

  • Continuous or episodic, nonmenstrual pain lasting at least 6 months, affecting both men and women
  • Pain may begin suddenly or gradually
  • Located at or below the umbilicus
  • Severe enough to disrupt daily activities
  • Frequently occurs with a history of PID, constipation, IBD, depression, or anxiety
  • Potentially involves multiple systems: gastroenterological, urological, gynecological, oncological, musculoskeletal, and psychosocial
  • A significant factor in 40% of gynecological laparoscopies and 12% of hysterectomies performed for benign conditions
  • Often multifactorial, making diagnosis challenging

Chronic Pelvic Pain Risk Factors

  • Physical and sexual abuse
  • Long-term medical conditions associated with abuse/trauma, including cardiovascular issues (like hypertension), diabetes, malnutrition, STIs, chronic pain, and incontinence
  • Mental health issues, such as educational difficulties, low self-esteem, and trouble forming/maintaining relationships

Chronic Pelvic Pain - Pelvic Inflammatory Disease (PID)

  • PID can also lead to chronic pain in the pelvis and lower abdomen
  • Can cause depression and sleep disturbances
  • Ectopic pregnancies are seen in approximately 9% of women with PID and chronic pelvic pain

Chronic Pelvic Pain - Endometriosis

  • One of the leading causes, and the most common diagnosis made during gynecological laparoscopy for CPP evaluation
  • Usually causes chronic pain in the pelvis during menstruation
  • Present in 71-87% of women with chronic pelvic pain
  • Infertility is a common problem that results
  • Primarily affects nulliparous women aged 20-30
  • Diagnosable using imaging techniques during laparoscopy
  • Treatment options include hormone therapy and/or surgery

Chronic Pelvic Pain - Interstitial Cystitis (IC)

  • Chronic bladder inflammation
  • Characterized by recurring discomfort, pressure, tenderness, or pain in the bladder, lower abdomen, and pelvis
  • Diagnosis involves various diagnostic tests
  • Polysulfate sodium (Elmiron) is a standard treatment
  • Dimethylsulfoxide is a newer, liquid treatment administered via a temporary catheter

Chronic Pelvic Pain - Irritable Bowel Syndrome (IBS)

  • About 1/3 of women with IBS report chronic pelvic pain, migraine headaches, bladder discomfort, and dyspareunia
  • Associated gastrointestinal issues include constipation, or IBS
  • Pain often localized beneath the navel or lower back, also possible in the rectum, vagina, or perineal area
  • Not related to pregnancy or menstruation

Chronic Pelvic Pain - Musculoskeletal Conditions

  • Pain and discomfort in the pelvic area
  • Associated with sacroiliac joint dysfunction, symphysis pubis dysfunction, and weak pelvic floor muscles
  • Immobility of joints can also be a factor
  • Physical therapy can be beneficial

Chronic Pelvic Pain - Postsurgical Pain

  • Common after abdominal or pelvic surgeries (cholecystectomy, groin hernia repair, Cesarean section, pelvic fracture)
  • Prevalence of this type of pain is between 10-40%
  • Pelvic nerves can be stretched or compressed during surgery, resulting in postoperative pain
  • Lasting more than 3-6 months after surgery is considered prolonged postsurgical pain

Chronic Pelvic Pain - Clinical Presentation

  • Evaluation often requires multiple visits
  • A thorough medical and surgical history, emphasizing the PQRST of pain, is crucial
  • Assessing the relationship between pain and each organ system is important
  • Associated symptoms, including fever, sweats, fatigue, anorexia, nausea, vomiting, and constipation, should also be noted

Chronic Pelvic Pain - Physical Exam and Diagnostics

  • Detailed abdominal, pelvic, and back exam is necessary
  • Gold standard for diagnosis is diagnostic laparoscopy
  • Evaluation should include tests for STIs, urinalysis, urine culture, CBC, pregnancy test, and ESR

Chronic Pelvic Pain - Differential Diagnosis

  • Musculoskeletal: Herniated disk disease, chronic pelvic tilt, degenerative joint disease, and myofascial trigger points
  • Gastrointestinal: IBS is a common contributor
  • Urologic: Urethral syndrome, chronic urethritis, interstitial cystitis, urethral diverticulum, and bladder spasms
  • Gynecologic: Endometriosis
  • Psychological: Depression

Chronic Pelvic Pain - Management

  • Supportive care: Counseling and positive reinforcement can be beneficial
  • Pharmacologic: NSAIDs, tricyclic antidepressants, anticonvulsants (gabapentin) can be used
  • Interventional: Neurostimulation and laparoscopy are possible options
  • Complementary and alternative medicine: Cognitive behavioral therapy (CBT), acupuncture, biofeedback, and the use of cannabis for medical purposes, hot/cold therapy, guided imagery, hypnosis, massage, and spinal manipulation may provide additional relief.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

More Like This

Women's Health: Chronic Pelvic Pain
6 questions
Chronic Pelvic Pain Mechanisms
5 questions

Chronic Pelvic Pain Mechanisms

RespectfulAlliteration avatar
RespectfulAlliteration
Chronic Pelvic Pain and Vulvodynia Quiz
24 questions
Use Quizgecko on...
Browser
Browser