Chronic Pelvic Pain-1-12.pdf

Chronic Pelvic Pain Sites 1. Pain (doesn’t necessarily correlate to the pathologic extent of the disease) Mechanism : 1. Distension of the ectopic endometrial glands within a closed space. 2. Release of inflammatory mediators (prostaglandins or cytokines) 3. Involvement and irrita...

Chronic Pelvic Pain Sites 1. Pain (doesn’t necessarily correlate to the pathologic extent of the disease) Mechanism : 1. Distension of the ectopic endometrial glands within a closed space. 2. Release of inflammatory mediators (prostaglandins or cytokines) 3. Involvement and irritation of pelvic nerves within the adhesions Types of pain 1. Dysmenorrhea:  starts few days before menstruation (congestion).  Then it increase in severity during menstruation (crescendo fashion).  Then pain gradually decrease after menses due to absorption of blood 2. Deep dysparuenia dt  Fixed RVF uterus or  Lesions in the POD or recto-vaginal septum 3. Deep chronic pelvic pain: unresolving pain for more than 6 months 4. Dorsal (Sacral) pain –Backache–: dt affection of uterosacral ligaments 5. Dysuria 6. Dyschezia