Chronic pelvic pain
Chronic pelvic pain (CPP) is a common condition in women of reproductive age affecting up to 1 in 4 women. This is an intermittent or constant pain in the pelvis or the lower abdomen of at least 6 months duration.
Findings in women with CPP
Adhesions may be caused by previous surgery, endometriosis or previous pelvic infection.
Irritable bowel syndrome.
Interstitial cystitis.
Musculoskeletal / nerve entrapment.
'No pathology'.
A multidisciplinary approach to CPP has been shown to be effective in reducing pain and in improving work and social functioning. The team will include a gynaecologist, clinical psychologist, pain physician and specialist nurse.
Investigations
Laparoscopy: Able to diagnose adhesions, PID and endometriosis. Irritable bowel syndrome and adenomyosis (endometriosis in the muscle wall of the uterus) will not be detected.
Ultrasound: to exclude ovarian cysts or an endometrioma.
Treatment
This is based on the history, examination and Laparoscopic findings.