Noncyclic Chronic Pelvic Pain Therapies for Women
Background: Evaluation of Noncyclic CPP
A thorough patient evaluation including pain history and pain mapping is a critical step in determining the potential etiology and an initial therapeutic course and in establishing rapport between the clinician and patient. The experience of pain will inevitably be affected by physical, psychological, and social factors, and these should be taken into consideration during patient evaluation to enable appropriate patient management.
Surgical approaches to evaluation include laparoscopy. Forty percent of diagnostic and therapeutic laparoscopic procedures in the United States are performed in patients with CPP. Laparoscopy aids in the diagnosis of endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, and ovarian cysts in patients with CPP.
In many women, a definitive diagnosis of CPP may not be made despite a thorough evaluation and identification of an underlying pathology. A retrospective study from the United Kingdom found that more than 25 percent of women with CPP never received a definitive diagnosis after nearly 4 years of followup.
- Andrews J, Yunker A, Reynolds WS, et al. Noncyclic Chronic Pelvic Pain Therapies for Women: Comparative Effectiveness. Comparative Effectiveness Review No. 41 (Prepared by the Vanderbilt Evidence-based Practice Center under Contract No. 290-2007-10065-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC088-EF. Available at www.effectivehealthcare.ahrq.gov/pelvicpain.cfm.
- Ortiz DD. Chronic pelvic pain in women. Am Fam Physician 2008;77:1535-42. PMID: 18581833.
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