Chronic pelvic pain.
Chronic pelvic pain affects both men and women; there are probably common mechanisms that involve the central nervous system. In many cases, the symptoms may be localised to a single end organ. However, the involvement of the central nervous system may result in a complex regional pain syndrome affecting the whole pelvis and as a consequence, multiple-organ symptomatology. The initial trigger may be relatively benign but a predisposed individual may develop a range of significant sensory and efferent functional abnormalities. Stimuli not normally reaching threshold may be perceived and normal sensations may be magnified to become dysphoric or painful. Problems of emptying viscera and maintaining continence may occur. Significant musculoskeletal disability may arise as well as abnormalities of the autonomic nervous system. There is an association with systemic disorders. Also, psychological, behavioural, sexual and social problems arise. In the chronic pelvic pain syndromes, treatment of the end organ has a limited role, and multidisciplinary as well as interdisciplinary management is essential.
Baranowski
Andrew Paul
AP
The Centre for Urogenital Pain Medicine, University College London Hospitals Foundation Trust, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. apbuk@btinternet.com
D002908:Chronic Disease; D003131:Combined Modality Therapy; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D017288:Pain Threshold; D010348:Patient Care Team; D017699:Pelvic Pain / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome