title: Surgical evaluation and treatment of the patient with chronic pelvic pain.
abstract: Treatment of patients with chronic pelvic pain is assisted by detailed history, physical examination, pain diary, and ultrasonography. The possibility of other contributing systems (eg, gastrointestinal, genitourinary, musculoskeletal) should also be addressed and treatment initiated if present. A diagnostic surgical procedure is helpful in patients for whom medical management or whose severity of pain warrants an urgent diagnosis. Limited evidence exists to support adhesions, endometriosis, ovarian cysts, ovarian remnants, and hernias as being causes of chronic pelvic pain. In select patients, ovarian cystectomy, excision of endometriosis and ovarian remnants, adhesiolysis, hysterectomy, hernia repair, and presacral neurectomy may provide relief.
authors.affiliation: Saint Louis University School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 6420 Clayton Road, Suite 230, St Louis, MO 63117, USA. Electronic address: holloran@slu.edu.
authors.forename: M Brigid
authors.initials: MB
authors.lastname: Holloran-Schwartz
mesh_terms: D017763:Autonomic Denervation / Q000379:methods*; D059350:Chronic Pain / Q000209:etiology* / Q000601:surgery; D004715:Endometriosis / Q000601:surgery; D005260:Female; D052776:Female Urogenital Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005767:Gastrointestinal Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery*; D007044:Hysterectomy / Q000706:statistics & numerical data; D010535:Laparoscopy; D010048:Ovarian Cysts / Q000601:surgery; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology* / Q000601:surgery; D011379:Prognosis; D013997:Time Factors; D000267:Tissue Adhesions / Q000601:surgery; D016896:Treatment Outcome
keywords: Adhesions and chronic pain; Conscious laparoscopic pain mapping; Diagnostic laparoscopy and chronic pelvic pain; Hysterectomy and chronic pain; Laparoscopic uterine nerve ablation; Presacral neurectomy