Pelvic painTereza Indrielle, ST1

Incidence4 in 100Asthma or back pain

Causes1. 2. 3. 4. 5.

Causes – gynae ONLY

1. endometriosis2. adhesions3. PID4. ovarian cyst5. psychogenic

Endometriosis

Endometriosis - stages

DiagnosisMacroscopicNot very accurate

TREATMENT

Stop periodsBurn it – might help or not (central sensitisation of NS established – pain continues)

Resect it

Adhesions

PID

Episode of PID -> 20%chronic painFitz - Hugh – Curtis SY

Ovarian cyst

PSYCHOGENIC

Psychosocial influence (Mathias et al. 1996 – separated, widowed and divorced more likely to have CPP and more likely to report it)

60% NO DIAGNOSIS

Antidepressants ineffective